{"reporting_entity_name": "GQO_PPO","reporting_entity_type": "GQO_Risk Assuming Non Licensed Insurer","last_updated_on": "2026-10-07","version": "2.0","provider_references": [                                                                                                                                                         
{"provider_group_id":833863123,"network_name":[],"provider_groups":[{"npi":[1366492977],"tin":{"type":"ein","value":"530196602","business_name":"Sibley Memorial Hospital"}}]}
], "in_network" : [
{"negotiation_arrangement":"ffs","name":"ICD-CDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYA0","description":"ICD-CDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of proinsulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84206","description":"Assay of proinsulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARA0","description":"ICD-PARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correct inverted nipple(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19355","description":"Correct inverted nipple(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOB0","description":"ICD-HCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES316","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28B","description":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay phosphohexose enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84087","description":"Assay phosphohexose enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES104","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Campylobacter antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86625","description":"Campylobacter antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multipo locking shoulder jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6646","description":"Multipo locking shoulder jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular blood flow measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0198T","description":"Ocular blood flow measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDB0","description":"ICD-AFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt ed write/oral pts w/ hf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4003F","description":"Pt ed write/oral pts w/ hf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVE0","description":"ICD-NCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLC1","description":"ICD-JHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score le not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8658","description":"Fun stat score le not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBD0","description":"ICD-EHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPF0","description":"ICD-BCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23174","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Superimposed prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5954","description":"Superimposed prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVF0","description":"ICD-KDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUA0","description":"ICD-IFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJA1","description":"ICD-BIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBE1","description":"ICD-JGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5947","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5947","description":"CDT-D5947","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUC1","description":"ICD-AFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWF1","description":"ICD-KAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIA0","description":"ICD-KIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKE1","description":"ICD-KBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIE1","description":"ICD-JAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJE1","description":"ICD-KDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aud osseo dev_ int/ext comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8690","description":"Aud osseo dev_ int/ext comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rn services up to 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1002","description":"Rn services up to 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDB1","description":"ICD-MEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPB0","description":"ICD-CFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8H","description":"High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33902","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTD1","description":"ICD-NBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1938","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","description":"HCPCS-J1938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RARE DS XOM DNA ALYS EA COMP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0215U","description":"RARE DS XOM DNA ALYS EA COMP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFE0","description":"ICD-NLFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7530","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7530","description":"HCPCS-J7530","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJE1","description":"ICD-NJJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGE0","description":"ICD-GCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMD0","description":"ICD-BBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Val rsn hd ct ord reg indic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9595","description":"Val rsn hd ct ord reg indic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD120","description":"Reduced Physical Function _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGME0","description":"ICD-EGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15D","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB44","description":"Medium Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ing hernia init blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49501","description":"Rpr ing hernia init blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prism lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2715","description":"Prism lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hemorrhoid clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46320","description":"Removal of hemorrhoid clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of oral tissue hard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7285","description":"Biopsy of oral tissue hard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debridement of a periimplant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6101","description":"Debridement of a periimplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amniocentesis diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59000","description":"Amniocentesis diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFD1","description":"ICD-OFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11643","description":"Exc f/e/e/n/l mal+mrg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUF0","description":"ICD-FFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWB0","description":"ICD-DBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDB1","description":"ICD-JGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLB1","description":"ICD-NCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDA0","description":"ICD-ECDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rx ace or arb therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8935","description":"Rx ace or arb therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00400","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","description":"CPT-00400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel-skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44640","description":"Repair bowel-skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBF0","description":"ICD-FDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Guide nerv destr needle emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95874","description":"Guide nerv destr needle emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEF1","description":"ICD-BIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXA0","description":"ICD-BDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92311","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray bile/panc endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74330","description":"X-ray bile/panc endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Derma-Gide_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4203","description":"Derma-Gide_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96377","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHB0","description":"ICD-JBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKB1","description":"ICD-OIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAD1","description":"ICD-ABAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of homovanillic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83150","description":"Assay of homovanillic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIC0","description":"ICD-GCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOD0","description":"ICD-OBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cltx post ankle fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27768","description":"Cltx post ankle fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hinge ext/flex wrist finger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3901","description":"Hinge ext/flex wrist finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx dental pain minor proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9110","description":"Tx dental pain minor proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52700","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBA0","description":"ICD-NLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15937","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA136","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALF1","description":"ICD-AALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Near-infrared dual imaging (ie_ simultaneous reflective and trans-illuminated light) of meibomian glands_ unilateral or bilateral_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0507T","description":"Near-infrared dual imaging (ie_ simultaneous reflective and trans-illuminated light) of meibomian glands_ unilateral or bilateral_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18B","description":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACC0","description":"ICD-KACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETF1","description":"ICD-EETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 21 targets (adenovirus_ coronavirus 229E_ coronaviru","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0100U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 21 targets (adenovirus_ coronavirus 229E_ coronaviru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXF0","description":"ICD-OKXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNB0","description":"ICD-KDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of gentamicin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80170","description":"Assay of gentamicin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61582","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anal/urinary muscle study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51784","description":"Anal/urinary muscle study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cold agglutinin titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86157","description":"Cold agglutinin titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29845","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYF1","description":"ICD-HEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUD1","description":"ICD-CGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJE0","description":"ICD-OIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVF0","description":"ICD-BBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTB1","description":"ICD-GGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATF0","description":"ICD-EATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUF0","description":"ICD-IGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEE0","description":"ICD-CBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Twin zygosity_ genomic targeted sequence analysis of chromosome 2_ using circulating cell-free fetal DNA in maternal blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0060U","description":"Twin zygosity_ genomic targeted sequence analysis of chromosome 2_ using circulating cell-free fetal DNA in maternal blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFA1","description":"ICD-FIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch urine w lock flng/ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4434","description":"Ost pch urine w lock flng/ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHD0","description":"ICD-AFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55400","description":"Repair of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYE1","description":"ICD-DEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA20","description":"Ultra High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBC0","description":"ICD-CHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted to the ICU in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9853","description":"Patient admitted to the ICU in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coccidioidomycosis skin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86490","description":"Coccidioidomycosis skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; aspiration(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38220","description":"Diagnostic bone marrow; aspiration(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAA1","description":"ICD-GFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy/lung bx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31632","description":"Bronchoscopy/lung bx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAC1","description":"ICD-NFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA24","description":"High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXF1","description":"ICD-BFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0479U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","description":"CPT-0479U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit est age 12-17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99394","description":"Prev visit est age 12-17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75982","description":"Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0C","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Composite byp grft 2 veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35682","description":"Composite byp grft 2 veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFID0","description":"ICD-JFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVF0","description":"ICD-NFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD126","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD125","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"DuoAmnion_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4327","description":"DuoAmnion_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aortic dysfunction/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81410","description":"Aortic dysfunction/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEE0","description":"ICD-CCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group I_ for microorganisms (eg_ acid fast_ methenamine silver) (List separatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0756T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group I_ for microorganisms (eg_ acid fast_ methenamine silver) (List separatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTA0","description":"ICD-ACTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSD0","description":"ICD-PLSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; 50 Cc Or Less Injectate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15771","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; 50 Cc Or Less Injectate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric suction pump hme mdl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2000","description":"Gastric suction pump hme mdl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEC1","description":"ICD-NCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1304","description":"HCPCS-A1304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAC1","description":"ICD-ACAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lorazepam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2060","description":"Lorazepam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69955","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGID1","description":"ICD-MGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1285","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRB0","description":"ICD-DDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMD0","description":"ICD-GAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFA1","description":"ICD-BIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3D","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81182","description":"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95705","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIA0","description":"ICD-JHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACB1","description":"ICD-KACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spec coll non-blood:a/d test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0048","description":"Spec coll non-blood:a/d test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ levoleucovorin_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9043","description":"Injection_ levoleucovorin_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria lmtd add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33257","description":"Ablate atria lmtd add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNC1","description":"ICD-FDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNC1","description":"ICD-NKNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHA1","description":"ICD-OJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVF1","description":"ICD-FGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risperidone (uzedy)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2799","description":"Injection_ risperidone (uzedy)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC224","description":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASF1","description":"ICD-LASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUA0","description":"ICD-EHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEE0","description":"ICD-KEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIB1","description":"ICD-MCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVF1","description":"ICD-NBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arm trough each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2209","description":"Arm trough each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGD1","description":"ICD-OFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFA1","description":"ICD-KCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w iv ab given on time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8916","description":"Pt w iv ab given on time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGA1","description":"ICD-FBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBE1","description":"ICD-NLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk pn xm on init visit date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2040F","description":"Bk pn xm on init visit date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHC1","description":"ICD-AFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXD1","description":"ICD-GCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tablo Hemodialysis System For The Billable Dialysis Service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1629","description":"Tablo Hemodialysis System For The Billable Dialysis Service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHE1","description":"ICD-NDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCA1","description":"ICD-EDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoperfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90997","description":"Hemoperfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+cell cnt 200-499 cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3495F","description":"Cd4+cell cnt 200-499 cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAC0","description":"ICD-BIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0555U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","description":"CPT-0555U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEE0","description":"ICD-JCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impact tooth remov comp bony","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7240","description":"Impact tooth remov comp bony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGF1","description":"ICD-GBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ meropenem (b. braun) not therapeutically equivalent to j2185_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2184","description":"Injection_ meropenem (b. braun) not therapeutically equivalent to j2185_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGB0","description":"ICD-BAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUC1","description":"ICD-CAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHD0","description":"ICD-NLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAE1","description":"ICD-IGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHE0","description":"ICD-JHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No pneumococcal admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8867","description":"No pneumococcal admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKA1","description":"ICD-BHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy remove adnexa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58661","description":"Laparoscopy remove adnexa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESD0","description":"ICD-CESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFE1","description":"ICD-GBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMC0","description":"ICD-BEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENA0","description":"ICD-GENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a medication dispensing event indicator of a history of asthma any time during the patient_s history through the end of the measure period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9799","description":"Patients with a medication dispensing event indicator of a history of asthma any time during the patient_s history through the end of the measure period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aed garment w elec analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0606","description":"Aed garment w elec analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise urethra stage 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53405","description":"Revise urethra stage 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUB1","description":"ICD-BEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYD0","description":"ICD-CBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB11","description":"ICD-3GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUA1","description":"ICD-MEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEC1","description":"ICD-MLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNA0","description":"ICD-NKNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQB1","description":"ICD-CGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pyridoxine hcl 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3415","description":"Pyridoxine hcl 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINF1","description":"ICD-OINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMA0","description":"ICD-FGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ gemcitabine hydrochloride_ (Infugem)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9198","description":"Injection_ gemcitabine hydrochloride_ (Infugem)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGD0","description":"ICD-OGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA06","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18X","description":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy w/biopsy(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31625","description":"Bronchoscopy w/biopsy(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ faricimab-svoa_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2777","description":"Injection_ faricimab-svoa_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFB1","description":"ICD-OFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing 1 locus lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81373","description":"Hla i typing 1 locus lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXA1","description":"ICD-JHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult speech aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5953","description":"Adult speech aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAC0","description":"ICD-GHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLD1","description":"ICD-GHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21A","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNA0","description":"ICD-CBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNE0","description":"ICD-GCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mrs discogenic pain i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0612T","description":"Mrs discogenic pain i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA24","description":"Default_ /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBID1","description":"ICD-EBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHB0","description":"ICD-JEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Serum lvls ca/ipth/lpd ord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3278F","description":"Serum lvls ca/ipth/lpd ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subtalar arthro w/exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29905","description":"Subtalar arthro w/exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERF0","description":"ICD-GERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAF0","description":"ICD-ECAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator jun","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3207","description":"Hightop w/ supp/pronator jun","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYE1","description":"ICD-HGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatorrhaphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48545","description":"Pancreatorrhaphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lurbinectedin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9223","description":"Injection_ lurbinectedin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28090","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGD0","description":"ICD-NAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of nasal bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70160","description":"X-ray exam of nasal bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEC1","description":"ICD-MIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTC1","description":"ICD-EBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXA0","description":"ICD-JEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJF1","description":"ICD-JBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knuckle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26516","description":"Fusion of knuckle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISF0","description":"ICD-GISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or bila","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7505","description":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or bila","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAD1","description":"ICD-AGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOE1","description":"ICD-LFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AmnioBind_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4225","description":"AmnioBind_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBB1","description":"ICD-OJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRF1","description":"ICD-LFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMB1","description":"ICD-OLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ necitumumab_ 1mg (Portrazza)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9475","description":"Injection_ necitumumab_ 1mg (Portrazza)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0637U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0637U","description":"CPT-0637U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEA1","description":"ICD-IIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAC0","description":"ICD-NLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0907T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","description":"CPT-0907T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWE1","description":"ICD-OIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cbc/diffwbc w/o platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0306","description":"Cbc/diffwbc w/o platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWD1","description":"ICD-LAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compression stocking bk30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6531","description":"Compression stocking bk30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glucose tolerance test (gtt)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82951","description":"Glucose tolerance test (gtt)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKF1","description":"ICD-FGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKD1","description":"ICD-BFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath place cardio brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92974","description":"Cath place cardio brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physician Direct Care - Must be provided by a hospice physician and must be related to the patient_s terminal illness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0607","description":"Physician Direct Care - Must be provided by a hospice physician and must be related to the patient_s terminal illness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLA1","description":"ICD-NFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5A","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo torsion unilat rot str","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2070","description":"Hkafo torsion unilat rot str","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of digoxin free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80163","description":"Assay of digoxin free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOB1","description":"ICD-HAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJD0","description":"ICD-BEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDD0","description":"ICD-GIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SanoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4319","description":"SanoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lenticular lens_ single","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2121","description":"Lenticular lens_ single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leuprolide acetate /3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1950","description":"Leuprolide acetate /3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiology port images(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77417","description":"Radiology port images(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00160","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","description":"CPT-00160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETB0","description":"ICD-AETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDC0","description":"ICD-CDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARB1","description":"ICD-OARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alloskin ac_ 1 cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4141","description":"Alloskin ac_ 1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKE1","description":"ICD-BIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQC1","description":"ICD-DHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine/uric acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84560","description":"Assay of urine/uric acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16020","description":"Dress/debrid p-thick burn s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCF0","description":"ICD-GHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYB0","description":"ICD-HEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBE1","description":"ICD-MIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKC1","description":"ICD-KCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFF0","description":"ICD-CIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronch thermoplsty 2/> lobes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31661","description":"Bronch thermoplsty 2/> lobes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMF0","description":"ICD-BFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15853","description":"Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert eye socket implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67550","description":"Insert eye socket implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Palate/uvula surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42299","description":"Palate/uvula surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVD1","description":"ICD-KIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNA1","description":"ICD-KGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDID0","description":"ICD-FDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cancer treatmentplan initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0353","description":"Cancer treatmentplan initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKB0","description":"ICD-NIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEC1","description":"ICD-BAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAA0","description":"ICD-JHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FUT2 GNOTYP FUT2 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0186U","description":"FUT2 GNOTYP FUT2 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXB0","description":"ICD-CIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPE1","description":"ICD-OFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove lung pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32440","description":"Remove lung pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJA0","description":"ICD-JHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11444","description":"Exc face-mm b9+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENE1","description":"ICD-JENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXF1","description":"ICD-FBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEC1","description":"ICD-OFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Composite drsg <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6203","description":"Composite drsg <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYE1","description":"ICD-HHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHE0","description":"ICD-NCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMB0","description":"ICD-EBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBE0","description":"ICD-NGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Battery elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0496","description":"Battery elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVF0","description":"ICD-NLVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJC1","description":"ICD-JDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22842","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGF1","description":"ICD-NGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0905T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","description":"CPT-0905T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0534","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","description":"HCPCS-G0534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB11","description":"ICD-2CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOB0","description":"ICD-HAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLME0","description":"ICD-MLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43122","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit high risk/escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9381","description":"Hit high risk/escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOB0","description":"ICD-CAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41850","description":"Treatment of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01620","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","description":"CPT-01620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp axillary-pop-tibial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35623","description":"Art byp axillary-pop-tibial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth insert penis device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93851","description":"Anesth insert penis device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX24","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXC0","description":"ICD-CAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIE0","description":"ICD-NFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo femoral fx cast rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2136","description":"Kafo femoral fx cast rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0547U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","description":"CPT-0547U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo intralesional up to 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96405","description":"Chemo intralesional up to 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWB0","description":"ICD-KFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autotransplant parathyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60512","description":"Autotransplant parathyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHE0","description":"ICD-FIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAD0","description":"ICD-KCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMF1","description":"ICD-GEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUF1","description":"ICD-EBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Init nb em per day hosp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99460","description":"Init nb em per day hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Negative pressure ventilator;  portable or stationary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0460","description":"Negative pressure ventilator;  portable or stationary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gtt-added samples","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82952","description":"Gtt-added samples","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18I","description":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical opening of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42955","description":"Surgical opening of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMF1","description":"ICD-JEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHC1","description":"ICD-JGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISB0","description":"ICD-KISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair vessel defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33803","description":"Repair vessel defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHE1","description":"ICD-IHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVC0","description":"ICD-NAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYB1","description":"ICD-CAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILE0","description":"ICD-JILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34471","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt no ref oto reas no spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8563","description":"Pt no ref oto reas no spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMF1","description":"ICD-BCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWB0","description":"ICD-PEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDF0","description":"ICD-BCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUE1","description":"ICD-JIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Paclitaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9267","description":"Paclitaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit blood products diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9538","description":"Hit blood products diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGC1","description":"ICD-OKGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso s/c shell/panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0640","description":"Lso s/c shell/panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49615","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDB1","description":"ICD-KIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc count of ct in 12mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9322","description":"No doc count of ct in 12mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILE0","description":"ICD-NILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"InnovaBurn or InnovaMatrix XL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2022","description":"InnovaBurn or InnovaMatrix XL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVE0","description":"ICD-KIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWC1","description":"ICD-GAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35363","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; aortic counterpulsation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0461T","description":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; aortic counterpulsation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asthma mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8646","description":"Asthma mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQF1","description":"ICD-HAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Advnc care plan in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1157F","description":"Advnc care plan in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Global eswl kidney","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0400","description":"Global eswl kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEF0","description":"ICD-OKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQF0","description":"ICD-GBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion_ subcutaneous cardiac rhythm monitor_ including programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33285","description":"Insertion_ subcutaneous cardiac rhythm monitor_ including programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mens shoes hightop depth inl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3222","description":"Mens shoes hightop depth inl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHE1","description":"ICD-BEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anti-inflm/anlgsc agent rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4016F","description":"Anti-inflm/anlgsc agent rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECF0","description":"ICD-IECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJF1","description":"ICD-NFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4023","description":"Pathology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIC1","description":"ICD-ODIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCE0","description":"ICD-MDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBC0","description":"ICD-GDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pelvic abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57010","description":"Drainage of pelvic abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEA1","description":"ICD-JIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Goserelin acetate implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9202","description":"Goserelin acetate implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIF0","description":"ICD-JHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB54","description":"Low Rehab_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of iris prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0616T","description":"Insertion of iris prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIA0","description":"ICD-CCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMB1","description":"ICD-MHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31766","description":"Reconstruction of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64760","description":"Incision of vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Galactose transferase test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82776","description":"Galactose transferase test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGC1","description":"ICD-CDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42510","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATC0","description":"ICD-GATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20B","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCF1","description":"ICD-CHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEB1","description":"ICD-CEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGA0","description":"ICD-NFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q9998","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","description":"HCPCS-Q9998","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCC1","description":"ICD-KCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBID0","description":"ICD-GBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation of wheezing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94070","description":"Evaluation of wheezing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; each additional 30 minutes of technician time (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0365T","description":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; each additional 30 minutes of technician time (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPD1","description":"ICD-OJPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGB1","description":"ICD-GFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33755","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Long chain fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82726","description":"Long chain fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; biopsy(ies)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38221","description":"Diagnostic bone marrow; biopsy(ies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEF0","description":"ICD-JGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHA0","description":"ICD-IEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy br/wa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44381","description":"Small bowel endoscopy br/wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E2513","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","description":"HCPCS-E2513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac guide differs nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9062","description":"Onc prac guide differs nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTB1","description":"ICD-OKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSE1","description":"ICD-OHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLC0","description":"ICD-KGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDND1","description":"ICD-CDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSC1","description":"ICD-CDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploratory heart surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33310","description":"Exploratory heart surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth skull repair/fract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21551","description":"Anesth skull repair/fract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHE0","description":"ICD-MDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absorp drg <= 16 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0744","description":"Absorp drg <= 16 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11C","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change of bladder tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51705","description":"Change of bladder tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81545","description":"Oncology thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXC0","description":"ICD-NHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phototherap keratect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0812","description":"Phototherap keratect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPE1","description":"ICD-GEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTE0","description":"ICD-MGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABE0","description":"ICD-MABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmic endoscope add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66990","description":"Ophthalmic endoscope add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMB1","description":"ICD-BHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNE0","description":"ICD-NDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBC1","description":"ICD-NLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX52","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23C","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB212","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc skin abd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15830","description":"Exc skin abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ unilateral; one view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73500","description":"Radiologic examination_ hip_ unilateral; one view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYD1","description":"ICD-OAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHC0","description":"ICD-OGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAND0","description":"ICD-OAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGB0","description":"ICD-NIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQC1","description":"ICD-KDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAE0","description":"ICD-AIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth esophageal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50051","description":"Anesth esophageal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLA1","description":"ICD-GGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ciprofloxacin iv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0744","description":"Ciprofloxacin iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Advncd care plan addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99498","description":"Advncd care plan addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJE1","description":"ICD-NBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Teniposide_ 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2017","description":"Teniposide_ 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37279","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","description":"CPT-37279","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKC1","description":"ICD-FFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subcut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0818T","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subcut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77402","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61519","description":"Remove brain lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALB0","description":"ICD-EALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52315","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lisocabtagene maraleucel_ up to 110 million autologous anti-cd19 car-positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9076","description":"Lisocabtagene maraleucel_ up to 110 million autologous anti-cd19 car-positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42961","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE210","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATB1","description":"ICD-FATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHME0","description":"ICD-BHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMF0","description":"ICD-KEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28X","description":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI joint of lwr extr w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73722","description":"MRI joint of lwr extr w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46200","description":"Removal of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPC1","description":"ICD-NDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65750","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOA1","description":"ICD-PIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1304","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFE0","description":"ICD-NKFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15D","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA STREPTOCOCCUS GROUP A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87430","description":"IAAD IA STREPTOCOCCUS GROUP A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCA1","description":"ICD-NLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYF0","description":"ICD-GDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stationary o2 contents_ liq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0442","description":"Stationary o2 contents_ liq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ampicillin 500 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0290","description":"Ampicillin 500 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAE0","description":"ICD-FIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAC1","description":"ICD-OFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59851","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0824","description":"Pwc gp 2 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIC0","description":"ICD-JHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTA0","description":"ICD-BBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKC1","description":"ICD-JEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDE0","description":"ICD-MGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQC0","description":"ICD-OFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHF0","description":"ICD-OJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm receiver_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5287","description":"Ald fm/dm receiver_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICD1","description":"ICD-EICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXE0","description":"ICD-NGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCE0","description":"ICD-GGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anticoag clinic per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9401","description":"Anticoag clinic per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAF0","description":"ICD-NFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cover eye w/membrane","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65778","description":"Cover eye w/membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSF1","description":"ICD-DFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE145","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25B","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE150","description":"Reduced Physical Function _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB31","description":"ICD-2IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJE0","description":"ICD-BEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10D","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD204","description":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18A","description":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHD1","description":"ICD-OGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin b-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84252","description":"Assay of vitamin b-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQA1","description":"ICD-CEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHD0","description":"ICD-JAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dipyridamole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1245","description":"Dipyridamole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0497U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","description":"CPT-0497U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt trnsfrd from anesth to cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0581F","description":"Pt trnsfrd from anesth to cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITD0","description":"ICD-JITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGB1","description":"ICD-BIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX40","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehen metabolic panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80053","description":"Comprehen metabolic panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCB1","description":"ICD-GBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVE1","description":"ICD-BEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artacent AC_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4190","description":"Artacent AC_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB134","description":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHE1","description":"ICD-NGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJD0","description":"ICD-FBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10C","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIB1","description":"ICD-KHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METD0","description":"ICD-METD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Forceps esoph biopsy done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3150F","description":"Forceps esoph biopsy done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44155","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty tricuspid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33464","description":"Valvuloplasty tricuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQF1","description":"ICD-KCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDC1","description":"ICD-MKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Idecabtagene Vicleucel_ Up To 460 Million Autologous B-Cell Maturation Antigen (Bcma) Directed Car-Positive T Cells_ Including Leukapheresis And Dose Preparation Procedures_ P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2055","description":"Idecabtagene Vicleucel_ Up To 460 Million Autologous B-Cell Maturation Antigen (Bcma) Directed Car-Positive T Cells_ Including Leukapheresis And Dose Preparation Procedures_ P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWD1","description":"ICD-GHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disp fee inhal drugs/30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0513","description":"Disp fee inhal drugs/30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAE1","description":"ICD-CCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUA1","description":"ICD-BAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAB1","description":"ICD-CEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDC1","description":"ICD-GEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGF1","description":"ICD-CDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALE0","description":"ICD-IALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHD1","description":"ICD-EBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIF0","description":"ICD-EAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reimplant artery each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35697","description":"Reimplant artery each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPB1","description":"ICD-OBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Safety concerns screening positive screen is without provision of mitigation recommendations_ including but not limited to referral to other resources","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9926","description":"Safety concerns screening positive screen is without provision of mitigation recommendations_ including but not limited to referral to other resources","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOB1","description":"ICD-DAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWC0","description":"ICD-DHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20250","description":"Open bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt tk tams hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9503","description":"Pt tk tams hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caloric vestibular test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92533","description":"Caloric vestibular test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWB1","description":"ICD-LFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOD1","description":"ICD-GGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Poliovirus ipv sc/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90713","description":"Poliovirus ipv sc/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLC0","description":"ICD-MHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX22","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1403","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1403","description":"CDT-D1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21C","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAD1","description":"ICD-NDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tempr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0278T","description":"Tempr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLF0","description":"ICD-EDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIB1","description":"ICD-CBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWC0","description":"ICD-GBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0715T","description":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr epigastric hern reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49570","description":"Rpr epigastric hern reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg vein fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34530","description":"Leg vein fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUA1","description":"ICD-FAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCF1","description":"ICD-OJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep b vac series prev recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4157F","description":"Hep b vac series prev recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Splint supplies misc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4051","description":"Splint supplies misc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHD0","description":"ICD-MFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUB0","description":"ICD-EFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rh ig minidose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90385","description":"Rh ig minidose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx/proph/dg addl seq iv inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96367","description":"Tx/proph/dg addl seq iv inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA45","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQD1","description":"ICD-GGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLD0","description":"ICD-BGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVC1","description":"ICD-CBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20B","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic colonoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45378","description":"Diagnostic colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise aqueous shunt eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66185","description":"Revise aqueous shunt eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/transplant tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23440","description":"Remove/transplant tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDD0","description":"ICD-BIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAF0","description":"ICD-MAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX44","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14C","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGC1","description":"ICD-NLGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMA0","description":"ICD-NLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tacrine hydrochloride_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0014","description":"Tacrine hydrochloride_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Of Drug-Eluting Implant_ Including Punctal Dilation When Performed_ Into Lacrimal Canaliculus_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68841","description":"Insertion Of Drug-Eluting Implant_ Including Punctal Dilation When Performed_ Into Lacrimal Canaliculus_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9312","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9312","description":"HCPCS-C9312","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cemiplimab-rwlc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9119","description":"Injection_ cemiplimab-rwlc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco non-user","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1036F","description":"Tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain neck/chest lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21501","description":"Drain neck/chest lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYF0","description":"ICD-HDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDA1","description":"ICD-NEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFF0","description":"ICD-OGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28238","description":"Revision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73040","description":"Contrast x-ray of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18E","description":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGF1","description":"ICD-NBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDC0","description":"ICD-FHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Activated carbon filter_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4680","description":"Activated carbon filter_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gadoxetate disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9581","description":"Gadoxetate disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTE0","description":"ICD-FFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUF1","description":"ICD-AGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93590","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0453T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ hydroxyprogesterone caproate_ not otherwise specified_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1729","description":"Injection_ hydroxyprogesterone caproate_ not otherwise specified_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0591U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","description":"CPT-0591U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWA0","description":"ICD-PGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair semi-recl detach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1110","description":"Wheelchair semi-recl detach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKF1","description":"ICD-CAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1202","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1202","description":"CDT-D1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47553","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIE0","description":"ICD-KDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXA0","description":"ICD-FDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cocoon membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4264","description":"Cocoon membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLF1","description":"ICD-GFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB11","description":"ICD-4CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESF1","description":"ICD-CESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelv band/spread bar thigh c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1640","description":"Pelv band/spread bar thigh c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVF0","description":"ICD-CIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33985","description":"Ecmo/ecls rmvl ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRB1","description":"ICD-PIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Establish access to artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36100","description":"Establish access to artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Single pivot hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6605","description":"Single pivot hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFB0","description":"ICD-NKFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of calf tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27687","description":"Revision of calf tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0802","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0802","description":"CDT-D0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88374","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSB1","description":"ICD-HHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEF1","description":"ICD-ADEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJD0","description":"ICD-CEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long arm ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4007","description":"Cast sup long arm ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADA1","description":"ICD-KADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace tissue expander","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11970","description":"Replace tissue expander","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDC1","description":"ICD-OJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOB1","description":"ICD-CAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYB1","description":"ICD-OLYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37285","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","description":"CPT-37285","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANA1","description":"ICD-NANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHID1","description":"ICD-GHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE235","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABME1","description":"ICD-ABME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0675T","description":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infrared therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97026","description":"Infrared therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWC0","description":"ICD-CDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIB1","description":"ICD-FEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLE0","description":"ICD-ACLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remv&replc pm gen mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33229","description":"Remv&replc pm gen mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sheath above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8410","description":"Sheath above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81596","description":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKME1","description":"ICD-OKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ coagulation factor ix (recombinant)_ ixinity_ 1 i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7213","description":"Injection_ coagulation factor ix (recombinant)_ ixinity_ 1 i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20D","description":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGF0","description":"ICD-JHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit wound care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9097","description":"Home visit wound care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport meals escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0210","description":"Noner transport meals escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mon cable elec/pneum vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0486","description":"Mon cable elec/pneum vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aicd_ single chamber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1722","description":"Aicd_ single chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTB1","description":"ICD-KFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEF1","description":"ICD-CEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB220","description":"Special Care Low _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary_s home that has been made provider","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0248","description":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary_s home that has been made provider","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96112","description":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXF0","description":"ICD-BEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41828","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASD0","description":"ICD-CASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct elbow med ligmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24346","description":"Reconstruct elbow med ligmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISE0","description":"ICD-KISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA105","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Torsion mechanism knee/ankle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2861","description":"Torsion mechanism knee/ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy into cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96450","description":"Chemotherapy into cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKF0","description":"ICD-CGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27742","description":"Repair of leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFF0","description":"ICD-CHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDC1","description":"ICD-BHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBF0","description":"ICD-ICBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk addl 5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13102","description":"Cmplx rpr trunk addl 5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFF1","description":"ICD-FEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJA0","description":"ICD-NLJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMB0","description":"ICD-KDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRE0","description":"ICD-KFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUD0","description":"ICD-IGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PalinGen or PalinGen XPlus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4173","description":"PalinGen or PalinGen XPlus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICB1","description":"ICD-OICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBD1","description":"ICD-GHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVD0","description":"ICD-NGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVE1","description":"ICD-GEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Case management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1016","description":"Case management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIB1","description":"ICD-MGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXF0","description":"ICD-NEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Protector heel or elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0191","description":"Protector heel or elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNE0","description":"ICD-FBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDB1","description":"ICD-IHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDA0","description":"ICD-FIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWF0","description":"ICD-OIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth lens surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14251","description":"Anesth lens surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAF0","description":"ICD-MKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHA0","description":"ICD-MFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2048","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2048","description":"HCPCS-A2048","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEC1","description":"ICD-MBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza imm rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4035F","description":"Influenza imm rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC221","description":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVE1","description":"ICD-OEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hdtrans bench w/wo comm open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0248","description":"Hdtrans bench w/wo comm open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo remove w/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50548","description":"Laparo remove w/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMD0","description":"ICD-OJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker seat attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0156","description":"Walker seat attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSF1","description":"ICD-OGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg_ DiGeorge syndrome_ Cri-du-chat syndrome)_ circulating cell-free fetal DNA in maternal blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81422","description":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg_ DiGeorge syndrome_ Cri-du-chat syndrome)_ circulating cell-free fetal DNA in maternal blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M.tuberculo dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87556","description":"M.tuberculo dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocortisone sodium succ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1720","description":"Hydrocortisone sodium succ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNF0","description":"ICD-NFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCD1","description":"ICD-BCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRF0","description":"ICD-KFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01780","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","description":"CPT-01780","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test socket knee disarticula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5622","description":"Test socket knee disarticula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQB1","description":"ICD-HIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHF0","description":"ICD-AHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monthly supplies for use of device coded at K1016","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1017","description":"Monthly supplies for use of device coded at K1016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 5999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4726","description":"Dialys sol fld vol > 5999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUC1","description":"ICD-FAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGA1","description":"ICD-KGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKA1","description":"ICD-GDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRA1","description":"ICD-OKRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Moderately Complex Clinical Problem_ With Review Of Patient_S History And Medical Records And Moderate Level Of Medical Decision Making","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80504","description":"Pathology Clinical Consultation; For A Moderately Complex Clinical Problem_ With Review Of Patient_S History And Medical Records And Moderate Level Of Medical Decision Making","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTE0","description":"ICD-OFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTD0","description":"ICD-CBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDF0","description":"ICD-EFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFF0","description":"ICD-KHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ leuprolide acetate for depot suspension (fensolvi)_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1951","description":"Injection_ leuprolide acetate for depot suspension (fensolvi)_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring_ including deployment and calibration of the sensor_ right heart c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33289","description":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring_ including deployment and calibration of the sensor_ right heart c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXC0","description":"ICD-CCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJE0","description":"ICD-BGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPB1","description":"ICD-JIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tebentafusp-tebn_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9095","description":"Injection_ tebentafusp-tebn_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUF1","description":"ICD-EHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAA0","description":"ICD-MLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel dressing >48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6233","description":"Hydrogel dressing >48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft brchl-ulnr-rdl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35523","description":"Art byp grft brchl-ulnr-rdl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYA0","description":"ICD-CFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPB1","description":"ICD-JEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIB0","description":"ICD-CHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of pancreas open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48100","description":"Biopsy of pancreas open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOA0","description":"ICD-OHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKA0","description":"ICD-ODKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35266","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGD1","description":"ICD-KAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDD1","description":"ICD-EDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABB0","description":"ICD-JABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB146","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impact tooth remov soft tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7220","description":"Impact tooth remov soft tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAD1","description":"ICD-IEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEA1","description":"ICD-JAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNC1","description":"ICD-CFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGA1","description":"ICD-KEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEC0","description":"ICD-OJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bp scrn perf rec interval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8783","description":"Bp scrn perf rec interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth chest procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52051","description":"Anesth chest procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYC1","description":"ICD-CCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0484U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","description":"CPT-0484U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic interventions that focus on cognitive function (eg_ attention_ memory_ reasoning_ executive function_ problem solving_ and/or pragmatic functioning) and compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97127","description":"Therapeutic interventions that focus on cognitive function (eg_ attention_ memory_ reasoning_ executive function_ problem solving_ and/or pragmatic functioning) and compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDF0","description":"ICD-JIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Provisional retainer crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6793","description":"Provisional retainer crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temple bne implnt w/stimulat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69715","description":"Temple bne implnt w/stimulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIME1","description":"ICD-NIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sedative hypnotics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80368","description":"Sedative hypnotics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tacrol envarsus ex rel oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7503","description":"Tacrol envarsus ex rel oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77771","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 2/3 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72082","description":"X-ray exam entire spi 2/3 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHE1","description":"ICD-JGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sterile cefuroxime injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0697","description":"Sterile cefuroxime injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Counseling for the control and prevention of adverse oral_ behavioral_ and systemic health effects associated with high-risk substance use","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1321","description":"Counseling for the control and prevention of adverse oral_ behavioral_ and systemic health effects associated with high-risk substance use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGA0","description":"ICD-OEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRD1","description":"ICD-OKRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTD1","description":"ICD-KHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHE0","description":"ICD-KDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I&d p-spine c/t/cerv-thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22010","description":"I&d p-spine c/t/cerv-thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETF0","description":"ICD-KETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRD0","description":"ICD-DHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75978","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFF0","description":"ICD-FGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELE0","description":"ICD-GELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transpetrosal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61598","description":"Transpetrosal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of leg artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34203","description":"Removal of leg artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHB0","description":"ICD-AFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit cont chem diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9330","description":"Hit cont chem diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for ESRD on dialysis)_ 100 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5105","description":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for ESRD on dialysis)_ 100 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise inner ear window","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69840","description":"Revise inner ear window","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRF1","description":"ICD-OHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0544","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","description":"HCPCS-G0544","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84702","description":"Chorionic gonadotropin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1123","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ixabepilone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9207","description":"Ixabepilone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLD0","description":"ICD-KDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of bladder abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51080","description":"Drainage of bladder abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43045","description":"Incision of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adrenal tissue transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2103","description":"Adrenal tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATB1","description":"ICD-KATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUC1","description":"ICD-EIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAB1","description":"ICD-NGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSC0","description":"ICD-CHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAC1","description":"ICD-NKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXE0","description":"ICD-JBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Car-car bp grft/endovas taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33891","description":"Car-car bp grft/endovas taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFID0","description":"ICD-IFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0301","description":"HCPCS-A0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70486","description":"Ct maxillofacial w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Withdrawal of arterial blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36600","description":"Withdrawal of arterial blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEB1","description":"ICD-NAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0985T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","description":"CPT-0985T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69646","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mdd in remission","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3092F","description":"Mdd in remission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bcg vaccine percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90585","description":"Bcg vaccine percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34708","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Graftjacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4107","description":"Graftjacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:1)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1728","description":"Employment - Employment Skills Development (1:1)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUD1","description":"ICD-OKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTB0","description":"ICD-OHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARE1","description":"ICD-PARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac Tx Nsg Fac Res W/Skn Inf Bill Sid-Bnef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9682","description":"Onsite Ac Tx Nsg Fac Res W/Skn Inf Bill Sid-Bnef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQF0","description":"ICD-PHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCE0","description":"ICD-FHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAA1","description":"ICD-BGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBE0","description":"ICD-GFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nikaidoh proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33782","description":"Nikaidoh proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMC0","description":"ICD-BBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gonadorelin hydroch/ 100 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1620","description":"Gonadorelin hydroch/ 100 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUB1","description":"ICD-IFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty per toot","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4211","description":"Gingivectomy/plasty per toot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Establish inner ear window","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69820","description":"Establish inner ear window","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB26","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAC1","description":"ICD-KDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bowel surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44899","description":"Bowel surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB130","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25D","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFC1","description":"ICD-NFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTC1","description":"ICD-ABTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDF0","description":"ICD-EGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATE0","description":"ICD-FATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Path rpt malig cancer docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3318F","description":"Path rpt malig cancer docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 1 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72081","description":"X-ray exam entire spi 1 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUF0","description":"ICD-NEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLB1","description":"ICD-OFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJA0","description":"ICD-OEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEF1","description":"ICD-BAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFD0","description":"ICD-GHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMF1","description":"ICD-GGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem mntr pulm flu mntr alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0608T","description":"Rem mntr pulm flu mntr alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28107","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAC1","description":"ICD-CFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYD1","description":"ICD-LEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLME1","description":"ICD-MLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERF0","description":"ICD-LERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22A","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITA1","description":"ICD-AITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJE0","description":"ICD-KCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23620","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPB0","description":"ICD-NAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJD1","description":"ICD-NIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAD1","description":"ICD-OEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGB1","description":"ICD-FBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGB1","description":"ICD-KBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLB1","description":"ICD-GGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX53","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDF1","description":"ICD-FIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBC0","description":"ICD-JEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pressure treatment esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43460","description":"Pressure treatment esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mohs addl stage t/a/l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17314","description":"Mohs addl stage t/a/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36012","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Uvl sys panel 4 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0692","description":"Uvl sys panel 4 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOB0","description":"ICD-HDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1435","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","description":"HCPCS-M1435","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXE0","description":"ICD-GFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJD1","description":"ICD-FEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis_ including reported phenotypes and imp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0349U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis_ including reported phenotypes and imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained without concurrent CT examination of any structure contained in pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0721T","description":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained without concurrent CT examination of any structure contained in pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intens cardiac rehab no exer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0423","description":"Intens cardiac rehab no exer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUF1","description":"ICD-BCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0641T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOF0","description":"ICD-OKOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVE0","description":"ICD-KFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOF0","description":"ICD-CFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUC0","description":"ICD-ACUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUD1","description":"ICD-GEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36013","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB212","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Via matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4309","description":"Via matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc system reas adv imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9537","description":"Doc system reas adv imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKA0","description":"ICD-CHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQC1","description":"ICD-KCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk joint covers pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5678","description":"Bk joint covers pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGE1","description":"ICD-CGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96542","description":"Chemotherapy injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0533U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","description":"CPT-0533U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWC1","description":"ICD-KHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat scor nek/ts pt no e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8673","description":"Fun stat scor nek/ts pt no e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDA0","description":"ICD-BBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLD0","description":"ICD-MFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0640T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUD1","description":"ICD-MCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap esoph lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43283","description":"Lap esoph lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGC0","description":"ICD-GIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Lefamulin (Xenleta)_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9054","description":"Injection_ Lefamulin (Xenleta)_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUD1","description":"ICD-FAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCB1","description":"ICD-JBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00873","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","description":"CPT-00873","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual semi-reclining back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1225","description":"Manual semi-reclining back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abx reg prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9498","description":"Abx reg prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDF1","description":"ICD-BDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD246","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDF0","description":"ICD-FHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18C","description":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERE0","description":"ICD-OERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWE1","description":"ICD-PKWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cor artery disease mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81493","description":"Cor artery disease mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extrnl bleaching per arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9972","description":"Extrnl bleaching per arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFB0","description":"ICD-OBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA230","description":"Reduced Physical Function _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization admin each add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90472","description":"Immunization admin each add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOE0","description":"ICD-GEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Navigational bronchoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31627","description":"Navigational bronchoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIA0","description":"ICD-EHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQA1","description":"ICD-GDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66505","description":"Incision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHD1","description":"ICD-FIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19120","description":"Removal of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDC0","description":"ICD-GEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTF1","description":"ICD-NJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBC1","description":"ICD-FIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEF0","description":"ICD-JCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thxp apheresis w/hdl delip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0342T","description":"Thxp apheresis w/hdl delip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arm/leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64857","description":"Repair arm/leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHF1","description":"ICD-BEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITC1","description":"ICD-NITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXE1","description":"ICD-JCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cont pas motion exercise dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0935","description":"Cont pas motion exercise dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score neck/ts >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8671","description":"Fun stat score neck/ts >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aneurysm press sensor add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34806","description":"Aneurysm press sensor add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRE1","description":"ICD-CFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76826","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICE0","description":"ICD-MICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"E & M Of Beneficiary_S Ac Change Cond Nsg Fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9685","description":"E & M Of Beneficiary_S Ac Change Cond Nsg Fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUB0","description":"ICD-GFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFC0","description":"ICD-NJFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22846","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDE0","description":"ICD-KFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBA1","description":"ICD-KCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEF1","description":"ICD-MLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42962","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0271T","description":"Rev/remvl crtd sns dev gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOD0","description":"ICD-GAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 4 visits p mo <2yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90951","description":"Esrd serv 4 visits p mo <2yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features_ reported as a recurrence score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0418U","description":"Oncology (breast)_ augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features_ reported as a recurrence score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVE1","description":"ICD-JCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doripenem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1267","description":"Doripenem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zidovudine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3485","description":"Zidovudine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX31","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"2 pc drainable ost pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4413","description":"2 pc drainable ost pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEE0","description":"ICD-MHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9903","description":"Patient screened for tobacco use and identified as a tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETC0","description":"ICD-JETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNF0","description":"ICD-KBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low frequency non-thermal us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97610","description":"Low frequency non-thermal us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0244","description":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compres burn garment panty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6511","description":"Compres burn garment panty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57000","description":"Exploration of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Needle Insertion(S) Without Injection(S); 3 Or More Muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20561","description":"Needle Insertion(S) Without Injection(S); 3 Or More Muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFA1","description":"ICD-NIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHD0","description":"ICD-CFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB21","description":"ICD-4IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt queried prkns complic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4324F","description":"Pt queried prkns complic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid trnso dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43191","description":"Esophagoscopy rigid trnso dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening proctoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0601","description":"Screening proctoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERB1","description":"ICD-PERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High energy neutron radiation treatment delivery_ 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge_ and/or compensator(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77423","description":"High energy neutron radiation treatment delivery_ 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge_ and/or compensator(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHF1","description":"ICD-MDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUF1","description":"ICD-FIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQA1","description":"ICD-LGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJA0","description":"ICD-NDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTB1","description":"ICD-FBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIC1","description":"ICD-BBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antibiotic not pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8708","description":"Antibiotic not pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemorrhoidopexy by stapling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46947","description":"Hemorrhoidopexy by stapling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; each additional hour_ including physiological and laboratory assessments (eg_ perfu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0896T","description":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; each additional hour_ including physiological and laboratory assessments (eg_ perfu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAE1","description":"ICD-GIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMC0","description":"ICD-NKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBE1","description":"ICD-GIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Advancing rheumatology patient care mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0053","description":"Advancing rheumatology patient care mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cholinesterase challenge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95857","description":"Cholinesterase challenge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOB1","description":"ICD-HGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystometrogram w/vp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51728","description":"Cystometrogram w/vp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQC0","description":"ICD-GAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC125","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVB1","description":"ICD-FHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUD0","description":"ICD-AFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary peripheral neuropathies (eg_ Charcot-Marie-Tooth_ spastic paraplegia)_ genomic sequence analysis panel_ must include sequencing of at least 5 peripheral neuropathy-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81448","description":"Hereditary peripheral neuropathies (eg_ Charcot-Marie-Tooth_ spastic paraplegia)_ genomic sequence analysis panel_ must include sequencing of at least 5 peripheral neuropathy-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIE0","description":"ICD-MKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8D","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1372","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","description":"HCPCS-M1372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXD0","description":"ICD-BAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUD0","description":"ICD-IIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCC1","description":"ICD-NGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC255","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGC0","description":"ICD-BAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71046","description":"Radiologic examination_ chest; 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRC0","description":"ICD-LCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJC0","description":"ICD-NEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alpha-1-antitrypsin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82103","description":"Alpha-1-antitrypsin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special eye exam initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92225","description":"Special eye exam initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PuraPly or PuraPly AM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4172","description":"PuraPly or PuraPly AM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJF1","description":"ICD-CGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7543","description":"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of bradykinin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82286","description":"Assay of bradykinin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic lightbox tabletp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0203","description":"Therapeutic lightbox tabletp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAE0","description":"ICD-OEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trnscth renal symp denrv unl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0338T","description":"Trnscth renal symp denrv unl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPF1","description":"ICD-OIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1330","description":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Report_ prev care measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8486","description":"Report_ prev care measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB255","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA22","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHF1","description":"ICD-NLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D7252","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D7252","description":"CDT-D7252","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","description":"HCPCS-J0164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose/normal saline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7042","description":"5% dextrose/normal saline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fem/popl revas w/tla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37224","description":"Fem/popl revas w/tla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCA1","description":"ICD-GDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX10","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB41","description":"Low Rehab_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQD0","description":"ICD-DAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of needle or intracatheter_ upper or lower extremity artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36140","description":"Introduction of needle or intracatheter_ upper or lower extremity artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYB1","description":"ICD-CFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apheresis platelets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36513","description":"Apheresis platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDC1","description":"ICD-EEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE121","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIE0","description":"ICD-KFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vaginal hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58260","description":"Vaginal hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye service or procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92499","description":"Eye service or procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITB0","description":"ICD-BITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOC0","description":"ICD-OHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ aicd_ non sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1896","description":"Lead_ aicd_ non sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECE0","description":"ICD-BECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14D","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of donor heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33930","description":"Removal of donor heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrics/Gynecology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4018","description":"Obstetrics/Gynecology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHC0","description":"ICD-KBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTB1","description":"ICD-NLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUA1","description":"ICD-IGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHB1","description":"ICD-MBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMC1","description":"ICD-KGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCC0","description":"ICD-FCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital bed var ht w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0256","description":"Hospital bed var ht w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVA0","description":"ICD-FFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16372","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16372","description":"CPT-16372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAE0","description":"ICD-GHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0801","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0801","description":"CDT-D0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ meropenem_ vaborbactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2186","description":"Injection_ meropenem_ vaborbactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEF0","description":"ICD-CAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA31","description":"ICD-2KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES106","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"DermaBind FM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4313","description":"DermaBind FM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RHD&RHCE GNTYP NEXT GNRJ SEQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0222U","description":"RHD&RHCE GNTYP NEXT GNRJ SEQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telemonitoring/home per mnth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9110","description":"Telemonitoring/home per mnth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Theraskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4121","description":"Theraskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC251","description":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise foot tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28086","description":"Excise foot tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg during surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95955","description":"Eeg during surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMB1","description":"ICD-BBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx esophageal t4 no prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9097","description":"Onc dx esophageal t4 no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth lumbar puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63551","description":"Anesth lumbar puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGC0","description":"ICD-BBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBF1","description":"ICD-FDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ccp antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86200","description":"Ccp antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fabric wrapping of aneurysm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0301","description":"Fabric wrapping of aneurysm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Duplex scan of hemodialysis fistula_ computer-aided_ limited (volume flow_ diameter_ and depth_ including only body of fistula)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0876T","description":"Duplex scan of hemodialysis fistula_ computer-aided_ limited (volume flow_ diameter_ and depth_ including only body of fistula)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain image 4+ views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78605","description":"Brain image 4+ views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1469","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","description":"HCPCS-M1469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray&fluoro 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71034","description":"Chest x-ray&fluoro 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATC0","description":"ICD-NATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGE0","description":"ICD-NLGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O2 saturation doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3028F","description":"O2 saturation doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHA1","description":"ICD-JHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Convert nephrostomy catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50434","description":"Convert nephrostomy catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26740","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPF1","description":"ICD-CDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAF0","description":"ICD-BFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiofrequency Ablation_ Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64625","description":"Radiofrequency Ablation_ Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKC1","description":"ICD-OKKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE114","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"P2y inhib not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9439","description":"P2y inhib not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc leukoreduced irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9040","description":"Rbc leukoreduced irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repr of anal fistula w/glue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46706","description":"Repr of anal fistula w/glue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain stem w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70553","description":"MRI brain stem w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKB0","description":"ICD-GEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICD0","description":"ICD-FICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doxepin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6034","description":"Doxepin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transport parking fees/tolls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0170","description":"Transport parking fees/tolls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAF1","description":"ICD-IDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLA0","description":"ICD-NLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSC0","description":"ICD-GFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEA0","description":"ICD-BHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMB0","description":"ICD-MFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture screen only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87081","description":"Culture screen only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAC1","description":"ICD-IIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUD1","description":"ICD-OCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mobility goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8979","description":"Mobility goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEE0","description":"ICD-IBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOF0","description":"ICD-KGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair palate pharynx/uvula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42145","description":"Repair palate pharynx/uvula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPF1","description":"ICD-BHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPD1","description":"ICD-GIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00626","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","description":"CPT-00626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJE0","description":"ICD-KDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy faceplt/silicone ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4384","description":"Ostomy faceplt/silicone ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0228T","description":"Njx tfrml eprl w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair tear ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68700","description":"Repair tear ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37255","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","description":"CPT-37255","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXD1","description":"ICD-FEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDE0","description":"ICD-JIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhv-6 dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87532","description":"Hhv-6 dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epiandrosterone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6049","description":"Epiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen quant tiagabine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80199","description":"Drug screen quant tiagabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33660","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRF0","description":"ICD-CFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2C","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional outcome assessment documented_ care plan not documented_ documentation the patient is not eligible for a care plan at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9227","description":"Functional outcome assessment documented_ care plan not documented_ documentation the patient is not eligible for a care plan at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo sing upright w/ adjust s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1920","description":"Afo sing upright w/ adjust s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol 10 gm lipids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4185","description":"Parenteral sol 10 gm lipids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder joint surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23101","description":"Shoulder joint surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLC1","description":"ICD-FCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDB0","description":"ICD-GGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKF0","description":"ICD-FCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11A","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRC0","description":"ICD-DCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVB1","description":"ICD-OIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefiderocol_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0693","description":"Injection_ cefiderocol_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBD1","description":"ICD-MJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYF0","description":"ICD-OEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part pulp for apexogenesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3222","description":"Part pulp for apexogenesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7207","description":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1014","description":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1A","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35305","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBE1","description":"ICD-JBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray of mammary ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77054","description":"X-ray of mammary ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0604","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0604","description":"CDT-D0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADC0","description":"ICD-EADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct interprete tmj","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0368","description":"Cone beam ct interprete tmj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOD1","description":"ICD-DCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC135","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28B","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKC0","description":"ICD-FCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEF0","description":"ICD-BFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1413","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","description":"HCPCS-M1413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIF1","description":"ICD-MKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIB0","description":"ICD-NIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEC1","description":"ICD-EFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA255","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWA1","description":"ICD-CIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIE0","description":"ICD-BBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE212","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0495T","description":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20A","description":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDA1","description":"ICD-CBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pinworm examinations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0113","description":"Pinworm examinations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWD0","description":"ICD-LHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXB0","description":"ICD-NFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of protein other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84157","description":"Assay of protein other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXE1","description":"ICD-CEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCF0","description":"ICD-NHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGF0","description":"ICD-OGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDB0","description":"ICD-BCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIME0","description":"ICD-AIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ which may include simultaneous direction of tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97155","description":"Adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ which may include simultaneous direction of tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Protein western blot test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84182","description":"Protein western blot test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10D","description":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGD1","description":"ICD-GDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENC1","description":"ICD-CENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL10","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXC0","description":"ICD-FBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9902","description":"Patient screened for tobacco use and identified as a tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gi tract capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91110","description":"Gi tract capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64728","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","description":"CPT-64728","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFB0","description":"ICD-FGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCND1","description":"ICD-OCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCB1","description":"ICD-FGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","description":"CPT-76014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/us guide bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45342","description":"Sigmoidoscopy w/us guide bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWB1","description":"ICD-HCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-BMI1_ CEP 164_ 3_-UTR-Ropporin_ Desmocollin_ AURKAIP-1_ CSNK2A2)_ multiplexed immunoassay and flow cy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0021U","description":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-BMI1_ CEP 164_ 3_-UTR-Ropporin_ Desmocollin_ AURKAIP-1_ CSNK2A2)_ multiplexed immunoassay and flow cy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIB1","description":"ICD-NEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYB1","description":"ICD-KBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPA0","description":"ICD-FCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARC1","description":"ICD-LARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSD1","description":"ICD-OLSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCA1","description":"ICD-NJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBF1","description":"ICD-IHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOA1","description":"ICD-OIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mans shoe oxford brace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3225","description":"Mans shoe oxford brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIME1","description":"ICD-CIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneum full leg splnt pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4370","description":"Pneum full leg splnt pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKF1","description":"ICD-NBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with dementia at any time prior to or during the month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1271","description":"Patients with dementia at any time prior to or during the month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAE0","description":"ICD-ADAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mlh1 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81293","description":"Mlh1 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Didanosine_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0137","description":"Didanosine_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ftl cgen abnor three anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81510","description":"Ftl cgen abnor three anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove lamina/facets lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63012","description":"Remove lamina/facets lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHC1","description":"ICD-JHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANC0","description":"ICD-BANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of uvula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42140","description":"Excision of uvula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatology (nonalcoholic steatohepatitis [NASH])_ miR-34a-5p_ alpha 2-macroglobulin_ YKL40_ HbA1c_ serum and whole blood_ algorithm reported as a single score for NASH activit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0468U","description":"Hepatology (nonalcoholic steatohepatitis [NASH])_ miR-34a-5p_ alpha 2-macroglobulin_ YKL40_ HbA1c_ serum and whole blood_ algorithm reported as a single score for NASH activit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meckels divert exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78290","description":"Meckels divert exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77332","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dry pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0184","description":"Dry pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQD0","description":"ICD-OCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIB0","description":"ICD-OCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJD0","description":"ICD-BAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB150","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg arterial three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33535","description":"Cabg arterial three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD111","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98002","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","description":"CPT-98002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28E","description":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGC1","description":"ICD-CAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0644","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0644","description":"HCPCS-J0644","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aerosol inhalation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94642","description":"Aerosol inhalation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9184","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","description":"HCPCS-J9184","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2100","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWB1","description":"ICD-CDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDA1","description":"ICD-JBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXE1","description":"ICD-FHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99220","description":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16375","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16375","description":"CPT-16375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACF0","description":"ICD-OACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHE1","description":"ICD-NJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKD1","description":"ICD-KIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIE1","description":"ICD-NBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBED0","description":"ICD-KBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 std mult pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0885","description":"Pwc gp4 std mult pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33774","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC111","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGA1","description":"ICD-NHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDA0","description":"ICD-MGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTB0","description":"ICD-IGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin a1c level >9.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3046F","description":"Hemoglobin a1c level >9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maxillary part denture flex","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5225","description":"Maxillary part denture flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28525","description":"Treat toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1403","description":"HCPCS-B1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2D","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELA1","description":"ICD-OELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOC1","description":"ICD-DAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64865","description":"Repair of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative near-infrared fluorescence lymphatic mapping of lymp node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in add","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9756","description":"Intraoperative near-infrared fluorescence lymphatic mapping of lymp node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLB1","description":"ICD-MDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTD0","description":"ICD-BBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0640U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0640U","description":"CPT-0640U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJD1","description":"ICD-GIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Torsion ank & half solid sti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2375","description":"Torsion ank & half solid sti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correct finger deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26567","description":"Correct finger deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainable plastic pch w fcpl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4375","description":"Drainable plastic pch w fcpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supprelin la implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9226","description":"Supprelin la implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPD0","description":"ICD-BCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIE0","description":"ICD-EFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33287","description":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close bladder-uterus fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51920","description":"Close bladder-uterus fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive hand surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26250","description":"Extensive hand surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFB0","description":"ICD-GCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHC1","description":"ICD-NBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt no ref otolo no spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8568","description":"Pt no ref otolo no spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUD1","description":"ICD-OAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCD0","description":"ICD-KCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65781","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00836","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","description":"CPT-00836","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N blk inj sciatic cont inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64446","description":"N blk inj sciatic cont inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML33","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSE0","description":"ICD-GCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGF0","description":"ICD-OAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHD0","description":"ICD-NHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIC0","description":"ICD-OHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stimulants synthetic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80371","description":"Stimulants synthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXC1","description":"ICD-GCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESC0","description":"ICD-PESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation_ upper extremity_ separate access sites of the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36837","description":"Percutaneous arteriovenous fistula creation_ upper extremity_ separate access sites of the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy finger joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26105","description":"Biopsy finger joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arformoterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7605","description":"Arformoterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incis spine 3 column lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22207","description":"Incis spine 3 column lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp subclav-vertebrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35645","description":"Art byp subclav-vertebrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA111","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2C","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVA1","description":"ICD-CEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66988","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open/perq place stent 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37236","description":"Open/perq place stent 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0519U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","description":"CPT-0519U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIB1","description":"ICD-GHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA105","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJC1","description":"ICD-CGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPE0","description":"ICD-KDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDC0","description":"ICD-AFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADE1","description":"ICD-GADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srs cranial lesion complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61798","description":"Srs cranial lesion complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25450","description":"Revision of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33427","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNC0","description":"ICD-OCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Personal Emergency Response System (Installation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1894","description":"Personal Emergency Response System (Installation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWA1","description":"ICD-OLWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDA1","description":"ICD-KEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral counseling for diabetes prevention_ distance learning_ 60 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9887","description":"Behavioral counseling for diabetes prevention_ distance learning_ 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAA0","description":"ICD-CBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAF1","description":"ICD-NHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSF1","description":"ICD-PDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thigh/wght bear lacer non-mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2530","description":"Thigh/wght bear lacer non-mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computer-aided detection_ including computer algorithm analysis of breast MRI image data for lesion detection/characterization_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8937","description":"Computer-aided detection_ including computer algorithm analysis of breast MRI image data for lesion detection/characterization_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAC0","description":"ICD-FHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWE1","description":"ICD-PJWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ acute myeloid leukemia_ myelodysplastic syndrome_ and myeloproliferative neoplasms_ DNA analysis_ 23 genes_ interrogation for sequenc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171U","description":"Targeted genomic sequence analysis panel_ acute myeloid leukemia_ myelodysplastic syndrome_ and myeloproliferative neoplasms_ DNA analysis_ 23 genes_ interrogation for sequenc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess inc xray docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3340F","description":"Mammo assess inc xray docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGD0","description":"ICD-NFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB120","description":"Reduced Physical Function _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65870","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient transfer system >300","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1036","description":"Patient transfer system >300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41827","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA235","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL12","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8X","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDE0","description":"ICD-GDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28I","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kerecis omega3 marigen shield_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2019","description":"Kerecis omega3 marigen shield_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXC0","description":"ICD-KAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation caregiver is trained and certified in dementia care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2185","description":"Documentation caregiver is trained and certified in dementia care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HIV-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87391","description":"IAAD IA HIV-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJB0","description":"ICD-JIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEE1","description":"ICD-OLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFID1","description":"ICD-GFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXA1","description":"ICD-FFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELB1","description":"ICD-KELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen quant gabapentin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80171","description":"Drug screen quant gabapentin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antipsychotics nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80344","description":"Antipsychotics nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTC1","description":"ICD-ICTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQC1","description":"ICD-PJQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTD1","description":"ICD-BDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ An","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2069","description":"Medication Assisted Treatment_ Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOB0","description":"ICD-KBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBE0","description":"ICD-OBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB21","description":"ICD-1IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEB1","description":"ICD-BEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEA0","description":"ICD-CDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72131","description":"Ct lumbar spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXF1","description":"ICD-BDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWA0","description":"ICD-OCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVE0","description":"ICD-OGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m sulfur colloid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9541","description":"Tc99m sulfur colloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESF0","description":"ICD-GESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX25","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50783","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXB0","description":"ICD-GBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47554","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1737","description":"HCPCS-C1737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31605","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX26","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor liver whole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47143","description":"Prep donor liver whole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGED1","description":"ICD-GGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMC0","description":"ICD-GDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGA0","description":"ICD-ODGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMF1","description":"ICD-IHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMD1","description":"ICD-GCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9907","description":"Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSE1","description":"ICD-KGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Focusing on women_s health mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1366","description":"Focusing on women_s health mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAB1","description":"ICD-OAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXD0","description":"ICD-OGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUF0","description":"ICD-JGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNE0","description":"ICD-NBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITF1","description":"ICD-AITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transthor diaphrag hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43335","description":"Transthor diaphrag hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray stereo frontal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71015","description":"Chest x-ray stereo frontal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDB0","description":"ICD-FEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSA0","description":"ICD-CFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGC0","description":"ICD-OLGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYE1","description":"ICD-LHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUC1","description":"ICD-GAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27350","description":"Removal of kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAC1","description":"ICD-KEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGE0","description":"ICD-KEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCD0","description":"ICD-OCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEC1","description":"ICD-OIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 2.6-5.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12052","description":"Intmd rpr face/mm 2.6-5.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBE1","description":"ICD-ICBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBB1","description":"ICD-KEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETC1","description":"ICD-GETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX16","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mold socket ank hgt w/ toe f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5010","description":"Mold socket ank hgt w/ toe f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28D","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIE1","description":"ICD-MHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0238","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","description":"HCPCS-M0238","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Map tachycardia add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93609","description":"Map tachycardia add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixed appliance therapy habt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8220","description":"Fixed appliance therapy habt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Typhoid vaccine oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90690","description":"Typhoid vaccine oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB254","description":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx gastric no recurrence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9100","description":"Onc dx gastric no recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUB0","description":"ICD-EHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX36","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alkaloids_ urine_ quantitative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6041","description":"Alkaloids_ urine_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M.avium-intra dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87562","description":"M.avium-intra dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXD0","description":"ICD-GAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Core build-up incl any pins","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2950","description":"Core build-up incl any pins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYC1","description":"ICD-GHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHA1","description":"ICD-KIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEA0","description":"ICD-MJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67971","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWF0","description":"ICD-GAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIB1","description":"ICD-GIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Critical care first hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99291","description":"Critical care first hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDD1","description":"ICD-CEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCE1","description":"ICD-MHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ferumoxytol_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0138","description":"Ferumoxytol_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35261","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair single ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33619","description":"Repair single ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj heparin sodium per 10 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1642","description":"Inj heparin sodium per 10 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEA0","description":"ICD-JIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9763","description":"Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pin ulnar styloid fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25651","description":"Pin ulnar styloid fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/tr/ext 7.6-12.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12034","description":"Intmd rpr s/tr/ext 7.6-12.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject sinus tract for x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20501","description":"Inject sinus tract for x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKE1","description":"ICD-FDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of bile ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47800","description":"Reconstruction of bile ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVA0","description":"ICD-JBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYB0","description":"ICD-OLYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy supply misc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4421","description":"Ostomy supply misc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUC1","description":"ICD-MLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEA0","description":"ICD-GFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull for brain wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61458","description":"Incise skull for brain wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDD0","description":"ICD-ICDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 2 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3386F","description":"Ajcc cln cncr stage 2 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL56","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARC0","description":"ICD-CARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50437","description":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFC0","description":"ICD-CAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mnpj of tmj w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21073","description":"Mnpj of tmj w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFD1","description":"ICD-FHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Butorphanol tartrate 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0595","description":"Butorphanol tartrate 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65900","description":"Remove eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFB0","description":"ICD-BCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXE0","description":"ICD-BAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPA1","description":"ICD-OBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infliximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1745","description":"Infliximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reverse osmosis h2o puri sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1610","description":"Reverse osmosis h2o puri sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVF1","description":"ICD-NLVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB02","description":"Medium Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWC0","description":"ICD-CIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transparent film >16<=48 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6258","description":"Transparent film >16<=48 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTE0","description":"ICD-KCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISB1","description":"ICD-HISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUD1","description":"ICD-OFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFID0","description":"ICD-OFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5D","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove radius bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24136","description":"Remove radius bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTE1","description":"ICD-ODTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove tendon sheath lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26160","description":"Remove tendon sheath lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXE1","description":"ICD-GCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26499","description":"Revision of finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ motixafortide_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2277","description":"Injection_ motixafortide_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVE1","description":"ICD-BBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRA1","description":"ICD-KIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Devlopment test interpt&rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0451","description":"Devlopment test interpt&rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUA0","description":"ICD-OBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHB1","description":"ICD-JAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no 30 day f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9403","description":"Doc reas no 30 day f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dementia severity classified_ moderate (DEM)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2033F","description":"Dementia severity classified_ moderate (DEM)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cyclosporine oral 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7502","description":"Cyclosporine oral 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFA0","description":"ICD-FEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIB1","description":"ICD-JEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJB0","description":"ICD-FBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE124","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Central dexa ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3096F","description":"Central dexa ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKE0","description":"ICD-GHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOB0","description":"ICD-OEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEC1","description":"ICD-ADEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86052","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUB1","description":"ICD-ABUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rb82 rubidium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9555","description":"Rb82 rubidium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vent mgmt inpat init day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94002","description":"Vent mgmt inpat init day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73085","description":"Contrast x-ray of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35281","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJB0","description":"ICD-CBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64901","description":"Nerve graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYA0","description":"ICD-LBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRC1","description":"ICD-DHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0879T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMF1","description":"ICD-EGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTC1","description":"ICD-OCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATA1","description":"ICD-IATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99374","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABC1","description":"ICD-GABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKD0","description":"ICD-CDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMF0","description":"ICD-KFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opto-acoustic imaging_ breast_ unilateral_ including axilla when performed_ real-time with image documentation_ augmentative analysis and report (List separately in addition t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0857T","description":"Opto-acoustic imaging_ breast_ unilateral_ including axilla when performed_ real-time with image documentation_ augmentative analysis and report (List separately in addition t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINE1","description":"ICD-JINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBB0","description":"ICD-AGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ guselkumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9029","description":"Injection_ guselkumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBB0","description":"ICD-JGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAA0","description":"ICD-JAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMD1","description":"ICD-IGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSF0","description":"ICD-KDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALE0","description":"ICD-MALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE111","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment_ history obtained from pati","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0505","description":"Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment_ history obtained from pati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIE0","description":"ICD-IEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0535U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","description":"CPT-0535U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oth resp proc_ indiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0238","description":"Oth resp proc_ indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transseptal fiberotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7291","description":"Transseptal fiberotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEF0","description":"ICD-CGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt no ther chg or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9650","description":"Doc pt no ther chg or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJC0","description":"ICD-BHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Duodenal motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91022","description":"Duodenal motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIB0","description":"ICD-FCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42665","description":"Ligation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMA0","description":"ICD-FIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patten bottom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2370","description":"Patten bottom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBE0","description":"ICD-CIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair art intramural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33507","description":"Repair art intramural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMC0","description":"ICD-KIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vehicle mod waiver/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2039","description":"Vehicle mod waiver/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic analysis of vestibular implant_ unilateral; with initial programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0728T","description":"Diagnostic analysis of vestibular implant_ unilateral; with initial programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOA0","description":"ICD-DGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBA0","description":"ICD-AHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECE1","description":"ICD-KECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELA0","description":"ICD-MELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI_ Rorschach_ WAIS)_ per hour of t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96101","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI_ Rorschach_ WAIS)_ per hour of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62141","description":"Repair of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMD1","description":"ICD-EIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped specmetabolic inherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4162","description":"Ef ped specmetabolic inherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAD1","description":"ICD-MBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol renal-amirosy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5000","description":"Parenteral sol renal-amirosy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Design mlc device for imrt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77338","description":"Design mlc device for imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA16","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chronic b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2175","description":"Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chronic b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of multivisc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2054","description":"Transplantation of multivisc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5172","description":"HCPCS-Q5172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKF1","description":"ICD-OGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apc gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81202","description":"Apc gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNE0","description":"ICD-CFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (Teva) not therapeutically equivalent to J9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9314","description":"Injection_ pemetrexed (Teva) not therapeutically equivalent to J9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy w/markers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31626","description":"Bronchoscopy w/markers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11A","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29710","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental other tmj films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0321","description":"Dental other tmj films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXA1","description":"ICD-OIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant ureter in bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50800","description":"Implant ureter in bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0237","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","description":"HCPCS-Q0237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exome (ie_ somatic mutations)_ paired formalin-fixed paraffin-embedded tumor tissue and normal specimen_ sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0036U","description":"Exome (ie_ somatic mutations)_ paired formalin-fixed paraffin-embedded tumor tissue and normal specimen_ sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of homocystine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83090","description":"Assay of homocystine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"repair resin partial denture base_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5612","description":"repair resin partial denture base_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKD0","description":"ICD-BDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal function studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92512","description":"Nasal function studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values_ with analysis_ review_ and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0528T","description":"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values_ with analysis_ review_ and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXF0","description":"ICD-OAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4354","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","description":"HCPCS-Q4354","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIA1","description":"ICD-KBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCC1","description":"ICD-KBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","description":"HCPCS-L6034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed semi-electr w/ matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0260","description":"Hosp bed semi-electr w/ matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOF0","description":"ICD-GGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHF1","description":"ICD-GGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIB0","description":"ICD-IAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIE1","description":"ICD-OFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8I","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVC1","description":"ICD-OIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Did Not Receive An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period; Or Did Not Have A Prior In","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2165","description":"Patient Did Not Receive An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period; Or Did Not Have A Prior In","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mogamulizumab-kpkc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9204","description":"Injection_ mogamulizumab-kpkc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22D","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLE1","description":"ICD-EGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMB0","description":"ICD-IHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXA1","description":"ICD-CBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genetic test brugada","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3861","description":"Genetic test brugada","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIE1","description":"ICD-OKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMB0","description":"ICD-ABMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25130","description":"Removal of wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx cesium-131 chloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2644","description":"Brachytx cesium-131 chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALC0","description":"ICD-FALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95832","description":"Hand muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Translum dil eye canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66174","description":"Translum dil eye canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric wheelchair nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1229","description":"Pediatric wheelchair nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWE0","description":"ICD-CGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clin tx mdd comm to tx clin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8959","description":"Clin tx mdd comm to tx clin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGB1","description":"ICD-JEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp5 ped sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0890","description":"Pwc gp5 ped sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allogen_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4212","description":"Allogen_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19499","description":"Breast surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAF1","description":"ICD-KGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUD0","description":"ICD-IFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contour of face bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21029","description":"Contour of face bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7567","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7567","description":"HCPCS-C7567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening tapentadol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80372","description":"Drug screening tapentadol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13A","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Participant-Directed Community Supports","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1900","description":"Participant-Directed Community Supports","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJA1","description":"ICD-OHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYTOG CONST ALYS INTERROG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0209U","description":"CYTOG CONST ALYS INTERROG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPB1","description":"ICD-OFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOD0","description":"ICD-LDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVD0","description":"ICD-JIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter w/bag 3-way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4313","description":"Catheter w/bag 3-way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJE0","description":"ICD-JDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev care mg qual act perfrm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8496","description":"Prev care mg qual act perfrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB111","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADF1","description":"ICD-FADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replc sockt above elbow disa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6884","description":"Replc sockt above elbow disa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHC1","description":"ICD-GBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYD1","description":"ICD-DAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVE0","description":"ICD-NJVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11471","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Had smoke b/4 anes day surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9645","description":"Had smoke b/4 anes day surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2205","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse upper gi structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47721","description":"Fuse upper gi structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELC0","description":"ICD-EELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraop oct brst/node spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0351T","description":"Intraop oct brst/node spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (prior disease)_ cerebrospinal fluid_ detection of prion protein by quaking-induced conf conversion_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0035U","description":"Neurology (prior disease)_ cerebrospinal fluid_ detection of prion protein by quaking-induced conf conversion_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apligraf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4101","description":"Apligraf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJD1","description":"ICD-GHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl artific disc addl crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0095T","description":"Rmvl artific disc addl crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKF1","description":"ICD-OJKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLD1","description":"ICD-FCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24546","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFE1","description":"ICD-BCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0403","description":"HCPCS-B0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAB0","description":"ICD-AIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEA1","description":"ICD-KGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1805","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1805","description":"CDT-D1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair narrowing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0969","description":"Wheelchair narrowing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Care coord at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9477","description":"Care coord at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJD0","description":"ICD-BFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEA0","description":"ICD-OBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB155","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAF0","description":"ICD-ADAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB31","description":"ICD-4HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cesarean delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59515","description":"Cesarean delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUC1","description":"ICD-AGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43107","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUC0","description":"ICD-KIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHC1","description":"ICD-MFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNA0","description":"ICD-GHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWA0","description":"ICD-GHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX02","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68135","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNF1","description":"ICD-BHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKE1","description":"ICD-NCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasonic generator w svneb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0574","description":"Ultrasonic generator w svneb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54860","description":"Removal of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINF0","description":"ICD-GINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIA0","description":"ICD-KHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHD0","description":"ICD-GCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTD1","description":"ICD-MBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUD1","description":"ICD-OJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJE0","description":"ICD-BFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abrasion lesion single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15786","description":"Abrasion lesion single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12B","description":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone/skin graft great toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20973","description":"Bone/skin graft great toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject spine w/cath lmb/scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62319","description":"Inject spine w/cath lmb/scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKC0","description":"ICD-OHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0598U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","description":"CPT-0598U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8E","description":"Low Rehab_ ADL Index 0-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0150U","description":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRB0","description":"ICD-PFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVB1","description":"ICD-KIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98980","description":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph scope w/sclerosis inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43204","description":"Esoph scope w/sclerosis inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTF1","description":"ICD-IBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKF1","description":"ICD-JFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCID1","description":"ICD-KCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65800","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67908","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21450","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed total elec w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0266","description":"Hosp bed total elec w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ BICROS_ behind the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5220","description":"Hearing aid_ BICROS_ behind the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27700","description":"Revision of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resin two surfaces-anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2331","description":"Resin two surfaces-anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYF1","description":"ICD-CHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPD1","description":"ICD-KBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOA1","description":"ICD-CIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18D","description":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWC1","description":"ICD-GBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAE1","description":"ICD-MDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTF0","description":"ICD-MLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHA0","description":"ICD-IHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEC1","description":"ICD-BBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caffeine citrate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0706","description":"Caffeine citrate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exercise Test For Bronchospasm_ Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94619","description":"Exercise Test For Bronchospasm_ Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABA1","description":"ICD-GABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level III_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0752T","description":"Digitization of glass microscope slides for level III_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCID0","description":"ICD-GCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAED0","description":"ICD-GAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBF1","description":"ICD-MLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLF0","description":"ICD-CGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHB0","description":"ICD-KFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEA0","description":"ICD-NIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIC1","description":"ICD-NAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKF0","description":"ICD-FFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove in/ex hem grps & fiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46261","description":"Remove in/ex hem grps & fiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE154","description":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18A","description":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA11","description":"ICD-2LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext ecg complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0295T","description":"Ext ecg complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vitolarsen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1427","description":"Injection_ vitolarsen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMB0","description":"ICD-GAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCID1","description":"ICD-BCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmptr ophth img optic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92133","description":"Cmptr ophth img optic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4413","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","description":"HCPCS-Q4413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARD0","description":"ICD-PARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTF1","description":"ICD-EGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD236","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBA0","description":"ICD-IGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYE0","description":"ICD-PGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBB0","description":"ICD-OJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental recement bridge","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6930","description":"Dental recement bridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXC0","description":"ICD-JHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCC1","description":"ICD-CFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95708","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5938","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5938","description":"CDT-D5938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scan proc spinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61783","description":"Scan proc spinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALC1","description":"ICD-FALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-rays for bone age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77072","description":"X-rays for bone age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diab shoe w/metatarsal bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5505","description":"Diab shoe w/metatarsal bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Salicylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6038","description":"Salicylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOB1","description":"ICD-ODOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1049","description":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Odontics transosteal implnt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6050","description":"Odontics transosteal implnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ESCHERICHIA COLI 0157","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87335","description":"IAAD IA ESCHERICHIA COLI 0157","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10B","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBID0","description":"ICD-IBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0264U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63090","description":"Remove vert body dcmprn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEF0","description":"ICD-ODEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBD1","description":"ICD-CEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDA0","description":"ICD-JFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX02","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ceftaroline fosamil inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0712","description":"Ceftaroline fosamil inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24C","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthodontic retention","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8680","description":"Orthodontic retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGA1","description":"ICD-FFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or ili","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34709","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or ili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELA0","description":"ICD-GELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr guidance for needle place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77021","description":"Mr guidance for needle place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Axolotl graft or axolotl dualgraft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4210","description":"Axolotl graft or axolotl dualgraft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ talimogene laherparepvec_ per 1 million plaque forming units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9325","description":"Injection_ talimogene laherparepvec_ per 1 million plaque forming units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cochlear implt f/up exam 7/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92603","description":"Cochlear implt f/up exam 7/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC226","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYF0","description":"ICD-GEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMC0","description":"ICD-EGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair brow defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67900","description":"Repair brow defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1806","description":"HCPCS-A1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARB0","description":"ICD-OARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAC0","description":"ICD-CEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supported housing_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0043","description":"Supported housing_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Omental flap extra-abdom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49904","description":"Omental flap extra-abdom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13A","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCC1","description":"ICD-NJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDB1","description":"ICD-JDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cough stimulating device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0482","description":"Cough stimulating device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLA0","description":"ICD-IFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACE0","description":"ICD-KACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFA1","description":"ICD-NDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 2-3 vsts p mo <2yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90952","description":"Esrd serv 2-3 vsts p mo <2yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transposition ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58825","description":"Transposition ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBE1","description":"ICD-OKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFE0","description":"ICD-KAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXF0","description":"ICD-JHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKC1","description":"ICD-JBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITF0","description":"ICD-NITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment mouth roof lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42160","description":"Treatment mouth roof lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert pulse gen mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33221","description":"Insert pulse gen mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTF1","description":"ICD-OJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITC0","description":"ICD-EITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22B","description":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ melphalan flufenamide hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9080","description":"Injection_ melphalan flufenamide hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVF1","description":"ICD-CFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQF0","description":"ICD-KEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of 65 common drugs by LC-MS/MS_ urine_ each drug reported detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0093U","description":"Prescription drug monitoring_ evaluation of 65 common drugs by LC-MS/MS_ urine_ each drug reported detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYE1","description":"ICD-PFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep ak ischial open end","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5585","description":"Prep ak ischial open end","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEB1","description":"ICD-EIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMF0","description":"ICD-IIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Testosterone response","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80414","description":"Testosterone response","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUB0","description":"ICD-MFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTF1","description":"ICD-AHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplant related per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9975","description":"Transplant related per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXA1","description":"ICD-FBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOE1","description":"ICD-OFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61860","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMC0","description":"ICD-IHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUD1","description":"ICD-IBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFC1","description":"ICD-NLFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23420","description":"Repair of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYD0","description":"ICD-DHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33875","description":"Thoracic aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYE0","description":"ICD-DAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUD1","description":"ICD-NFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA120","description":"Reduced Physical Function _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYE0","description":"ICD-DBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28755","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDF1","description":"ICD-EGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ coated/cov w/o del sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1875","description":"Stent_ coated/cov w/o del sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein access cutdown < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36420","description":"Vein access cutdown < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUB0","description":"ICD-BBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect arm/elbow tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24079","description":"Resect arm/elbow tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open red simp malar/zygom fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7650","description":"Open red simp malar/zygom fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUB1","description":"ICD-FCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCA0","description":"ICD-OKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIE0","description":"ICD-MFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAA0","description":"ICD-KDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject skin lesions </w 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11900","description":"Inject skin lesions </w 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAA0","description":"ICD-EEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24A","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTD1","description":"ICD-GCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ck (cpk)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82550","description":"Assay of ck (cpk)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUE1","description":"ICD-BDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge noble metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6212","description":"Bridge noble metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDED0","description":"ICD-GDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Outrigger bil w/ vert extens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1085","description":"Outrigger bil w/ vert extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair rotator cuff acute","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23410","description":"Repair rotator cuff acute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGE0","description":"ICD-GEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMB1","description":"ICD-KCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of serum potassium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84132","description":"Assay of serum potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKB0","description":"ICD-KCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL06","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGB1","description":"ICD-NKGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rh ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90386","description":"Rh ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEE0","description":"ICD-JDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPD1","description":"ICD-BGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interface_ cough stim device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7020","description":"Interface_ cough stim device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Specialized Medical Equipment and Supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0137","description":"Specialized Medical Equipment and Supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31230","description":"Removal of upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNE0","description":"ICD-GBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Depo-estradiol cypionate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1000","description":"Depo-estradiol cypionate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBB0","description":"ICD-JDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOA0","description":"ICD-DAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55040","description":"Removal of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBD1","description":"ICD-IEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDF0","description":"ICD-MBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRD1","description":"ICD-PDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBD0","description":"ICD-JDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRA1","description":"ICD-GBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ artesunate_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0391","description":"Injection_ artesunate_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hm preeclamp per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9213","description":"Hm preeclamp per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Assessment_ Or Re-Assessment (Ie_ Health-Focused Clinical Interview_ Behavioral Observations_ Clinical Decision Making)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96156","description":"Health Behavior Assessment_ Or Re-Assessment (Ie_ Health-Focused Clinical Interview_ Behavioral Observations_ Clinical Decision Making)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL50","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Er/ip hosp =/>2 in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9522","description":"Er/ip hosp =/>2 in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76140","description":"X-ray consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic compression controller with sequential calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0680","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDB0","description":"ICD-KHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAD0","description":"ICD-GFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37232","description":"Tib/per revasc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHB1","description":"ICD-EDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MYD88 (myeloid differentiation primary response 88) (eg_ Waldenstrom_s macroglobulinemia_ lymphoplasmacytic leukemia) gene analysis_ p.Leu265Pro (L265P) variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81305","description":"MYD88 (myeloid differentiation primary response 88) (eg_ Waldenstrom_s macroglobulinemia_ lymphoplasmacytic leukemia) gene analysis_ p.Leu265Pro (L265P) variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1073T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1073T","description":"CPT-1073T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20D","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report_ unilateral or b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92242","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report_ unilateral or b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQE0","description":"ICD-GIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSC1","description":"ICD-HFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-2 piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21146","description":"Lefort i-2 piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQA0","description":"ICD-DIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26392","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPD0","description":"ICD-FIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aldosterone suppression eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80408","description":"Aldosterone suppression eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg_ colorectal cancer) promoter methylation analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0229U","description":"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg_ colorectal cancer) promoter methylation analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of sexual activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9818","description":"Documentation of sexual activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hair trnspl >15 punch grafts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15776","description":"Hair trnspl >15 punch grafts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Vedolizumab_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9026","description":"Injection_ Vedolizumab_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTA1","description":"ICD-OKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTA0","description":"ICD-FCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01844","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","description":"CPT-01844","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELE0","description":"ICD-JELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYD1","description":"ICD-KFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBE1","description":"ICD-IBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLD0","description":"ICD-MBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOC1","description":"ICD-HFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Incomplete Abortion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X2060","description":"Hospital Special Treatment Room Support Component (Hstrsc) Incomplete Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","description":"HCPCS-L6032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASA1","description":"ICD-KASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALF0","description":"ICD-JALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEF1","description":"ICD-EEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88304","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX13","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD150","description":"Clinically Complex _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECA0","description":"ICD-EECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKB0","description":"ICD-OIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAC0","description":"ICD-EBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB125","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Had History Of At Least One Of The Following Contraindications Any Time During Or Before The Measurement Period: Anaphylaxis Due To Tdap Vaccine_ Anaphylaxis Due To Td","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2155","description":"Patient Had History Of At Least One Of The Following Contraindications Any Time During Or Before The Measurement Period: Anaphylaxis Due To Tdap Vaccine_ Anaphylaxis Due To Td","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTA1","description":"ICD-NCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m exametazime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9521","description":"Tc99m exametazime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat odontoid fx w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22319","description":"Treat odontoid fx w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16371","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16371","description":"CPT-16371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74430","description":"Contrast x-ray bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELC0","description":"ICD-NELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAF0","description":"ICD-OHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDC0","description":"ICD-IEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLB0","description":"ICD-IBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-expandable controller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2375","description":"Non-expandable controller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23D","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6535","description":"Gc stocking thighlngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session_ core maintenance session_ or ongoing maintenance session furnished b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9890","description":"Bridge payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session_ core maintenance session_ or ongoing maintenance session furnished b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ThyGeNEXT® Thyroid Oncogene Panel_ Interpace Diagnostics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0245U","description":"ThyGeNEXT® Thyroid Oncogene Panel_ Interpace Diagnostics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRB0","description":"ICD-KIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC240","description":"Special Care Low _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUA0","description":"ICD-OLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hbot_ full body chamber_ 30m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0277","description":"Hbot_ full body chamber_ 30m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14B","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUE1","description":"ICD-KFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOA1","description":"ICD-LFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lecanemab-irmb_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0174","description":"Injection_ lecanemab-irmb_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of subcutaneous peritoneal ascites pump system_ percutaneous_ including pump-pocket creation_ insertion of tunneled indwelling bladder and peritoneal catheters wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0870T","description":"Implantation of subcutaneous peritoneal ascites pump system_ percutaneous_ including pump-pocket creation_ insertion of tunneled indwelling bladder and peritoneal catheters wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWD1","description":"ICD-DDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5272","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILE1","description":"ICD-JILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (anxiety disorders)_ mRNA_ gene expression profiling by RNA sequencing of 15 biomarkers_ whole blood_ algorithm reported as predictive risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0437U","description":"Psychiatry (anxiety disorders)_ mRNA_ gene expression profiling by RNA sequencing of 15 biomarkers_ whole blood_ algorithm reported as predictive risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPB0","description":"ICD-JGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electromagnetic therapy onc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0295","description":"Electromagnetic therapy onc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDE0","description":"ICD-GIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove groin lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38765","description":"Remove groin lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPD1","description":"ICD-GAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBA0","description":"ICD-EDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy & polypectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45333","description":"Sigmoidoscopy & polypectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mediastinoscopy_ with or without biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39400","description":"Mediastinoscopy_ with or without biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGD1","description":"ICD-OJGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTF1","description":"ICD-MBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIF1","description":"ICD-FEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA231","description":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of inf vena cava","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37619","description":"Ligation of inf vena cava","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAA1","description":"ICD-MCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB11","description":"ICD-1DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBA0","description":"ICD-GCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFE0","description":"ICD-CAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respirator motion mgmt simul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77293","description":"Respirator motion mgmt simul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8F","description":"High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGE0","description":"ICD-JEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUB1","description":"ICD-AGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecg/review interpret only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93272","description":"Ecg/review interpret only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIB0","description":"ICD-OKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVE0","description":"ICD-FAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ olipudase alfa-rpcp_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0218","description":"Injection_ olipudase alfa-rpcp_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKC0","description":"ICD-CBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Islet cell tissue transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2102","description":"Islet cell tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colorec ca scr_ sto bas dna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0464","description":"Colorec ca scr_ sto bas dna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54800","description":"Biopsy of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect thigh/knee tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27364","description":"Resect thigh/knee tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGB1","description":"ICD-CCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral dexamethasone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8540","description":"Oral dexamethasone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPE1","description":"ICD-GBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Feces culture aerobic bact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87045","description":"Feces culture aerobic bact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); each additional 30 minutes of technicians","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0374T","description":"Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); each additional 30 minutes of technicians","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBE1","description":"ICD-FGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJE1","description":"ICD-GIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXA1","description":"ICD-CDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise/drain tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68420","description":"Incise/drain tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of finger abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26011","description":"Drainage of finger abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFD1","description":"ICD-NLFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLA1","description":"ICD-OBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIC0","description":"ICD-AGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-91323","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","description":"CPT-91323","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNF0","description":"ICD-BGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraop colon lavage add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44701","description":"Intraop colon lavage add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ercp w/optical endomicroscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0397T","description":"Ercp w/optical endomicroscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHC1","description":"ICD-KEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy dose plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77300","description":"Radiation therapy dose plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCA0","description":"ICD-BGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair ventrl hern block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49566","description":"Rerepair ventrl hern block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHE1","description":"ICD-KAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOF0","description":"ICD-PDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXA1","description":"ICD-CAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33735","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB11","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVA1","description":"ICD-FAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB251","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gene test hippel-lindau","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3842","description":"Gene test hippel-lindau","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMB0","description":"ICD-MJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLA1","description":"ICD-NHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMB1","description":"ICD-JDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g._ inside-out technique)_ including imaging guidance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9780","description":"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g._ inside-out technique)_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE130","description":"Clinically Complex _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTA0","description":"ICD-ICTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTD0","description":"ICD-KDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular photodynamic ther","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67221","description":"Ocular photodynamic ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28F","description":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70480","description":"Ct orbit/ear/fossa w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25B","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGB0","description":"ICD-NAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJC0","description":"ICD-KBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWB0","description":"ICD-HCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYC1","description":"ICD-CGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15D","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFF0","description":"ICD-CDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped home apnea rec report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94777","description":"Ped home apnea rec report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of bursa of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28001","description":"Drainage of bursa of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISD0","description":"ICD-CISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMB0","description":"ICD-FCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRD1","description":"ICD-HBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLC1","description":"ICD-EBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove pulmonary shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33924","description":"Remove pulmonary shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIED0","description":"ICD-AIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic graft facial bones","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7995","description":"Synthetic graft facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDC1","description":"ICD-KHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excavation of a tooth resulting in the determination of non-restorability","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2989","description":"Excavation of a tooth resulting in the determination of non-restorability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95147","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTE0","description":"ICD-AHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASF0","description":"ICD-HASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABE1","description":"ICD-BABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Veritas collagen matrix_ cm2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9354","description":"Veritas collagen matrix_ cm2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc w/ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37229","description":"Tib/per revasc w/ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCE0","description":"ICD-NKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC245","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy/needle bx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31633","description":"Bronchoscopy/needle bx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FlowerDerm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4179","description":"FlowerDerm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIE0","description":"ICD-ACIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCF1","description":"ICD-CGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc order cefazolin/cefurox","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4041F","description":"Doc order cefazolin/cefurox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of neck of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27161","description":"Incision of neck of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADC1","description":"ICD-GADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXE1","description":"ICD-OGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of calcium in urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82340","description":"Assay of calcium in urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEF0","description":"ICD-NLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXF1","description":"ICD-FAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGC1","description":"ICD-ODGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXE0","description":"ICD-JFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ctr mount pwr elev leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1012","description":"Ctr mount pwr elev leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add le poly knee custom kafo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2387","description":"Add le poly knee custom kafo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYC1","description":"ICD-PJYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUB1","description":"ICD-OJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 13_ 18_ and 21)_ DNA sequence analysis of selected regions using maternal plasma_ algorithm reported as a risk score for each trisomy_ includes sex r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0327U","description":"Fetal aneuploidy (trisomy 13_ 18_ and 21)_ DNA sequence analysis of selected regions using maternal plasma_ algorithm reported as a risk score for each trisomy_ includes sex r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX07","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHA1","description":"ICD-OHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"T3 reverse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84482","description":"T3 reverse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAD1","description":"ICD-GBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Janssen Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1712","description":"Janssen Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2043","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","description":"HCPCS-A2043","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of topiramate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80201","description":"Assay of topiramate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAB1","description":"ICD-EFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUC1","description":"ICD-NIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD246","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHE1","description":"ICD-MDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOC1","description":"ICD-OLOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep c antiviral started","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9205","description":"Hep c antiviral started","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHD0","description":"ICD-NDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB11","description":"ICD-4KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Daclizumab_ parenteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7513","description":"Daclizumab_ parenteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59325","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HPYLORI","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87339","description":"IAAD IA HPYLORI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAA0","description":"ICD-IIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA134","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast add lesion us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19084","description":"Bx breast add lesion us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/hemodynam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75885","description":"Vein x-ray liver w/hemodynam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28104","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWF0","description":"ICD-OEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as an unhealthy alcohol user received brief counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2200","description":"Patient identified as an unhealthy alcohol user received brief counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01214","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","description":"CPT-01214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1957","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1957","description":"HCPCS-J1957","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCB0","description":"ICD-KCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWC1","description":"ICD-DFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52285","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01820","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","description":"CPT-01820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50951","description":"Endoscopy of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0606U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","description":"CPT-0606U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQE1","description":"ICD-KFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval self-assess depression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3005","description":"Eval self-assess depression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCB0","description":"ICD-OGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDF1","description":"ICD-EHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYE0","description":"ICD-GCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUB1","description":"ICD-GDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHA0","description":"ICD-MEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKE1","description":"ICD-GAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXC0","description":"ICD-NJXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9275","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","description":"HCPCS-J9275","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing rbc antigens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86905","description":"Blood typing rbc antigens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIF0","description":"ICD-KBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc hand tum deep < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26116","description":"Exc hand tum deep < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBC0","description":"ICD-OHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01916","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","description":"CPT-01916","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSC0","description":"ICD-HBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ gene expression profiling by RTqPCR_ <i>PRAME</i> and <i>LINC00518</i>_ superficial collection using adhesive patch(es)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0089U","description":"Oncology (melanoma)_ gene expression profiling by RTqPCR_ <i>PRAME</i> and <i>LINC00518</i>_ superficial collection using adhesive patch(es)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA41","description":"Very High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medrsn no pt category","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9292","description":"Medrsn no pt category","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBA0","description":"ICD-CDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFA0","description":"ICD-GAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEF0","description":"ICD-FCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEA1","description":"ICD-GGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKA1","description":"ICD-NDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE125","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01942","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","description":"CPT-01942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27786","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59410","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPC0","description":"ICD-KAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAF0","description":"ICD-JIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAA1","description":"ICD-IBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFD1","description":"ICD-JAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOC0","description":"ICD-GIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCC1","description":"ICD-NDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove intrvas foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37197","description":"Remove intrvas foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAD1","description":"ICD-CGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBF1","description":"ICD-KBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autologous prp for ulcers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0460","description":"Autologous prp for ulcers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathogen(s) test for platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9100","description":"Pathogen(s) test for platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nafcillin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0032","description":"Injection_ nafcillin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGD0","description":"ICD-NDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGA1","description":"ICD-JBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown full noble metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6792","description":"Crown full noble metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59821","description":"Treatment of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMA1","description":"ICD-BDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI angio abdom w orw/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74185","description":"MRI angio abdom w orw/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited ankle motion ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2200","description":"Limited ankle motion ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVC0","description":"ICD-JAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of imipramine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6036","description":"Assay of imipramine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFF1","description":"ICD-BCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCD0","description":"ICD-BDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainable rubber pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4378","description":"Drainable rubber pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOC0","description":"ICD-KFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Morphine sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2270","description":"Morphine sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lepirudin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1945","description":"Lepirudin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove in/ex hem grp w/fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46258","description":"Remove in/ex hem grp w/fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore chest vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35820","description":"Explore chest vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVD1","description":"ICD-KFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73525","description":"Contrast x-ray of hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1122","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLB1","description":"ICD-OHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lab labial veneer resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2961","description":"Lab labial veneer resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD114","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWE1","description":"ICD-DDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTA0","description":"ICD-MHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUA0","description":"ICD-CFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUE1","description":"ICD-OHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWA0","description":"ICD-HIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB31","description":"ICD-1BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHE0","description":"ICD-IFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKE1","description":"ICD-JHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for ureter x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50690","description":"Injection for ureter x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNC1","description":"ICD-OJNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMB0","description":"ICD-ACMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPA0","description":"ICD-GAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBA1","description":"ICD-NFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDC0","description":"ICD-BFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25A","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJD1","description":"ICD-BDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00640","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","description":"CPT-00640","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFD1","description":"ICD-JFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj test 9-10 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95911","description":"Nrv cndj test 9-10 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","description":"HCPCS-M1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPD0","description":"ICD-NFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLD1","description":"ICD-IHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESA0","description":"ICD-HESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSA0","description":"ICD-OCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC235","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67005","description":"Partial removal of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB234","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL05","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1008T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","description":"CPT-1008T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 15 genotyping (HPA-15)_ CD109 (CD109 molecule) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion purpura)_ gene analysis_ common varian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81112","description":"Human Platelet Antigen 15 genotyping (HPA-15)_ CD109 (CD109 molecule) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion purpura)_ gene analysis_ common varian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood glucose/reagent strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4253","description":"Blood glucose/reagent strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Brixadi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9154","description":"Injection_ buprenorphine extended-release (Brixadi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDD1","description":"ICD-JEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9846","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBC1","description":"ICD-BGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Streptokinase antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86590","description":"Streptokinase antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRF0","description":"ICD-DDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Init bk ptb plaster direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5500","description":"Init bk ptb plaster direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam/fabric leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5114","description":"Foam/fabric leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA03","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC21","description":"ICD-3FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 5 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP05","description":"Auto.test pane pricing code_ 5 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKB0","description":"ICD-OAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tmj condyle","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7840","description":"Removal of tmj condyle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXE1","description":"ICD-NJXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBF0","description":"ICD-IEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWD1","description":"ICD-KCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBB1","description":"ICD-CGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chap services at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9473","description":"Chap services at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEB1","description":"ICD-JCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1603","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1603","description":"CDT-D1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iron sucrose injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1756","description":"Iron sucrose injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE245","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB50","description":"Medium Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALF1","description":"ICD-MALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31375","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sc ther infusion reset pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96371","description":"Sc ther infusion reset pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMB1","description":"ICD-EHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complex lymphedema therapy_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8950","description":"Complex lymphedema therapy_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hib-hepb vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90748","description":"Hib-hepb vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOE0","description":"ICD-GDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 9 genotyping (HPA-9w)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex_ antigen CD41] [GPIIb]) (eg_ neonatal alloimmune thromb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81111","description":"Human Platelet Antigen 9 genotyping (HPA-9w)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex_ antigen CD41] [GPIIb]) (eg_ neonatal alloimmune thromb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGC1","description":"ICD-CEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nushield 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4160","description":"Nushield 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tandem cuff","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53444","description":"Insert tandem cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99255","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMF1","description":"ICD-KDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c vent tray fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1029","description":"W/c vent tray fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE156","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place gastrostomy tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49440","description":"Place gastrostomy tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB51","description":"Very High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAC1","description":"ICD-MIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIF0","description":"ICD-KEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIA1","description":"ICD-AGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22C","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wedge resect of lung diag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32507","description":"Wedge resect of lung diag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTF0","description":"ICD-GBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIE0","description":"ICD-ECIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq transcath closure pda","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93582","description":"Perq transcath closure pda","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPB1","description":"ICD-JCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic vein harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33508","description":"Endoscopic vein harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grp a strep test performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3210F","description":"Grp a strep test performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVB0","description":"ICD-FBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGED0","description":"ICD-AGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMA1","description":"ICD-OBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUF0","description":"ICD-FAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50395","description":"Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOD0","description":"ICD-LFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB215","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx dprsd zygomatic arch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21356","description":"Opn tx dprsd zygomatic arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBD0","description":"ICD-BDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKF1","description":"ICD-KBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTA1","description":"ICD-BHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVC0","description":"ICD-NIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer tendon to pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27098","description":"Transfer tendon to pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAB0","description":"ICD-MJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAA0","description":"ICD-EDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDB1","description":"ICD-MFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDB0","description":"ICD-MFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27814","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8G","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIF1","description":"ICD-AFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELE1","description":"ICD-MELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMC0","description":"ICD-BIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDB1","description":"ICD-GFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63088","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWA1","description":"ICD-LEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAD1","description":"ICD-JGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hammertoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28286","description":"Repair of hammertoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMF0","description":"ICD-NGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIB0","description":"ICD-BFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXE1","description":"ICD-NFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGD1","description":"ICD-KFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of jaw muscle/bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21295","description":"Revision of jaw muscle/bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCA0","description":"ICD-CFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNE1","description":"ICD-NDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHB0","description":"ICD-OBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTE1","description":"ICD-IGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYC0","description":"ICD-LDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9786","description":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj subq impltbl dfb elctrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33271","description":"Insj subq impltbl dfb elctrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imm admin by intramuscular injection of (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula_ second dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052A","description":"Imm admin by intramuscular injection of (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula_ second dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB11","description":"ICD-1IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCD0","description":"ICD-ACCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for elbow x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24220","description":"Injection for elbow x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplant of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27396","description":"Transplant of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBF0","description":"ICD-AEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAB1","description":"ICD-MCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTA1","description":"ICD-GBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coronary art/grft angio s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93455","description":"Coronary art/grft angio s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHB1","description":"ICD-NEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAID0","description":"ICD-EAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIF0","description":"ICD-BIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAD1","description":"ICD-IBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEF0","description":"ICD-ICEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMC1","description":"ICD-EFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49596","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASD0","description":"ICD-LASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGD0","description":"ICD-NBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGED1","description":"ICD-EGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLD0","description":"ICD-CFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methacholine chloride_ neb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7674","description":"Methacholine chloride_ neb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMA0","description":"ICD-NCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21B","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNB1","description":"ICD-CHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECF0","description":"ICD-MECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21261","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUF1","description":"ICD-MGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGB0","description":"ICD-OFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Macular pigment optical density measurement by heterochromatic flicker photometry_ unilateral or bilateral_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0506T","description":"Macular pigment optical density measurement by heterochromatic flicker photometry_ unilateral or bilateral_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4005","description":"Family Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr umbil hern reduc < 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49580","description":"Rpr umbil hern reduc < 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBD1","description":"ICD-CCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLF1","description":"ICD-JFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pleurectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32656","description":"Thoracoscopy w/pleurectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOA1","description":"ICD-OLOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXE0","description":"ICD-CGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of skin tags <w/15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11200","description":"Removal of skin tags <w/15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAD1","description":"ICD-BFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen dressing >48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6023","description":"Collagen dressing >48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLB0","description":"ICD-IHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evoked auditory test qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92558","description":"Evoked auditory test qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial prenatal care visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0500F","description":"Initial prenatal care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA35","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA204","description":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5995","description":"Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37180","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAC0","description":"ICD-KFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGE0","description":"ICD-CIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69120","description":"Removal of external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC21","description":"ICD-1EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGC1","description":"ICD-NGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMA1","description":"ICD-FDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A5101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5101","description":"HCPCS-A5101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVB0","description":"ICD-GAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic spirometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0487","description":"Electronic spirometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow imaging mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78103","description":"Bone marrow imaging mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0943T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","description":"CPT-0943T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home ventilator_ dual-function respiratory device_ also performs additional function of cough stimulation_ includes all accessories_ components and supplies for all functions","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0468","description":"Home ventilator_ dual-function respiratory device_ also performs additional function of cough stimulation_ includes all accessories_ components and supplies for all functions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cervic collar w air bladders","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0856","description":"Cervic collar w air bladders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAC1","description":"ICD-NIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0773T","description":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWE1","description":"ICD-PBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95712","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIF0","description":"ICD-KCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXC0","description":"ICD-NIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMA0","description":"ICD-IBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKF1","description":"ICD-BEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGE1","description":"ICD-BEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcervical ablation of uterine fibroid(s)_ including intraoperative ultrasound guidance and monitoring_ radiofrequency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58580","description":"Transcervical ablation of uterine fibroid(s)_ including intraoperative ultrasound guidance and monitoring_ radiofrequency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQE1","description":"ICD-PLQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen concentrator_ dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1391","description":"Oxygen concentrator_ dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95148","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUC1","description":"ICD-BFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc hip pelvis les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27043","description":"Exc hip pelvis les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv combination assay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0475","description":"Hiv combination assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMA1","description":"ICD-CBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWD0","description":"ICD-DDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mapcp demo community","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9152","description":"Mapcp demo community","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete sl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4270","description":"Complete sl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flowcytometry/tc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88185","description":"Flowcytometry/tc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial treatment of burn(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16000","description":"Initial treatment of burn(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport meals recip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0190","description":"Noner transport meals recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFC1","description":"ICD-NKFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43195","description":"Esophagoscopy rigid balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj ia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96373","description":"Ther/proph/diag inj ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fluphenazine hcl_ 1.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2679","description":"Injection_ fluphenazine hcl_ 1.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer - Porcelain Fused To Predominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6098","description":"Implant Supported Retainer - Porcelain Fused To Predominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVB0","description":"ICD-OJVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01392","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","description":"CPT-01392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPE1","description":"ICD-NBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJE1","description":"ICD-OBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFB0","description":"ICD-NAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJE0","description":"ICD-OAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral periapical ea add","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0230","description":"Intraoral periapical ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTA1","description":"ICD-EGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHE1","description":"ICD-MGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Igg 1 2 3 or 4 each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82787","description":"Igg 1 2 3 or 4 each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99153","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIB1","description":"ICD-IIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBC0","description":"ICD-MCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dent appl desensitizing med","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9910","description":"Dent appl desensitizing med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL34","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQF0","description":"ICD-OJQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIB1","description":"ICD-NBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKB1","description":"ICD-NJKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVE0","description":"ICD-OBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Locm >= 400 mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9951","description":"Locm >= 400 mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCA1","description":"ICD-MJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHB0","description":"ICD-OJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Integra bmwd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4104","description":"Integra bmwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice general care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2045","description":"Hospice general care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCF0","description":"ICD-AHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Saquinavir_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0140","description":"Saquinavir_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUF1","description":"ICD-IIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJB1","description":"ICD-NAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9312","description":"Injection_ rituximab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst hgh nbl mtl >=3srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6611","description":"Onlay cst hgh nbl mtl >=3srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec size w/ leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1224","description":"Wheelchair spec size w/ leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABA1","description":"ICD-FABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3D","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYB1","description":"ICD-OJYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Long-acting inhaled bronchodilator not prescribed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9699","description":"Long-acting inhaled bronchodilator not prescribed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCC0","description":"ICD-EGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23650","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECD1","description":"ICD-IECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA21","description":"ICD-4LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFA1","description":"ICD-BFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Single lens spectacle mount","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2610","description":"Single lens spectacle mount","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGB1","description":"ICD-OEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28515","description":"Treatment of toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGF1","description":"ICD-NKGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHF0","description":"ICD-OAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay triiodothyronine (t3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84480","description":"Assay triiodothyronine (t3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWE1","description":"ICD-CGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATE0","description":"ICD-JATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quant results activity &symp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3115F","description":"Quant results activity &symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYB0","description":"ICD-OHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xray place dist ext thor ao","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75959","description":"Xray place dist ext thor ao","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCF0","description":"ICD-MBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELB1","description":"ICD-OELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIF1","description":"ICD-FAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDC0","description":"ICD-GDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHC1","description":"ICD-NFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQF0","description":"ICD-KGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28H","description":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lead wires_ pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4557","description":"Lead wires_ pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKD0","description":"ICD-KGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Filleted finger/toe flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14350","description":"Filleted finger/toe flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAA0","description":"ICD-NDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOB1","description":"ICD-LEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAE0","description":"ICD-FGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMC0","description":"ICD-AEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Placement of drain pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48001","description":"Placement of drain pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dimenhydrinate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1240","description":"Dimenhydrinate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"DO GNOTYP ART4 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0184U","description":"DO GNOTYP ART4 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Waiver service_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2025","description":"Waiver service_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37259","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","description":"CPT-37259","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ gemtuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9203","description":"Injection_ gemtuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lipid profile perf doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8725","description":"Lipid profile perf doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23530","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMA1","description":"ICD-GDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18A","description":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services for patient occurred any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9720","description":"Hospice services for patient occurred any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYE0","description":"ICD-CGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHA1","description":"ICD-KHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVD1","description":"ICD-GGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optical endomicroscpy interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88375","description":"Optical endomicroscpy interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic endoscopic retrograde cholangiopancreatography (ercp)_ including collection of specimen(s) by brushing or washing_ when performed_ with endoscopic cannulation of pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7541","description":"Diagnostic endoscopic retrograde cholangiopancreatography (ercp)_ including collection of specimen(s) by brushing or washing_ when performed_ with endoscopic cannulation of pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKA1","description":"ICD-OLKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chloramphenicol sodium injec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0720","description":"Chloramphenicol sodium injec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/balloon dilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45386","description":"Colonoscopy w/balloon dilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJC0","description":"ICD-BGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIE0","description":"ICD-OEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMA1","description":"ICD-OCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aicd_ dual chamber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1721","description":"Aicd_ dual chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00350","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","description":"CPT-00350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlh uterus over 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58572","description":"Tlh uterus over 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUB1","description":"ICD-EDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXF1","description":"ICD-GEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srsf2 (Serine And Arginine-Rich Splicing Factor 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ P95H_ P95L)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81348","description":"Srsf2 (Serine And Arginine-Rich Splicing Factor 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ P95H_ P95L)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73130","description":"X-ray exam of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAD0","description":"ICD-IDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIF1","description":"ICD-AEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPE0","description":"ICD-GIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHC0","description":"ICD-BGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOA0","description":"ICD-PCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Posterior vertebral joint replacement_ including bilateral facetectomy_ laminectomy_ and radical discectomy_ including imaging guidance_ lumbar spine_ single segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0719T","description":"Posterior vertebral joint replacement_ including bilateral facetectomy_ laminectomy_ and radical discectomy_ including imaging guidance_ lumbar spine_ single segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJB0","description":"ICD-OKJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","description":"HCPCS-J2601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; single view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71045","description":"Radiologic examination_ chest; single view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58800","description":"Drainage of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAE1","description":"ICD-CEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUE0","description":"ICD-KHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDC1","description":"ICD-BBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01852","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","description":"CPT-01852","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYF0","description":"ICD-OAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBC1","description":"ICD-IGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1757","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1757","description":"HCPCS-J1757","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJC0","description":"ICD-OJJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE201","description":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Most favored nation (mfn) model drug add-on amount_ per dose_ (do not bill with line items that have the jw modifier)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1145","description":"Most favored nation (mfn) model drug add-on amount_ per dose_ (do not bill with line items that have the jw modifier)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD212","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rehabilitation program 1/2 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2001","description":"Rehabilitation program 1/2 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAND1","description":"ICD-KAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15D","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of anterior segment intraocular nonbiodegradable drug-eluting system_ internal approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0660T","description":"Implantation of anterior segment intraocular nonbiodegradable drug-eluting system_ internal approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMB1","description":"ICD-KDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult size brief/diaper lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4523","description":"Adult size brief/diaper lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPE1","description":"ICD-CAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMC0","description":"ICD-MGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSC0","description":"ICD-GCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDF0","description":"ICD-EDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD213","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rhythm ecg tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93041","description":"Rhythm ecg tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLC0","description":"ICD-GHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTD1","description":"ICD-NGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBF0","description":"ICD-MFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ercp lithotripsy calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43265","description":"Ercp lithotripsy calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27216","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRE1","description":"ICD-PBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGF1","description":"ICD-BFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICC1","description":"ICD-IICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVE1","description":"ICD-JGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMD1","description":"ICD-BIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj manipulation under anest","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7830","description":"Tmj manipulation under anest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of uterus lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58100","description":"Biopsy of uterus lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPC1","description":"ICD-BDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKC1","description":"ICD-BBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36261","description":"Revision of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOB1","description":"ICD-LIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUB1","description":"ICD-OCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJB1","description":"ICD-NEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23C","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0592","description":"Hospital Special Treatment Room Support Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 19 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP19","description":"Auto test panel pricing code_ 19 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21615","description":"Removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA23","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Thorax_ Low Dose For Lung Cancer Screening_ Without Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71271","description":"Computed Tomography_ Thorax_ Low Dose For Lung Cancer Screening_ Without Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHE0","description":"ICD-AEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACA0","description":"ICD-CACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXD0","description":"ICD-FGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54326","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGC0","description":"ICD-GBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parvovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86747","description":"Parvovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive sternum surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21630","description":"Extensive sternum surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJE1","description":"ICD-JFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHB0","description":"ICD-ACHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pontic - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6243","description":"Pontic - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETF0","description":"ICD-EETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAD1","description":"ICD-BGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERB0","description":"ICD-OERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFA0","description":"ICD-GDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALC1","description":"ICD-NALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l addl 5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13153","description":"Cmplx rpr e/n/e/l addl 5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85097","description":"Bone marrow interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correct malrotation of bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44055","description":"Correct malrotation of bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0544U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0544U","description":"CPT-0544U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANF1","description":"ICD-JANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath report non routine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0551F","description":"Cytopath report non routine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA112","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary cardiomyopathy (eg_ hypertrophic cardiomyopathy_ dilated cardiomyopathy_ arrhythmogenic right ventricular cardiomyopathy)_ genomic sequence analysis panel_ must inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81439","description":"Hereditary cardiomyopathy (eg_ hypertrophic cardiomyopathy_ dilated cardiomyopathy_ arrhythmogenic right ventricular cardiomyopathy)_ genomic sequence analysis panel_ must inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGE1","description":"ICD-NKGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADD1","description":"ICD-BADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transthor cath for stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33621","description":"Transthor cath for stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes (Versiti™ Red Cell Genotyping Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0282U","description":"Red blood cell antigen typing_ DNA_ genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes (Versiti™ Red Cell Genotyping Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply forearm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29126","description":"Apply forearm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elliotts b solution per ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9175","description":"Elliotts b solution per ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1803","description":"HCPCS-B1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLA1","description":"ICD-CBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gba gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81251","description":"Gba gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin k","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84597","description":"Assay of vitamin k","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLC0","description":"ICD-OHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNA0","description":"ICD-NCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenervation anal musc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46505","description":"Chemodenervation anal musc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTF1","description":"ICD-GHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVD0","description":"ICD-FEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARC1","description":"ICD-GARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr hern preemie reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49491","description":"Rpr hern preemie reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECB0","description":"ICD-IECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADD1","description":"ICD-CADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55877","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","description":"CPT-55877","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHB0","description":"ICD-EAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA216","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBE0","description":"ICD-JFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00170","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","description":"CPT-00170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ semiquantitative measurement of thymidine kinase activity by immunoassay_ serum_ results reported as risk of disease progression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0404U","description":"Oncology (breast)_ semiquantitative measurement of thymidine kinase activity by immunoassay_ serum_ results reported as risk of disease progression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEF0","description":"ICD-GDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg bk ea add cast ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5410","description":"Postop dsg bk ea add cast ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care prof for COVID-19_ ages under 21_ 16-30 minutes time (This code is used for the Medicaid EPSDT)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0314","description":"Imm counseling by a physician or other qualified health care prof for COVID-19_ ages under 21_ 16-30 minutes time (This code is used for the Medicaid EPSDT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pne scrn done doc not ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9281","description":"Pne scrn done doc not ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHID1","description":"ICD-MHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1703","description":"HCPCS-A1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray 2vw frontal&latl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71020","description":"Chest x-ray 2vw frontal&latl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted px extraocular musc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67399","description":"Unlisted px extraocular musc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVB1","description":"ICD-FFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMC0","description":"ICD-NBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHE1","description":"ICD-MHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXA1","description":"ICD-KCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWA0","description":"ICD-OBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMD1","description":"ICD-CAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental cephalometric film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0340","description":"Dental cephalometric film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0175","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","description":"HCPCS-J0175","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANC1","description":"ICD-KANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCA0","description":"ICD-MKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEA1","description":"ICD-EAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of orbit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21256","description":"Reconstruction of orbit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including CT guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10010","description":"Fine needle aspiration biopsy_ including CT guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plicamycin (mithramycin) inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9270","description":"Plicamycin (mithramycin) inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIB0","description":"ICD-GFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEA0","description":"ICD-EFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiopha dx beta amyloid pet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9599","description":"Radiopha dx beta amyloid pet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKE1","description":"ICD-NAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLF1","description":"ICD-BGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC17","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCD1","description":"ICD-GDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBC0","description":"ICD-NEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOA1","description":"ICD-CAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX13","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACF1","description":"ICD-FACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBE0","description":"ICD-KCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42650","description":"Dilation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec stim cancer treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0766","description":"Elec stim cancer treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ ns_ non-hdrir-192","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1719","description":"Brachytx_ ns_ non-hdrir-192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ monaural_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5243","description":"Hearing aid_ monaural_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDF1","description":"ICD-KBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJB0","description":"ICD-KCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC144","description":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTE0","description":"ICD-EBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker variable wheel resist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0147","description":"Walker variable wheel resist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKA0","description":"ICD-BBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainable plstic pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4377","description":"Drainable plstic pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ common and select rare variants (ie_ *2_ *3_ *4_ *4N_ *5_ *6_ *7_ *8_ *9_ *","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0070U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ common and select rare variants (ie_ *2_ *3_ *4_ *4N_ *5_ *6_ *7_ *8_ *9_ *","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post 2 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2392","description":"Post 2 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC236","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGC1","description":"ICD-FCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIA1","description":"ICD-MFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB03","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocyte transformation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86353","description":"Lymphocyte transformation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In111 oxyquinoline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9547","description":"In111 oxyquinoline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/drain eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67405","description":"Explore/drain eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCF0","description":"ICD-FGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXA0","description":"ICD-GEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0683","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","description":"HCPCS-E0683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post-op hip abduct custom fa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1685","description":"Post-op hip abduct custom fa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKF1","description":"ICD-GAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRA0","description":"ICD-KHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEC1","description":"ICD-FEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLB0","description":"ICD-JGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXE1","description":"ICD-ODXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx head/neck t1-t2no prg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9109","description":"Onc dx head/neck t1-t2no prg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Morphine 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0093","description":"Morphine 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBA1","description":"ICD-CEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRB0","description":"ICD-LFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8C","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGA0","description":"ICD-NKGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBA1","description":"ICD-EFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCB0","description":"ICD-NFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0701","description":"HCPCS-B0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Motion fluoroscopy/swallow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92611","description":"Motion fluoroscopy/swallow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELA0","description":"ICD-CELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33780","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYF1","description":"ICD-GGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74251","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJF1","description":"ICD-CHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIC0","description":"ICD-CEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGA0","description":"ICD-JBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bl exchange/transfuse nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36450","description":"Bl exchange/transfuse nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBD0","description":"ICD-EEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDB0","description":"ICD-EFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVA1","description":"ICD-OBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43415","description":"Repair esophagus wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+cell count <200cells/mm3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3494F","description":"Cd4+cell count <200cells/mm3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCF1","description":"ICD-KFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKC0","description":"ICD-NDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCE0","description":"ICD-EDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complement total (ch50)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86162","description":"Complement total (ch50)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYC1","description":"ICD-PEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33645","description":"Revision of heart veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Puncture/clear windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31612","description":"Puncture/clear windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISA1","description":"ICD-DISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18G","description":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr-staph dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87641","description":"Mr-staph dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIB0","description":"ICD-ODIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0839","description":"Pwc gp2 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHC0","description":"ICD-FAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCB0","description":"ICD-JFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42426","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGF1","description":"ICD-JHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device [screw retained plate]_ requiring flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7298","description":"Removal of temporary anchorage device [screw retained plate]_ requiring flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD230","description":"Special Care Low _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBA1","description":"ICD-JCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8I","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERC1","description":"ICD-OERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFA1","description":"ICD-GFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOD1","description":"ICD-CEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB114","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Water pressure pad for mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0198","description":"Water pressure pad for mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal pelvic lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38562","description":"Removal pelvic lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pan-solid tumor)_ analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA_ biomarker comparison to a previous baseline pre-treatmen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0422U","description":"Oncology (pan-solid tumor)_ analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA_ biomarker comparison to a previous baseline pre-treatmen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAE0","description":"ICD-AGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biliary endo perq dx w/speci","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47552","description":"Biliary endo perq dx w/speci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter placement of intravascular stent(s)_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36908","description":"Transcatheter placement of intravascular stent(s)_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYE1","description":"ICD-OLYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13C","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA50","description":"Low Rehab_ ADL Index 0-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVE0","description":"ICD-JFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINA1","description":"ICD-FINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKF0","description":"ICD-KDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXC1","description":"ICD-ODXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCC0","description":"ICD-NGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKB1","description":"ICD-BDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54332","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFB1","description":"ICD-GAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA31","description":"ICD-1CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCF1","description":"ICD-BBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8X","description":"Medium Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Overdenture complete max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5863","description":"Overdenture complete max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJC1","description":"ICD-FGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0524U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","description":"CPT-0524U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-covered item or service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9270","description":"Non-covered item or service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relieve inner eye pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65820","description":"Relieve inner eye pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Single Study_ At Re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78430","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Single Study_ At Re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOC1","description":"ICD-LBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNC0","description":"ICD-CDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOC0","description":"ICD-CBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic image bone marrow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77084","description":"Magnetic image bone marrow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHE0","description":"ICD-EFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJID1","description":"ICD-OJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVE0","description":"ICD-OHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAB1","description":"ICD-JAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunotherapy one injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95115","description":"Immunotherapy one injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction By Neurolytic Agent_ Genicular Nerve Branches Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64624","description":"Destruction By Neurolytic Agent_ Genicular Nerve Branches Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8D","description":"Medium Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVE1","description":"ICD-NJVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone cutting segmented","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7944","description":"Bone cutting segmented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35013","description":"Repair artery rupture arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNA1","description":"ICD-JHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC42","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFD0","description":"ICD-KAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0519T","description":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21B","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tcd emboli detect w/o inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93892","description":"Tcd emboli detect w/o inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHD1","description":"ICD-ACHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brca2 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81216","description":"Brca2 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVE1","description":"ICD-NFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL33","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYC0","description":"ICD-DAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vinorelbine tartrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9390","description":"Vinorelbine tartrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWD1","description":"ICD-CFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLF1","description":"ICD-GGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTB1","description":"ICD-MHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIE0","description":"ICD-FEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METB0","description":"ICD-METB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITB1","description":"ICD-IITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNC1","description":"ICD-CBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJD1","description":"ICD-NFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic control band & belt b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2640","description":"Pelvic control band & belt b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIA1","description":"ICD-GGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOD0","description":"ICD-GDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTB1","description":"ICD-MDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDF1","description":"ICD-NCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove thoracic lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38746","description":"Remove thoracic lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44404","description":"Colonoscopy w/injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUA1","description":"ICD-CEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mrcp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8037","description":"Mrcp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral supp not othrws c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9999","description":"Parenteral supp not othrws c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRE0","description":"ICD-ODRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15A","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMB1","description":"ICD-CBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFB0","description":"ICD-CEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk molded supracondylar susp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5670","description":"Bk molded supracondylar susp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFA1","description":"ICD-OBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTD0","description":"ICD-EHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQE1","description":"ICD-PCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKB1","description":"ICD-NLKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB216","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDID0","description":"ICD-NDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIB1","description":"ICD-OJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral - complete series of radiographic images - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0709","description":"Intraoral - complete series of radiographic images - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILE0","description":"ICD-KILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYF1","description":"ICD-PJYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQE1","description":"ICD-LEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFD1","description":"ICD-FCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71552","description":"MRI chest w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cervical head harness/halter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0942","description":"Cervical head harness/halter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYB0","description":"ICD-PJYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAE1","description":"ICD-CFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice in inpatient psych","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5008","description":"Hospice in inpatient psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8E","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDB1","description":"ICD-OBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBA1","description":"ICD-IFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENB1","description":"ICD-FENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHF0","description":"ICD-NJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC25","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKD1","description":"ICD-OHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUB1","description":"ICD-NFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27506","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72133","description":"Ct lumbar spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNF1","description":"ICD-FHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAD0","description":"ICD-EAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATC0","description":"ICD-IATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDC1","description":"ICD-JDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTB0","description":"ICD-KDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABID1","description":"ICD-ABID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDB1","description":"ICD-AEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syst antimicrobial thx rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4131F","description":"Syst antimicrobial thx rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/implant finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26536","description":"Revise/implant finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMB1","description":"ICD-MCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient discharged alive following endovascular AAA repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9263","description":"Documentation of patient discharged alive following endovascular AAA repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCD1","description":"ICD-AHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Receiving <=5 Mg Daily Prednisone (Or Equivalent)_ Or Ra Activity Is Worsening_ Or Glucocorticoid Use Is For Less Than 6 Months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2112","description":"Patient Receiving <=5 Mg Daily Prednisone (Or Equivalent)_ Or Ra Activity Is Worsening_ Or Glucocorticoid Use Is For Less Than 6 Months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4397","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","description":"HCPCS-Q4397","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient was not admitted to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9856","description":"Patient was not admitted to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLE1","description":"ICD-OFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual diff wbc count b-coat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85009","description":"Manual diff wbc count b-coat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGC0","description":"ICD-NCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft subclav-carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35506","description":"Art byp grft subclav-carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0887T","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGF0","description":"ICD-NCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHME1","description":"ICD-BHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMC0","description":"ICD-JDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCC1","description":"ICD-MGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEB1","description":"ICD-OCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTC1","description":"ICD-KGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTF1","description":"ICD-JHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSA1","description":"ICD-OLSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEC1","description":"ICD-GIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKND1","description":"ICD-NKND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11B","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEE1","description":"ICD-CEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDD0","description":"ICD-JFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAME1","description":"ICD-JAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33722","description":"Repair of heart defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKB1","description":"ICD-OHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9982","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina wall partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57106","description":"Remove vagina wall partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28A","description":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARE1","description":"ICD-GARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Services performed by a doula birth worker_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1033","description":"Services performed by a doula birth worker_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ex arm/elbow tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24076","description":"Ex arm/elbow tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung cx bx rpt no doc class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9421","description":"Lung cx bx rpt no doc class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGC0","description":"ICD-JHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKB1","description":"ICD-CBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFD0","description":"ICD-BIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9732","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADE1","description":"ICD-MADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA expression profiling by real-time quantitative PCR of MDK_ HOXA13_ CDC2_ IGFBP5_ and CXCR2 in combination with droplet digital PCR (ddPCR) analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0420U","description":"Oncology (urothelial)_ mRNA expression profiling by real-time quantitative PCR of MDK_ HOXA13_ CDC2_ IGFBP5_ and CXCR2 in combination with droplet digital PCR (ddPCR) analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXE0","description":"ICD-FIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOA1","description":"ICD-GAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 2 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34842","description":"Endovasc visc aorta 2 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ tubular protective absorption padded layer_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6608","description":"Gradient compression bandaging supply_ tubular protective absorption padded layer_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFB1","description":"ICD-OEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45380","description":"Colonoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla x-match noncytotoxc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86826","description":"Hla x-match noncytotoxc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject hrt congntl art/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93564","description":"Inject hrt congntl art/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAD1","description":"ICD-MDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mycoplasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87109","description":"Mycoplasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht inj growth horm diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9558","description":"Ht inj growth horm diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLD0","description":"ICD-OHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNA0","description":"ICD-BHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDE0","description":"ICD-EEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocyte culture mixed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86821","description":"Lymphocyte culture mixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spirom fev/fvc>/=70%/w/ocopd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3027F","description":"Spirom fev/fvc>/=70%/w/ocopd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33945","description":"Transplantation of heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWC1","description":"ICD-LFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9561","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKE0","description":"ICD-BFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ conivaptan hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9488","description":"Injection_ conivaptan hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJB1","description":"ICD-NHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney function study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78725","description":"Kidney function study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFD1","description":"ICD-FGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-38225","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","description":"CPT-38225","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise hand/foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64704","description":"Revise hand/foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suction lipectomy trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15877","description":"Suction lipectomy trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABD1","description":"ICD-KABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corticorelin ovine triflutal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0795","description":"Corticorelin ovine triflutal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4D","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia with hypothermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99116","description":"Anesthesia with hypothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESC0","description":"ICD-KESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Barium swallow test not req","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3200F","description":"Barium swallow test not req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of rbc pg6d enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84085","description":"Assay of rbc pg6d enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTE0","description":"ICD-NGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHD0","description":"ICD-GEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Routine ophthalmological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0621","description":"Routine ophthalmological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTD1","description":"ICD-FDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTD1","description":"ICD-IHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWC0","description":"ICD-KEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAD0","description":"ICD-MJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSC0","description":"ICD-KBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHE0","description":"ICD-NEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRF0","description":"ICD-GIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEF0","description":"ICD-FFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHC1","description":"ICD-CIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKC0","description":"ICD-JEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPE1","description":"ICD-OLPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBD1","description":"ICD-BEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialyzer_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4690","description":"Dialyzer_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiofrequency spectroscopy_ real time_ intraoperative margin assessment_ at the time of partial mastectomy_ with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0546T","description":"Radiofrequency spectroscopy_ real time_ intraoperative margin assessment_ at the time of partial mastectomy_ with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso flexion control custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0634","description":"Lso flexion control custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESD1","description":"ICD-KESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFF1","description":"ICD-JIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo iv infus each addl seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96417","description":"Chemo iv infus each addl seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQE0","description":"ICD-GCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJE0","description":"ICD-FHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIF0","description":"ICD-BEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXC1","description":"ICD-OKXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQC1","description":"ICD-OGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0912T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","description":"CPT-0912T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92628","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","description":"CPT-92628","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYC1","description":"ICD-KCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFED0","description":"ICD-MFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPD0","description":"ICD-JIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduce testis torsion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54600","description":"Reduce testis torsion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24665","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIA1","description":"ICD-BDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43410","description":"Repair esophagus wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Punch biopsy of skin (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11105","description":"Punch biopsy of skin (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTD1","description":"ICD-AHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rhythm ecg report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93042","description":"Rhythm ecg report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal myoelectrical activity study_ stomach through colon_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0779T","description":"Gastrointestinal myoelectrical activity study_ stomach through colon_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0609U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","description":"CPT-0609U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPD0","description":"ICD-JDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aortic aneurysm 5-5.4cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9002F","description":"Aortic aneurysm 5-5.4cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB104","description":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKB1","description":"ICD-NGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBF0","description":"ICD-OLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUA0","description":"ICD-FBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Hyperbaric Oxygen Treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X2061","description":"Hospital Special Treatment Room Support Component (Hstrsc) Hyperbaric Oxygen Treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQE0","description":"ICD-GEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sock fracture or equal each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3995","description":"Sock fracture or equal each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iloprost non-comp unit dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4074","description":"Iloprost non-comp unit dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGA1","description":"ICD-KBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ efbemalenograstim alfa-vuxw_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9361","description":"Injection_ efbemalenograstim alfa-vuxw_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSD0","description":"ICD-KCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAF1","description":"ICD-MCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAC1","description":"ICD-BEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPE1","description":"ICD-JAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERB0","description":"ICD-HERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESE0","description":"ICD-LESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWA1","description":"ICD-GEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"22nf nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2360","description":"22nf nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUE1","description":"ICD-GEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPD0","description":"ICD-KGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELF0","description":"ICD-JELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ eflapegrastim-xnst_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1449","description":"Injection_ eflapegrastim-xnst_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYF0","description":"ICD-LDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Final refract +/- 1.0 in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9519","description":"Final refract +/- 1.0 in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sugars single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84378","description":"Sugars single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio abdom w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74175","description":"Ct angio abdom w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC111","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26125","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical nutrition group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97804","description":"Medical nutrition group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETE1","description":"ICD-FETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJA0","description":"ICD-GEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLB1","description":"ICD-BDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJA1","description":"ICD-CHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assist living waiver/month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2030","description":"Assist living waiver/month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFF0","description":"ICD-GFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMD0","description":"ICD-MDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFB1","description":"ICD-JGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFE0","description":"ICD-GBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"64 lead ecg w/tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0179T","description":"64 lead ecg w/tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wbc alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85540","description":"Wbc alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYA0","description":"ICD-PFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Na ferric gluconate complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2916","description":"Na ferric gluconate complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJA1","description":"ICD-CCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCA1","description":"ICD-EBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastroesophageal reflux exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78262","description":"Gastroesophageal reflux exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8977","description":"Oncology measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXE0","description":"ICD-FAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28F","description":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYA1","description":"ICD-KHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWF1","description":"ICD-PEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOC1","description":"ICD-CAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef adult fluids and electro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4102","description":"Ef adult fluids and electro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLF0","description":"ICD-FDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; UNILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53452","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; UNILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00532","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","description":"CPT-00532","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin barrier liquid per oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4369","description":"Skin barrier liquid per oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWF1","description":"ICD-CEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAE0","description":"ICD-NKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXD1","description":"ICD-FFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5153","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","description":"HCPCS-Q5153","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15D","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCA0","description":"ICD-FDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRB0","description":"ICD-LCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNF0","description":"ICD-JBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEME1","description":"ICD-NEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kt/v <1.2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3082F","description":"Kt/v <1.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28600","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSC1","description":"ICD-KHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABA0","description":"ICD-NABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXB0","description":"ICD-OBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45390","description":"Colonoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRF1","description":"ICD-OIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOC1","description":"ICD-LFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECID0","description":"ICD-ECID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE210","description":"Special Care High _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8C","description":"High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAD0","description":"ICD-GGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKF1","description":"ICD-NFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGF1","description":"ICD-JDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRD1","description":"ICD-OBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWD0","description":"ICD-CAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA40","description":"Low Rehab_ ADL Index 0-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No smok b/4 anes day of surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9644","description":"No smok b/4 anes day of surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9913","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9913","description":"CDT-D9913","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBB0","description":"ICD-IIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62280","description":"Treat spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUE0","description":"ICD-EIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOB0","description":"ICD-CBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infusion supplies with pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4222","description":"Infusion supplies with pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXA0","description":"ICD-BGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore chest free adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32124","description":"Explore chest free adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AmnioText_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4245","description":"AmnioText_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plastic eye prosth custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2623","description":"Plastic eye prosth custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0899","description":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC146","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9161","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","description":"HCPCS-J9161","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28C","description":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thumb fusion with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26842","description":"Thumb fusion with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18I","description":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body pos d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8983","description":"Body pos d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJA0","description":"ICD-OIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQD0","description":"ICD-OBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEA1","description":"ICD-MIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUC0","description":"ICD-EAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablation_ Malignant Breast Tumor(S)_ Percutaneous_ Cryotherapy_ Including Imaging Guidance When Performed_ Unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0581T","description":"Ablation_ Malignant Breast Tumor(S)_ Percutaneous_ Cryotherapy_ Including Imaging Guidance When Performed_ Unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICE1","description":"ICD-IICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSC0","description":"ICD-OGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBA1","description":"ICD-CIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJA1","description":"ICD-GHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88153","description":"Cytopath c/v redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8G","description":"Very High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB213","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42400","description":"Biopsy of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLD0","description":"ICD-OGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQD1","description":"ICD-LAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQC1","description":"ICD-KBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEE1","description":"ICD-NEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24155","description":"Removal of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5173","description":"HCPCS-Q5173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder blade lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23182","description":"Remove shoulder blade lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHE1","description":"ICD-JFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8X","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYB0","description":"ICD-GCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIB1","description":"ICD-OHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flowcytometry/read 9-15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88188","description":"Flowcytometry/read 9-15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIE0","description":"ICD-OJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLA1","description":"ICD-IHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAB1","description":"ICD-MFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegunigalsidase alfa-iwxj_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2508","description":"Injection_ pegunigalsidase alfa-iwxj_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDA0","description":"ICD-FCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family homecare training 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5110","description":"Family homecare training 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28C","description":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIC1","description":"ICD-NDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOB0","description":"ICD-PDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTD0","description":"ICD-ABTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88012","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imterprete diagnostic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0391","description":"Imterprete diagnostic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASC1","description":"ICD-LASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57100","description":"Biopsy of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4A","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIA0","description":"ICD-CHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLB1","description":"ICD-GCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0682","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","description":"HCPCS-G0682","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Referred for an av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4051F","description":"Referred for an av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos air press not prescribe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8853","description":"Pos air press not prescribe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEB1","description":"ICD-EBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAB0","description":"ICD-MEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISC0","description":"ICD-KISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFA1","description":"ICD-OAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icar ischm mntr interr eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0306T","description":"Icar ischm mntr interr eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE151","description":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAD1","description":"ICD-MKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stat lab home/nf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3601","description":"Stat lab home/nf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNF1","description":"ICD-CDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEF0","description":"ICD-KIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5949","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5949","description":"CDT-D5949","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28A","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2955","description":"Post removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mod solid food suppl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9434","description":"Mod solid food suppl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIB1","description":"ICD-FGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0879","description":"Pwc gp4 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB21","description":"ICD-3BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRE0","description":"ICD-OGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACD0","description":"ICD-IACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDD0","description":"ICD-CHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm adapt/boot couplin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5289","description":"Ald fm/dm adapt/boot couplin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACC1","description":"ICD-IACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lysis penil circumic lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54162","description":"Lysis penil circumic lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPF1","description":"ICD-OEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELB0","description":"ICD-KELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDA1","description":"ICD-FBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHF1","description":"ICD-KAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCA1","description":"ICD-OLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIE1","description":"ICD-BIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTD0","description":"ICD-OFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFE1","description":"ICD-BDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33766","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC220","description":"Reduced Physical Function _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLC0","description":"ICD-MDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0001","description":"Alcohol and/or drug assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAA0","description":"ICD-CAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ 14 or more classes of drugs and substances_ definitive tandem mass spectrometry with chromatography_ capillary blood_ quantitative report with th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054U","description":"Prescription drug monitoring_ 14 or more classes of drugs and substances_ definitive tandem mass spectrometry with chromatography_ capillary blood_ quantitative report with th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILA1","description":"ICD-KILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Augmentation lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21125","description":"Augmentation lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flexible metal hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6610","description":"Flexible metal hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDA1","description":"ICD-JGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHA0","description":"ICD-BBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEC0","description":"ICD-IGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Brain)_ Spheroid Cell Culture In A 3D Microenvironment_ 12 Drug Panel_ Tumor-Response Prediction For Each Drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0248U","description":"Oncology (Brain)_ Spheroid Cell Culture In A 3D Microenvironment_ 12 Drug Panel_ Tumor-Response Prediction For Each Drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDA1","description":"ICD-NKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHB1","description":"ICD-AGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLC1","description":"ICD-JDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKF0","description":"ICD-NCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC23","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARA1","description":"ICD-GARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26460","description":"Incise hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXD0","description":"ICD-KFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNB0","description":"ICD-GBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No reop req bld grft oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8578","description":"No reop req bld grft oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAA0","description":"ICD-OFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28D","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJF1","description":"ICD-JHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opioids & opiate analogs 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80362","description":"Opioids & opiate analogs 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACF0","description":"ICD-EACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18D","description":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWB1","description":"ICD-CAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCF0","description":"ICD-OJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKE0","description":"ICD-FCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24B","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1741","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1741","description":"HCPCS-C1741","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee ext/flex w act res ctrl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1812","description":"Knee ext/flex w act res ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTA1","description":"ICD-KHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLD0","description":"ICD-ECLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXF1","description":"ICD-GIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFB0","description":"ICD-KFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAA1","description":"ICD-AHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBF0","description":"ICD-IFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection into brain canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61026","description":"Injection into brain canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWD0","description":"ICD-HHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exchange biliary drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47536","description":"Exchange biliary drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine HCl (Bendeka)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9034","description":"Injection_ bendamustine HCl (Bendeka)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0698T","description":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDC0","description":"ICD-ABDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trans care mgmt 7 day disch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99496","description":"Trans care mgmt 7 day disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPD0","description":"ICD-GFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0364","description":"Cone beam ct capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVF1","description":"ICD-BCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPE0","description":"ICD-FFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTF1","description":"ICD-BCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVF1","description":"ICD-FDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVF0","description":"ICD-OFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/transpose nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64856","description":"Repair/transpose nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4385","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","description":"HCPCS-Q4385","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep c rna done prior to med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9203","description":"Hep c rna done prior to med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMB0","description":"ICD-BGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTE0","description":"ICD-BDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJD0","description":"ICD-OAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCND0","description":"ICD-BCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE226","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge base metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6211","description":"Bridge base metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hip prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27091","description":"Removal of hip prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOC1","description":"ICD-LDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0D","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPA0","description":"ICD-NBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8E","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAB1","description":"ICD-KCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove kidney living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50320","description":"Remove kidney living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQA0","description":"ICD-LBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Combo pegintf/rib rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4153F","description":"Combo pegintf/rib rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMF1","description":"ICD-AAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95707","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","description":"HCPCS-J1808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFC0","description":"ICD-KFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETC1","description":"ICD-KETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal pacemaker electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33235","description":"Removal pacemaker electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","description":"CPT-55882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ eptinezumab-jjmr_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3032","description":"Injection_ eptinezumab-jjmr_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKA1","description":"ICD-NIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9937","description":"Diagnostic colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pten gene dup/delet variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81323","description":"Pten gene dup/delet variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand tendon reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26500","description":"Hand tendon reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUA0","description":"ICD-OJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEE0","description":"ICD-GCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYB0","description":"ICD-KDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUB0","description":"ICD-OEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMD1","description":"ICD-KCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRB1","description":"ICD-KCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDB0","description":"ICD-BGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient has copd symptoms (e.g._ dyspnea_ cough/sputum_ wheezing)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1218","description":"Patient has copd symptoms (e.g._ dyspnea_ cough/sputum_ wheezing)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAC1","description":"ICD-FHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28635","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of toe tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28010","description":"Incision of toe tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARC1","description":"ICD-KARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHC1","description":"ICD-NDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (baxter)_ not therapeutically equivalent to j0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0689","description":"Injection_ cefazolin sodium (baxter)_ not therapeutically equivalent to j0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUF0","description":"ICD-NIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTE1","description":"ICD-EBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20611","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACA1","description":"ICD-KACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sugars single qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84376","description":"Sugars single qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCID1","description":"ICD-JCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJA0","description":"ICD-CHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPB1","description":"ICD-FIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 hd mult pow s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0886","description":"Pwc gp4 hd mult pow s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXC1","description":"ICD-NHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5A","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not disch home day#2 evar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8833","description":"Pt not disch home day#2 evar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKB1","description":"ICD-NKKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Porcine implant_ permacol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9364","description":"Porcine implant_ permacol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQC1","description":"ICD-DAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Homedelivered prepared meal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5170","description":"Homedelivered prepared meal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCF1","description":"ICD-OBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIE0","description":"ICD-NAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTB0","description":"ICD-NBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJB0","description":"ICD-BIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reset dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21480","description":"Reset dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOA1","description":"ICD-LHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0824T","description":"Transcatheter removal of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIE1","description":"ICD-BCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nsg aide service up to 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1004","description":"Nsg aide service up to 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect distal finger tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26262","description":"Resect distal finger tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11463","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"C-1 esterase_ berinert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0597","description":"C-1 esterase_ berinert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGC1","description":"ICD-JEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of anorectal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45108","description":"Removal of anorectal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMD1","description":"ICD-NKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDB0","description":"ICD-GDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5D","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure of valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33602","description":"Closure of valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEE1","description":"ICD-BIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11601","description":"Exc tr-ext mal+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCF1","description":"ICD-MFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0973T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","description":"CPT-0973T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBF1","description":"ICD-JEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add mech leg elevation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1009","description":"Add mech leg elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic appliance half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0666","description":"Pneumatic appliance half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip disartic sach thermopls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5595","description":"Hip disartic sach thermopls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJC1","description":"ICD-GFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Detach adjust armrest base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0017","description":"Detach adjust armrest base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAD0","description":"ICD-NKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmt harv/transpl 28d pkg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2150","description":"Bmt harv/transpl 28d pkg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270_ up to 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2272","description":"Injection_ morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270_ up to 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMB0","description":"ICD-NGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELA1","description":"ICD-IELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61150","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77431","description":"Radiation therapy management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1274","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDF1","description":"ICD-KCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXC0","description":"ICD-OKXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD255","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC212","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYD1","description":"ICD-PCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc breast risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0008M","description":"Onc breast risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45499","description":"Laparoscope proc rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair rectum-vagina fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57305","description":"Repair rectum-vagina fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUA0","description":"ICD-JBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTD1","description":"ICD-BBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDB0","description":"ICD-NCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXB1","description":"ICD-ODXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOF1","description":"ICD-DEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFB0","description":"ICD-GEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Refract not +/- 1.0 w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9520","description":"Refract not +/- 1.0 w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12C","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Kovaltry)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7211","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Kovaltry)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEA0","description":"ICD-OAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22852","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reposition venous catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36597","description":"Reposition venous catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vestibular rehab per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9476","description":"Vestibular rehab per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29891","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBA0","description":"ICD-EEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYA1","description":"ICD-HFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBF1","description":"ICD-CGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB211","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28X","description":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJF0","description":"ICD-NDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administrat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0090","description":"Professional services_ initial visit_ for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24110","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIF1","description":"ICD-IIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth abdomen vessel surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88051","description":"Anesth abdomen vessel surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0213T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esketamine_ nasal spray_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0013","description":"Esketamine_ nasal spray_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCB0","description":"ICD-JBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICE1","description":"ICD-AICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEA1","description":"ICD-GFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploratory heart surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33315","description":"Exploratory heart surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEC0","description":"ICD-JAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB126","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise ovarian tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58752","description":"Revise ovarian tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Talk pt/crgvr re areds prev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4177F","description":"Talk pt/crgvr re areds prev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRB1","description":"ICD-ODRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHC1","description":"ICD-FIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral administration ki","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4224","description":"Parenteral administration ki","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBF0","description":"ICD-NFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLE1","description":"ICD-JBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nos quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0110T","description":"Nos quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHD1","description":"ICD-EDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVE0","description":"ICD-OEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC104","description":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open reduct compd mandble fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7730","description":"Open reduct compd mandble fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients on peritoneal dialysis for any portion of the reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0052","description":"Patients on peritoneal dialysis for any portion of the reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted case management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1017","description":"Targeted case management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKB1","description":"ICD-KDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1292","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFC1","description":"ICD-CCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICB0","description":"ICD-MICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy vent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4366","description":"Ostomy vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo plas sing free knee mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2037","description":"Kafo plas sing free knee mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDD1","description":"ICD-MFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hair removal by electrolysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17380","description":"Hair removal by electrolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES150","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEA0","description":"ICD-IEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBE1","description":"ICD-MCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain fused base m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2751","description":"Crown porcelain fused base m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Safety counseling dem order","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6102F","description":"Safety counseling dem order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHC0","description":"ICD-CEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period_ (e.g._ patient declined_ other patient reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1202","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period_ (e.g._ patient declined_ other patient reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC251","description":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove epididymis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54840","description":"Remove epididymis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVA1","description":"ICD-GDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX33","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29897","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJA1","description":"ICD-KCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJD0","description":"ICD-JCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEID0","description":"ICD-EEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKA0","description":"ICD-FEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDND1","description":"ICD-JDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thaw preserved stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38208","description":"Thaw preserved stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEE0","description":"ICD-IFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00172","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","description":"CPT-00172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKE1","description":"ICD-FEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Each additional cervical vertebral body (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2361","description":"Each additional cervical vertebral body (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJF1","description":"ICD-FGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC54","description":"Very High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; first 20 sq cm or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0491T","description":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; first 20 sq cm or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periodic Assessment; Assessing Periodically By Qualified Personnel To Determine The Most Appropriate Combination Of Services And Treatment (Provision Of The Services By A Medi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2077","description":"Periodic Assessment; Assessing Periodically By Qualified Personnel To Determine The Most Appropriate Combination Of Services And Treatment (Provision Of The Services By A Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31288","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWE0","description":"ICD-LFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","description":"HCPCS-Q4406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBF1","description":"ICD-MCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWA0","description":"ICD-DIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQE0","description":"ICD-KHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adm Tocilizu COVID-19 1st dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0249","description":"Adm Tocilizu COVID-19 1st dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal chrmoml aneuploidy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81420","description":"Fetal chrmoml aneuploidy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYB1","description":"ICD-CDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAA1","description":"ICD-KHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag-coronal panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0638","description":"Lso sag-coronal panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALC0","description":"ICD-KALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retreat root canal anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3346","description":"Retreat root canal anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBA1","description":"ICD-CFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous laser 1st vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36478","description":"Endovenous laser 1st vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJE1","description":"ICD-NHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOD0","description":"ICD-OIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay tumor other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86316","description":"Immunoassay tumor other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXB1","description":"ICD-NDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63020","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sewho airplane w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3973","description":"Sewho airplane w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYD0","description":"ICD-CHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25650","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVC1","description":"ICD-GDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRD0","description":"ICD-PKRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEC0","description":"ICD-FHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTB0","description":"ICD-EHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMD0","description":"ICD-ECMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLE1","description":"ICD-BGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligate oviduct(s) add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58611","description":"Ligate oviduct(s) add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arch suprt att to sho longit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3070","description":"Arch suprt att to sho longit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen sng rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8685","description":"Implt nrostm pls gen sng rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol or peroxide per pint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4244","description":"Alcohol or peroxide per pint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 4 or more views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71048","description":"Radiologic examination_ chest; 4 or more views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crutch underarm each wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0113","description":"Crutch underarm each wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us guide vascular access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76937","description":"Us guide vascular access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDF0","description":"ICD-KDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB146","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYA0","description":"ICD-DAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXE1","description":"ICD-NCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score hip not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8654","description":"Fun stat score hip not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDB0","description":"ICD-IIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove&replace pm gen singl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33227","description":"Remove&replace pm gen singl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Salivary gland imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78230","description":"Salivary gland imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy swallow tst (fees)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92613","description":"Endoscopy swallow tst (fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0918T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","description":"CPT-0918T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGD0","description":"ICD-GBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYF0","description":"ICD-HIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKE1","description":"ICD-CCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2D","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAA0","description":"ICD-IEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITB1","description":"ICD-GITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92310","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient And/Or Care Partner Decline Referral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0041","description":"Patient And/Or Care Partner Decline Referral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1601","description":"HCPCS-C1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEA1","description":"ICD-NLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJF0","description":"ICD-FCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRD1","description":"ICD-GGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0532U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","description":"CPT-0532U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIA0","description":"ICD-KCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJC1","description":"ICD-NJJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEID1","description":"ICD-CEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVB0","description":"ICD-GDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remis 12m phq-9 score <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9509","description":"Remis 12m phq-9 score <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rad resect hand tumor < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26117","description":"Rad resect hand tumor < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOB0","description":"ICD-HBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLC1","description":"ICD-IGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVC1","description":"ICD-NGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incis spine 3 column thorac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22206","description":"Incis spine 3 column thorac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18B","description":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77401","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct soft tissue neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70491","description":"Ct soft tissue neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGF0","description":"ICD-NHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1129","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEB1","description":"ICD-JEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYA0","description":"ICD-GHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQC0","description":"ICD-HBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26735","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programmable infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0783","description":"Programmable infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gen w/c cushion wdth < 22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2601","description":"Gen w/c cushion wdth < 22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD130","description":"Clinically Complex _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0C","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAB0","description":"ICD-JGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ or hematolymphoid neoplasm or disorder_ 51 or greater genes (eg_ ALK_ BRAF_ CDKN2A_ CEBPA_ DNMT3A_ EGFR_ ERBB2_ EZH2_ FLT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81456","description":"Targeted genomic sequence analysis panel_ solid organ or hematolymphoid neoplasm or disorder_ 51 or greater genes (eg_ ALK_ BRAF_ CDKN2A_ CEBPA_ DNMT3A_ EGFR_ ERBB2_ EZH2_ FLT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40843","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24940","description":"Revision of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12D","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDA1","description":"ICD-KFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pouch clsd w barr attached","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5051","description":"Pouch clsd w barr attached","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Waist belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2190","description":"Waist belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVA0","description":"ICD-JIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVA1","description":"ICD-OGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLE1","description":"ICD-KCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUF0","description":"ICD-MJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76497","description":"Ct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUB0","description":"ICD-ABUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3A","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQF0","description":"ICD-OKQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXF0","description":"ICD-NBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29015","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAD1","description":"ICD-JEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRA1","description":"ICD-LCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIE1","description":"ICD-KAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep renal graft/ureteral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50329","description":"Prep renal graft/ureteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNE1","description":"ICD-BBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYB1","description":"ICD-HAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMA1","description":"ICD-GBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGB0","description":"ICD-KCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anal pressure record","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91122","description":"Anal pressure record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEF1","description":"ICD-GGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIA0","description":"ICD-NEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Snrpn/ube3a gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81331","description":"Snrpn/ube3a gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRE0","description":"ICD-LHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen)_ serum_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0058U","description":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen)_ serum_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXC0","description":"ICD-CGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBE1","description":"ICD-MKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQB1","description":"ICD-HHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLA1","description":"ICD-BCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIF0","description":"ICD-CFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD241","description":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam l-2 spine 4/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72110","description":"X-ray exam l-2 spine 4/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEA1","description":"ICD-BHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid caster tire_ integrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2392","description":"Solid caster tire_ integrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatology (nonalcoholic fatty liver disease [NAFLD])_ semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0344U","description":"Hepatology (nonalcoholic fatty liver disease [NAFLD])_ semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEC0","description":"ICD-EIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBF1","description":"ICD-MGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Donor pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48550","description":"Donor pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac mgmt disagree w/gui","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9058","description":"Onc prac mgmt disagree w/gui","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCB1","description":"ICD-KFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95725","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27601","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med reason for no ceph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9196","description":"Med reason for no ceph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIB1","description":"ICD-OGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDA1","description":"ICD-NBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRC1","description":"ICD-DFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKE1","description":"ICD-FBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3268","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3268","description":"HCPCS-J3268","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPC1","description":"ICD-FHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOF1","description":"ICD-DAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exercise equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9300","description":"Exercise equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASE1","description":"ICD-GASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51580","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without contrast material; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77047","description":"Magnetic resonance imaging_ breast_ without contrast material; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLE1","description":"ICD-ODLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDF0","description":"ICD-OJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETA0","description":"ICD-NETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8A","description":"Low Rehab_ ADL Index 0-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc no wrong event","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8913","description":"Pt doc no wrong event","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of endocrine hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84235","description":"Assay of endocrine hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYB1","description":"ICD-HFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLED1","description":"ICD-OLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat dental ridge fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21440","description":"Treat dental ridge fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA111","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQE1","description":"ICD-DFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXB1","description":"ICD-OCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKA1","description":"ICD-NBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJND0","description":"ICD-OJND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4B","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vit for membrane dissect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67043","description":"Vit for membrane dissect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27181","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8D","description":"Very High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Md service required for pmd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0372","description":"Md service required for pmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYD1","description":"ICD-PJYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFE0","description":"ICD-NBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLD0","description":"ICD-KCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of head of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23195","description":"Removal of head of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWD1","description":"ICD-KEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rolapitant_ oral_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8670","description":"Rolapitant_ oral_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01173","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","description":"CPT-01173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ amisulpride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9153","description":"Injection_ amisulpride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHA0","description":"ICD-CDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWD1","description":"ICD-PGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Trivisc_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7329","description":"Hyaluronan or derivative_ Trivisc_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34710","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/o dye_ upper extr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8935","description":"Mra_ w/o dye_ upper extr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQB1","description":"ICD-GEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBF1","description":"ICD-MEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNE0","description":"ICD-OCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYD1","description":"ICD-DFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTE1","description":"ICD-CCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUF1","description":"ICD-NCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYF1","description":"ICD-DGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSB0","description":"ICD-GBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extra heavy duty wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0007","description":"Extra heavy duty wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed xtra hvy dty x wide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0304","description":"Hosp bed xtra hvy dty x wide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Certified nurse midwife mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0064","description":"Certified nurse midwife mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81336","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1117","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lo flex l1-below l5 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0625","description":"Lo flex l1-below l5 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDF0","description":"ICD-ODDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMC1","description":"ICD-CEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11441","description":"Exc face-mm b9+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITE1","description":"ICD-JITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/biopsy eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67400","description":"Explore/biopsy eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBA0","description":"ICD-MBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXA1","description":"ICD-GFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone acet inj nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3301","description":"Triamcinolone acet inj nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITE1","description":"ICD-AITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIE0","description":"ICD-KHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGME0","description":"ICD-JGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conn tiss_ human(inc fascia)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1762","description":"Conn tiss_ human(inc fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERA0","description":"ICD-GERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAC0","description":"ICD-KCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASD0","description":"ICD-PASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBB1","description":"ICD-GGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQE1","description":"ICD-GHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMC1","description":"ICD-BEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sirolimus protein-bound particles_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9091","description":"Injection_ sirolimus protein-bound particles_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analysis skeletal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88355","description":"Analysis skeletal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36640","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBE1","description":"ICD-NFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Airway inhalation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94640","description":"Airway inhalation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDB0","description":"ICD-KDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILE0","description":"ICD-AILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCA1","description":"ICD-FGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ C-1 Esterase Inhibitor (Recombinant) Ruconest_ 10 Units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9445","description":"Injection_ C-1 Esterase Inhibitor (Recombinant) Ruconest_ 10 Units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYF1","description":"ICD-CBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYB1","description":"ICD-KIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5251","description":"Hearing aid_ prog_ bin_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC54","description":"High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Femoral lgth sock fx or equa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2850","description":"Femoral lgth sock fx or equa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0983T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","description":"CPT-0983T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compression form shoe insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5510","description":"Compression form shoe insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stool cultr aerobic bact ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87046","description":"Stool cultr aerobic bact ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vehicle Modifications","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0139","description":"Vehicle Modifications","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD155","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01212","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","description":"CPT-01212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor ix fc fusion recomb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7201","description":"Factor ix fc fusion recomb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGC0","description":"ICD-GGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDD1","description":"ICD-EIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28E","description":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL07","description":"High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWE0","description":"ICD-KDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC101","description":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBF0","description":"ICD-FCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDD1","description":"ICD-BCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRD1","description":"ICD-GCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHND0","description":"ICD-BHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64896","description":"Nerve graft hand/foot >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCE1","description":"ICD-GDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHD1","description":"ICD-GGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1209","description":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWB0","description":"ICD-OGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0502","description":"HCPCS-B0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCC1","description":"ICD-GBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYC1","description":"ICD-HDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCD0","description":"ICD-CGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCED1","description":"ICD-GCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MSH2 (mutS homolog 2) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0159U","description":"MSH2 (mutS homolog 2) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYB0","description":"ICD-HCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital call","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9420","description":"Hospital call","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFC0","description":"ICD-GAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microslide consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88321","description":"Microslide consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEA1","description":"ICD-FEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0898","description":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBD1","description":"ICD-MDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIE0","description":"ICD-EDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25100","description":"Biopsy of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCC0","description":"ICD-OKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUD0","description":"ICD-MKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABE0","description":"ICD-OABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37230","description":"Tib/per revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27532","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1253","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mononuclear cell antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86356","description":"Mononuclear cell antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External Ambulatory Infusion Pump_ Insulin_ Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0787","description":"External Ambulatory Infusion Pump_ Insulin_ Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLD0","description":"ICD-NBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flexhd/allopatchhd/matrixhd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4128","description":"Flexhd/allopatchhd/matrixhd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01962","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","description":"CPT-01962","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0232","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0232","description":"HCPCS-M0232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31601","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCF0","description":"ICD-KGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ing hernia baby blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49496","description":"Rpr ing hernia baby blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYF1","description":"ICD-KFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCF0","description":"ICD-GBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve_ percutaneous approach_ including right heart catheterization_ temporary pacemaker insertio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0646T","description":"Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve_ percutaneous approach_ including right heart catheterization_ temporary pacemaker insertio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSB0","description":"ICD-LCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELA1","description":"ICD-JELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE120","description":"Clinically Complex _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28H","description":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermabind ch_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4288","description":"Dermabind ch_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDB1","description":"ICD-NFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhc ot assistant ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0158","description":"Hhc ot assistant ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40810","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression gauntlet_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6582","description":"Gradient compression gauntlet_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 2.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12031","description":"Intmd rpr s/a/t/ext 2.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBC0","description":"ICD-KFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYE0","description":"ICD-CCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVC0","description":"ICD-NLVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clin depression screen not d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8432","description":"Clin depression screen not d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUC1","description":"ICD-CDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETE1","description":"ICD-GETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pasrr level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2011","description":"Pasrr level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0677","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0677","description":"HCPCS-G0677","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBC0","description":"ICD-NIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGC1","description":"ICD-OLGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No eval opi use instr/intv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9585","description":"No eval opi use instr/intv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICB0","description":"ICD-BICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQE0","description":"ICD-KFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shigella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86771","description":"Shigella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlamydia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86631","description":"Chlamydia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFA0","description":"ICD-OHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pcp prophylax rxd 3mon low %","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4280F","description":"Pcp prophylax rxd 3mon low %","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWA0","description":"ICD-DAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTF0","description":"ICD-AHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNB0","description":"ICD-OCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMA0","description":"ICD-FHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15936","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc oviduct-ovary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58679","description":"Laparo proc oviduct-ovary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1074","description":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ non-cor_ tem w/o del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2617","description":"Stent_ non-cor_ tem w/o del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCF1","description":"ICD-OKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit nb care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99502","description":"Home visit nb care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVE1","description":"ICD-BDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLF0","description":"ICD-EFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHB1","description":"ICD-MHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHB0","description":"ICD-CIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFID0","description":"ICD-BFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSF0","description":"ICD-GFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ferric pyrophosphate citrate solution (TrifericAVNU)_ 0.1 mg of iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1445","description":"Injection_ ferric pyrophosphate citrate solution (TrifericAVNU)_ 0.1 mg of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01730","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","description":"CPT-01730","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBB1","description":"ICD-MEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOA1","description":"ICD-KHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCD1","description":"ICD-GCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILB0","description":"ICD-FILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antinuclear antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86038","description":"Antinuclear antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAED1","description":"ICD-AAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYD1","description":"ICD-LDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1489","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","description":"HCPCS-M1489","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd tube/cath insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43241","description":"Egd tube/cath insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial complete study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93886","description":"Intracranial complete study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pros sock multi ply upper lm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8435","description":"Pros sock multi ply upper lm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total or near total esophagectomy_ with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy_ with or without pyloroplasty (ie_ McKeown esophagectomy or tri-i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43112","description":"Total or near total esophagectomy_ with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy_ with or without pyloroplasty (ie_ McKeown esophagectomy or tri-i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA54","description":"Very High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ 1000 units (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0886","description":"Injection_ epoetin alfa_ 1000 units (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pegademase bovine_ 25 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2504","description":"Pegademase bovine_ 25 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray bile duct endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74328","description":"X-ray bile duct endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRC1","description":"ICD-PGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMB0","description":"ICD-CIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0510U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","description":"CPT-0510U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIB1","description":"ICD-JHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of phenytoin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80185","description":"Assay of phenytoin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA21","description":"ICD-1HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50580","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPC1","description":"ICD-BAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion detection_ characterization_ an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0866T","description":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion detection_ characterization_ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTD0","description":"ICD-NBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sgd w multi methods msg/accs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2510","description":"Sgd w multi methods msg/accs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARE0","description":"ICD-KARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJD1","description":"ICD-JFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vesiculobullous disease carr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5991","description":"Vesiculobullous disease carr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1dose menig vac btwn 11 & 13","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9414","description":"1dose menig vac btwn 11 & 13","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHC1","description":"ICD-GDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0803","description":"HCPCS-A0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sterile water/saline_ 500 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4217","description":"Sterile water/saline_ 500 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGE0","description":"ICD-ODGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRC0","description":"ICD-KCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMC0","description":"ICD-MHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHA0","description":"ICD-MJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYC1","description":"ICD-KDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Personal Emergency Response System (Monthly Maintenance)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1895","description":"Personal Emergency Response System (Monthly Maintenance)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEE1","description":"ICD-GGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8F","description":"High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVD1","description":"ICD-CIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add pwr tiller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0984","description":"Add pwr tiller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMF0","description":"ICD-NKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSF0","description":"ICD-GBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAA0","description":"ICD-EBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54300","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap inc hern recur comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49657","description":"Lap inc hern recur comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRF0","description":"ICD-HHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"marsupialization of odontogenic cyst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7509","description":"marsupialization of odontogenic cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair fem hernia reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49555","description":"Rerepair fem hernia reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX24","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYB1","description":"ICD-HBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuroendoscopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62160","description":"Neuroendoscopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair hand joint with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26541","description":"Repair hand joint with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEA1","description":"ICD-GDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria x10sv add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33258","description":"Ablate atria x10sv add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEME0","description":"ICD-EEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast prosthesis bra & form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8001","description":"Breast prosthesis bra & form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1108","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14A","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFC1","description":"ICD-BHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28360","description":"Reconstruct cleft foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEE1","description":"ICD-JBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIE1","description":"ICD-FBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUA0","description":"ICD-MHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61680","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBA1","description":"ICD-MLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38505","description":"Needle biopsy lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKF1","description":"ICD-KHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACC1","description":"ICD-BACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDE0","description":"ICD-AGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXA1","description":"ICD-BCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVB1","description":"ICD-KEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOE1","description":"ICD-KGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUB0","description":"ICD-IEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAB1","description":"ICD-FIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVB1","description":"ICD-JCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDD0","description":"ICD-OKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEME0","description":"ICD-MEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC21","description":"ICD-4CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain cerebro spinal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62272","description":"Drain cerebro spinal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEA0","description":"ICD-MHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILC1","description":"ICD-CILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC116","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap place gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43770","description":"Lap place gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplt allo hct/donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38240","description":"Transplt allo hct/donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAA0","description":"ICD-NLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0B","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate inf turbinate submuc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30802","description":"Ablate inf turbinate submuc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXB0","description":"ICD-GHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYA0","description":"ICD-GGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUC1","description":"ICD-ACUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Out of office emerg med serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99060","description":"Out of office emerg med serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBC0","description":"ICD-FIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1 antibody testing of or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3645","description":"Hiv-1 antibody testing of or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ autologous white blood cell concentrate (autologous protein solution)_ any site_ including image guidance_ harvesting and preparation_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0481T","description":"Injection(s)_ autologous white blood cell concentrate (autologous protein solution)_ any site_ including image guidance_ harvesting and preparation_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUE1","description":"ICD-EIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGA1","description":"ICD-CIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB21","description":"High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27218","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65091","description":"Revise eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays lungs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75743","description":"Artery x-rays lungs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA31","description":"ICD-4JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEC0","description":"ICD-KDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1381","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","description":"HCPCS-M1381","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOB1","description":"ICD-GIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLB1","description":"ICD-CHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECA1","description":"ICD-FECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNC1","description":"ICD-GBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDB0","description":"ICD-NGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIA0","description":"ICD-KEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGE1","description":"ICD-JIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic mens shoes dpth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3221","description":"Orthopedic mens shoes dpth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDD1","description":"ICD-GDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYC1","description":"ICD-DAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCC1","description":"ICD-ICCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESB1","description":"ICD-OESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBA1","description":"ICD-GBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEA0","description":"ICD-KCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optokinetic nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92544","description":"Optokinetic nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCD0","description":"ICD-EBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB22","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt or manip for maint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8990","description":"Pt or manip for maint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tumor imaging limited area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78800","description":"Tumor imaging limited area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Agriflu vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2034","description":"Agriflu vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKF0","description":"ICD-NDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1903","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1903","description":"CDT-D1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSC0","description":"ICD-PHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLE1","description":"ICD-GHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUE0","description":"ICD-IBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATB1","description":"ICD-OATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Loop heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0951","description":"Loop heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic casts","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0470","description":"Diagnostic casts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMB1","description":"ICD-NJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thawing cryopresrved sperm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89353","description":"Thawing cryopresrved sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAB0","description":"ICD-JIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr trunk 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14000","description":"Tis trnfr trunk 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTC0","description":"ICD-JFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAB1","description":"ICD-KAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUE1","description":"ICD-NHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMC0","description":"ICD-OJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSD1","description":"ICD-HBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVF1","description":"ICD-CGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCD1","description":"ICD-KCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ bal tis dis_ non-vas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1727","description":"Cath_ bal tis dis_ non-vas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB217","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of large breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19318","description":"Reduction of large breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe clubfoot wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3380","description":"Shoe clubfoot wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDA1","description":"ICD-OEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMD0","description":"ICD-FGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid propulsion tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2220","description":"Solid propulsion tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFC0","description":"ICD-KBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTE0","description":"ICD-MLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCF0","description":"ICD-IGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34711","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore deep node(s) neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38542","description":"Explore deep node(s) neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hallux rigidus correction with cheilectomy_ debridement and capsular release of the first metatarsophalangeal joint; with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28291","description":"Hallux rigidus correction with cheilectomy_ debridement and capsular release of the first metatarsophalangeal joint; with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHB1","description":"ICD-NLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hm gest dm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9214","description":"Hm gest dm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whchr litwt det arm leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1240","description":"Whchr litwt det arm leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXF1","description":"ICD-GBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37140","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMA1","description":"ICD-KAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cataract surg w/iol 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66983","description":"Cataract surg w/iol 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fosphenytoin sodi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0078","description":"Injection_ fosphenytoin sodi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0603U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","description":"CPT-0603U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMC1","description":"ICD-IHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIC1","description":"ICD-OIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Beta pres or already taking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9189","description":"Beta pres or already taking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sugars multiple quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84379","description":"Sugars multiple quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOF0","description":"ICD-GFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBD1","description":"ICD-KGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96168","description":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERA0","description":"ICD-KERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0683","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","description":"HCPCS-G0683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXC0","description":"ICD-OJXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar bolster pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1030","description":"Lumbar bolster pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHA1","description":"ICD-BBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are counseled on connection with a csp and explicitly opt out","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1317","description":"Patients who are counseled on connection with a csp and explicitly opt out","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD110","description":"Special Care High _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPD0","description":"ICD-ODPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABA0","description":"ICD-OABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMC1","description":"ICD-IDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYB1","description":"ICD-GBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of spinal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27105","description":"Transfer of spinal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHD0","description":"ICD-MGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCB1","description":"ICD-CHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLF1","description":"ICD-MKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIA0","description":"ICD-GIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEF0","description":"ICD-FIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDE1","description":"ICD-OJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA25","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC116","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pure tone hearing test air","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92551","description":"Pure tone hearing test air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANE1","description":"ICD-CANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NFCT DS RNA 3 TARGETS UPPER RESPIRATORY SPECIMEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0240U","description":"NFCT DS RNA 3 TARGETS UPPER RESPIRATORY SPECIMEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAE1","description":"ICD-OKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJF0","description":"ICD-CIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vol reduction of blood/prod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86960","description":"Vol reduction of blood/prod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6516","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","description":"HCPCS-A6516","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24D","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA21","description":"ICD-2AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Powered air flotation bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0193","description":"Powered air flotation bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDB0","description":"ICD-GBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEED0","description":"ICD-AEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Propulsion whl excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2224","description":"Propulsion whl excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDF0","description":"ICD-JBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRA1","description":"ICD-PLRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1701","description":"HCPCS-A1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEF0","description":"ICD-OCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33781","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt ref doc oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8559","description":"Pt ref doc oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYD0","description":"ICD-DIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complex body section x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76101","description":"Complex body section x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No rec cortico>60d 1rx 600mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9470","description":"No rec cortico>60d 1rx 600mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31781","description":"Reconstruct windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49591","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32120","description":"Re-exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAC1","description":"ICD-NJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWE0","description":"ICD-CHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap colectomy w/proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44211","description":"Lap colectomy w/proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy snare les remv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43217","description":"Esophagoscopy snare les remv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUE0","description":"ICD-EFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDF0","description":"ICD-AFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA31","description":"ICD-3DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX46","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay ph body fluid nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83986","description":"Assay ph body fluid nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient pregnancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1061","description":"Patient pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21260","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXC0","description":"ICD-NBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWD0","description":"ICD-GHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc cath >90d for maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9265","description":"Doc cath >90d for maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder prosthesis removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23334","description":"Shoulder prosthesis removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADF0","description":"ICD-GADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJD1","description":"ICD-OAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11623","description":"Exc s/n/h/f/g mal+mrg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIA1","description":"ICD-FFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTD0","description":"ICD-NHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXC0","description":"ICD-NDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62323","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKE1","description":"ICD-OHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKC0","description":"ICD-NFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; With Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0634T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; With Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism persivia clinical decision support_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1023","description":"Clinical decision support mechanism persivia clinical decision support_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Christian sci pract visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9900","description":"Christian sci pract visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grad comp non-elastic bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6545","description":"Grad comp non-elastic bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; Each Additional Vertebral Body_ Lumbar Or Sacral (List Separately In Addition To Code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64629","description":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; Each Additional Vertebral Body_ Lumbar Or Sacral (List Separately In Addition To Code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWE0","description":"ICD-GEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYC1","description":"ICD-DCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDD1","description":"ICD-MKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHE0","description":"ICD-OJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iv tubing extension set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1015","description":"Iv tubing extension set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multi-durometer below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5665","description":"Multi-durometer below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQC0","description":"ICD-HHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61585","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical_ with frontal sinus exploration_ including removal of tissue from frontal sinus_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31276","description":"Nasal/sinus endoscopy_ surgical_ with frontal sinus exploration_ including removal of tissue from frontal sinus_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compl gift case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4013","description":"Compl gift case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFE0","description":"ICD-GIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNB1","description":"ICD-JBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng esa thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4171F","description":"Pt rcvng esa thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Annual nursing fac assessmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99318","description":"Annual nursing fac assessmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay secretory type ii pla2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0423T","description":"Assay secretory type ii pla2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (respiratory infection)_ Myxovirus resistance protein A (MxA) and C-reactive protein (CRP)_ fingerstick whole blood specimen_ each biomarker reported as pre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0442U","description":"Infectious disease (respiratory infection)_ Myxovirus resistance protein A (MxA) and C-reactive protein (CRP)_ fingerstick whole blood specimen_ each biomarker reported as pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skn sub grft f/n/hf/g ch add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15278","description":"Skn sub grft f/n/hf/g ch add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10B","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGC0","description":"ICD-FAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18I","description":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home mgmt preterm labor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9208","description":"Home mgmt preterm labor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFD0","description":"ICD-NKFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAF1","description":"ICD-JEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endometrial sampling or hysteroscopy with biopsy and results documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9823","description":"Endometrial sampling or hysteroscopy with biopsy and results documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHD0","description":"ICD-AEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMA1","description":"ICD-BBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phenotype dna hiv w/clt add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87904","description":"Phenotype dna hiv w/clt add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXB1","description":"ICD-JGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDE1","description":"ICD-CDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health  or substance use disorder_   initial 15-29 minutes_ provided remotely by hospital staff who are licensed to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7900","description":"Service for diagnosis_ evaluation_ or treatment of a mental health  or substance use disorder_   initial 15-29 minutes_ provided remotely by hospital staff who are licensed to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJF0","description":"ICD-BBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADC0","description":"ICD-JADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tetanus ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90389","description":"Tetanus ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHC0","description":"ICD-JBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTD0","description":"ICD-BDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLC1","description":"ICD-NGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNA1","description":"ICD-NFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESE1","description":"ICD-LESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYB0","description":"ICD-DGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLD1","description":"ICD-EFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHB0","description":"ICD-NHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHA1","description":"ICD-FFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ hematolymphoid neoplasm or disorder_ 5-50 genes (eg_ BRAF_ CEBPA_ DNMT3A_ EZH2_ FLT3_ IDH1_ IDH2_ JAK2_ KIT_ KRAS_ MLL_ NOTCH1_ NPM1_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81451","description":"Targeted genomic sequence analysis panel_ hematolymphoid neoplasm or disorder_ 5-50 genes (eg_ BRAF_ CEBPA_ DNMT3A_ EZH2_ FLT3_ IDH1_ IDH2_ JAK2_ KIT_ KRAS_ MLL_ NOTCH1_ NPM1_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44384","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap ing hernia repair init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49650","description":"Lap ing hernia repair init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEB1","description":"ICD-ADEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIC1","description":"ICD-JGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISD1","description":"ICD-PISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Choline C 11_ diagnostic_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9461","description":"Choline C 11_ diagnostic_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOA1","description":"ICD-ODOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Innovamatrix FS_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2013","description":"Innovamatrix FS_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEA1","description":"ICD-FIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; seco","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22868","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; seco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45110","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARA1","description":"ICD-KARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLA1","description":"ICD-BFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24D","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMF1","description":"ICD-NHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWD1","description":"ICD-PAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal Endo Surg; Balln Dilat Eust T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9745","description":"Nasal Endo Surg; Balln Dilat Eust T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBF1","description":"ICD-NGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy resect septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58560","description":"Hysteroscopy resect septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOD0","description":"ICD-PHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart image spect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78494","description":"Heart image spect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHB0","description":"ICD-NEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABA1","description":"ICD-CABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEED0","description":"ICD-OEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALA0","description":"ICD-NALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKD1","description":"ICD-BGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ticarcillin disod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0040","description":"Injection_ ticarcillin disod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient in hospice at any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9758","description":"Patient in hospice at any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVB1","description":"ICD-OJVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVC1","description":"ICD-KEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of elbow or wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29260","description":"Strapping of elbow or wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTA1","description":"ICD-JDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inlay porcelain/ceramic 2 su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2620","description":"Inlay porcelain/ceramic 2 su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDF1","description":"ICD-FDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSB0","description":"ICD-CGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tiss ex molecul study add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88388","description":"Tiss ex molecul study add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43246","description":"Egd place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA35","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide for artery repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76936","description":"Echo guide for artery repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALA0","description":"ICD-AALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of mesentery lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44820","description":"Excision of mesentery lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0995T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","description":"CPT-0995T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASF0","description":"ICD-DASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67882","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGB1","description":"ICD-CIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0301","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0301","description":"CDT-D0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDF1","description":"ICD-MBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22D","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSE0","description":"ICD-LFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reprogram cochlear implt 7/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92604","description":"Reprogram cochlear implt 7/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOE0","description":"ICD-GGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEE1","description":"ICD-IFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1478","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","description":"HCPCS-M1478","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC112","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB116","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTE0","description":"ICD-MFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFF0","description":"ICD-OCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation shield","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5984","description":"Radiation shield","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYE0","description":"ICD-KIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCB1","description":"ICD-NCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMF0","description":"ICD-EIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA130","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOD1","description":"ICD-GFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21470","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHE0","description":"ICD-AGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I131 iodobenguate_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9508","description":"I131 iodobenguate_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTF0","description":"ICD-BDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"C motor evoked uppr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95928","description":"C motor evoked uppr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27466","description":"Lengthening of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKB1","description":"ICD-KFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBE1","description":"ICD-GHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVC1","description":"ICD-KBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0848","description":"Pwc gp 3 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGE0","description":"ICD-JGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADF1","description":"ICD-NADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAC1","description":"ICD-OBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0924T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","description":"CPT-0924T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47720","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFB1","description":"ICD-NEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc 2x re-assess filt remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9543","description":"Doc 2x re-assess filt remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTF1","description":"ICD-IDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15854","description":"Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJB0","description":"ICD-BDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth spine manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64051","description":"Anesth spine manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28705","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYC1","description":"ICD-CIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla i & ii type verify lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81371","description":"Hla i & ii type verify lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso r fram soft ant pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0466","description":"Tlso r fram soft ant pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARF0","description":"ICD-PARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELD0","description":"ICD-KELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scoliosis dna alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004M","description":"Scoliosis dna alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDB0","description":"ICD-JEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXE0","description":"ICD-OHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0795T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22B","description":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dias bp less 90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8754","description":"Dias bp less 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHB1","description":"ICD-OHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye/revise socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65112","description":"Remove eye/revise socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIC1","description":"ICD-CGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I & d vag hematoma non-ob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57023","description":"I & d vag hematoma non-ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery of pancreatic cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48500","description":"Surgery of pancreatic cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLC0","description":"ICD-FCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elev bp plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0513F","description":"Elev bp plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complex rehabilitative power wheelchair accessory_ power seat elevation system_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2298","description":"Complex rehabilitative power wheelchair accessory_ power seat elevation system_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHC1","description":"ICD-OGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice care_ in the home_ p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9126","description":"Hospice care_ in the home_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXB1","description":"ICD-CGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam infant hips dynamic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76885","description":"Us exam infant hips dynamic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBE0","description":"ICD-BIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB260","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBB0","description":"ICD-NHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIME0","description":"ICD-OIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKB0","description":"ICD-JEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUE1","description":"ICD-JFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESE0","description":"ICD-HESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aortic anrysm 6/> cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9004F","description":"Aortic anrysm 6/> cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBB0","description":"ICD-NBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIA1","description":"ICD-BEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinogen test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85366","description":"Fibrinogen test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92987","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTE0","description":"ICD-EHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve (Monarch external Trigeminal Nerve Stimulation (eTNS) System.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1016","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve (Monarch external Trigeminal Nerve Stimulation (eTNS) System.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBA0","description":"ICD-FBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical placement of craniofacial implant - extra oral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7993","description":"Surgical placement of craniofacial implant - extra oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair Of Orthodontic Appliance - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8697","description":"Repair Of Orthodontic Appliance - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEA1","description":"ICD-MBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93971","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70482","description":"Ct orbit/ear/fossa w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33770","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOA1","description":"ICD-KEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATE0","description":"ICD-EATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAB1","description":"ICD-KIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDB0","description":"ICD-ICDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47125","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comb art/venous blood tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4755","description":"Comb art/venous blood tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise hip/thigh nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64763","description":"Incise hip/thigh nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLE1","description":"ICD-GGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial valve remov addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31649","description":"Bronchial valve remov addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB34","description":"Low Rehab_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hf measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8548","description":"Hf measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABF1","description":"ICD-GABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERD1","description":"ICD-LERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFID0","description":"ICD-GFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHB1","description":"ICD-FGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBC1","description":"ICD-IFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ntiol category 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q1005","description":"Ntiol category 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary hvy plstc pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4382","description":"Urinary hvy plstc pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plasma volume multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78111","description":"Plasma volume multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc hand les sc < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26115","description":"Exc hand les sc < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63308","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA125","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shorten radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25390","description":"Shorten radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQC0","description":"ICD-DEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90593","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","description":"CPT-90593","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine shunt to intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50815","description":"Urine shunt to intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement diaphragm/fplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7502","description":"Replacement diaphragm/fplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHD1","description":"ICD-IHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of throat abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42725","description":"Drainage of throat abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antiemetic drug oral nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8597","description":"Antiemetic drug oral nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKB1","description":"ICD-GIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUF0","description":"ICD-KEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWA1","description":"ICD-HCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41009","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOC0","description":"ICD-HCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunotherapy administration with electroporation_ intramuscular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0732T","description":"Immunotherapy administration with electroporation_ intramuscular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5D","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC145","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine_ on or after their 60th birthday and before or during measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1179","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine_ on or after their 60th birthday and before or during measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermagraft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4106","description":"Dermagraft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC226","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLD1","description":"ICD-CHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33779","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOB1","description":"ICD-GGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB141","description":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAD0","description":"ICD-MLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSE0","description":"ICD-LHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rabies ig im/sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90375","description":"Rabies ig im/sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXC1","description":"ICD-NGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSB1","description":"ICD-CHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXB1","description":"ICD-KFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQC1","description":"ICD-HBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGF0","description":"ICD-JBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDA0","description":"ICD-BFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGF0","description":"ICD-GEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDD1","description":"ICD-GIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart-vein defect(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33730","description":"Repair heart-vein defect(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKD1","description":"ICD-OEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Been Ordered Or Performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2119","description":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Been Ordered Or Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37269","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","description":"CPT-37269","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert heart pm atrial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33206","description":"Insert heart pm atrial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFB1","description":"ICD-KGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGF1","description":"ICD-BIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKD1","description":"ICD-KGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker rigid adjust/fixed ht","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0130","description":"Walker rigid adjust/fixed ht","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQC0","description":"ICD-OHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARD1","description":"ICD-PARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe sole wedge outside sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3360","description":"Shoe sole wedge outside sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEB1","description":"ICD-FGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGB0","description":"ICD-KDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1007T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","description":"CPT-1007T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAA0","description":"ICD-GHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of nasal adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30560","description":"Release of nasal adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBE0","description":"ICD-FFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTB0","description":"ICD-NGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYA1","description":"ICD-LAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATB1","description":"ICD-MATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin pedicle flap arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15572","description":"Skin pedicle flap arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysate conc pow per pack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4765","description":"Dialysate conc pow per pack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27495","description":"Reinforce thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA41","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22632","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cadmium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82300","description":"Assay of cadmium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQA1","description":"ICD-HAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare donor intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44715","description":"Prepare donor intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCD1","description":"ICD-MFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"T-cell depletion of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38210","description":"T-cell depletion of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below knee sus/seal sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5685","description":"Below knee sus/seal sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2_ 3_ 4)_ formalin-fixed paraffin-embedded (FFPE)_ predictive_ identificat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0471U","description":"Oncology (colorectal cancer)_ qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2_ 3_ 4)_ formalin-fixed paraffin-embedded (FFPE)_ predictive_ identificat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","description":"CPT-01930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disease management program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0315","description":"Disease management program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Work hardening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97545","description":"Work hardening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILF0","description":"ICD-NILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMA1","description":"ICD-ODMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral 50% dextrose solu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4164","description":"Parenteral 50% dextrose solu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q4h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9504","description":"Hit antibiotic q4h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 3mod sacro-scap pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0462","description":"Tlso 3mod sacro-scap pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cell enumeration & id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86152","description":"Cell enumeration & id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Somatropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2941","description":"Somatropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interim implant crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6085","description":"Interim implant crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMF0","description":"ICD-BDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reremove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25112","description":"Reremove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0203","description":"HCPCS-A0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALB1","description":"ICD-FALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAE1","description":"ICD-AGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOF1","description":"ICD-DIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4439","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","description":"HCPCS-Q4439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Who cock-up nonmolde pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3908","description":"Who cock-up nonmolde pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOE1","description":"ICD-CFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACE0","description":"ICD-FACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHC0","description":"ICD-OFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKE1","description":"ICD-GBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8F","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21122","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEF1","description":"ICD-NDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Testosterone; bioavailable_ direct measurement (eg_ differential precipitation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84410","description":"Testosterone; bioavailable_ direct measurement (eg_ differential precipitation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEF0","description":"ICD-EDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOB0","description":"ICD-ODOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDB1","description":"ICD-NKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRB0","description":"ICD-DBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sgd prerec msg >8min <=20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2502","description":"Sgd prerec msg >8min <=20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKE1","description":"ICD-KIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIC1","description":"ICD-AAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatic function panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80076","description":"Hepatic function panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUB1","description":"ICD-NHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHC0","description":"ICD-MGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMB1","description":"ICD-BEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD144","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWE1","description":"ICD-PGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGB1","description":"ICD-NFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMD0","description":"ICD-IEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ aicd_ endo single coil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1777","description":"Lead_ aicd_ endo single coil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBD0","description":"ICD-OGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of sciatic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64712","description":"Revision of sciatic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal t3 n0 no prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9091","description":"Onc dx rectal t3 n0 no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLD1","description":"ICD-GCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCF1","description":"ICD-AHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYA1","description":"ICD-KBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPC1","description":"ICD-FFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRF1","description":"ICD-GBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meniscal trnspl knee w/scpe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29868","description":"Meniscal trnspl knee w/scpe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAD0","description":"ICD-CFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAF0","description":"ICD-KGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBC1","description":"ICD-KEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDF1","description":"ICD-BHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGC0","description":"ICD-KHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFC0","description":"ICD-CBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQE0","description":"ICD-LDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICF1","description":"ICD-IICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVA0","description":"ICD-NKVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAND1","description":"ICD-GAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEF0","description":"ICD-KBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9173","description":"HCPCS-C9173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4367","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","description":"HCPCS-Q4367","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Term dev mech hand vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6708","description":"Term dev mech hand vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRC0","description":"ICD-DHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLB0","description":"ICD-MKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAF1","description":"ICD-MEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUA1","description":"ICD-KFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0138U","description":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEF1","description":"ICD-OAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cisplatin 10 mg injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9060","description":"Cisplatin 10 mg injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTB0","description":"ICD-KGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLC0","description":"ICD-CDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55821","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQA1","description":"ICD-CHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18H","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNB0","description":"ICD-GFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMC0","description":"ICD-GBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug-Induced Sleep Endoscopy_ With Dynamic Evaluation Of Velum_ Pharynx_ Tongue Base_ And Larynx For Evaluation Of Sleep-Disordered Breathing_ Flexible_ Diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42975","description":"Drug-Induced Sleep Endoscopy_ With Dynamic Evaluation Of Velum_ Pharynx_ Tongue Base_ And Larynx For Evaluation Of Sleep-Disordered Breathing_ Flexible_ Diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental tomographic survey","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0322","description":"Dental tomographic survey","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90912","description":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral fludarabine phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8562","description":"Oral fludarabine phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB11","description":"ICD-3DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct entire forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21179","description":"Reconstruct entire forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of intranasal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30117","description":"Removal of intranasal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERD1","description":"ICD-DERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12B","description":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ carboxymethyllysine_ methylglyoxal hydroimidazolone_ and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0384U","description":"Nephrology (chronic kidney disease)_ carboxymethyllysine_ methylglyoxal hydroimidazolone_ and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSB0","description":"ICD-LGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUE0","description":"ICD-CDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYF1","description":"ICD-DDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Florbetaben f18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9458","description":"Florbetaben f18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ padded foam_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6605","description":"Gradient compression bandaging supply_ padded foam_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHC0","description":"ICD-NCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urokinase 5000 iu injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3364","description":"Urokinase 5000 iu injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10A","description":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECD0","description":"ICD-KECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9024","description":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIB0","description":"ICD-FIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate t1no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9077","description":"Onc dx prostate t1no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGC1","description":"ICD-JFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIC0","description":"ICD-CBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNB0","description":"ICD-JGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0908T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","description":"CPT-0908T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQE1","description":"ICD-PKQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECC0","description":"ICD-AECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61518","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVE0","description":"ICD-KAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMA0","description":"ICD-ICMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53510","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHD0","description":"ICD-NCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal scalp blood sample","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59030","description":"Fetal scalp blood sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVE1","description":"ICD-KIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystatin c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82610","description":"Cystatin c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33710","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX56","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAC1","description":"ICD-KFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFD0","description":"ICD-KHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise ulnar nerve at elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64718","description":"Revise ulnar nerve at elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ eteplirsen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9484","description":"Injection_ eteplirsen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNC0","description":"ICD-FCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPB0","description":"ICD-BEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAA1","description":"ICD-FEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj perflutren lip micros_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9957","description":"Inj perflutren lip micros_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHF1","description":"ICD-GCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENE1","description":"ICD-GENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBA1","description":"ICD-GHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTA1","description":"ICD-GCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGB1","description":"ICD-BBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABE1","description":"ICD-JABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9764","description":"Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diuretic thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4221F","description":"Diuretic thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGB0","description":"ICD-OCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ceruloplasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82390","description":"Assay of ceruloplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD113","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUC1","description":"ICD-OGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA31","description":"ICD-3BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shrt leg ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4040","description":"Cast sup shrt leg ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKA1","description":"ICD-KHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIE0","description":"ICD-FFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANA1","description":"ICD-GANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx gastric p r1-r2noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9101","description":"Onc dx gastric p r1-r2noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAB0","description":"ICD-AGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPA0","description":"ICD-KHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHF0","description":"ICD-NDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQA1","description":"ICD-CAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXA0","description":"ICD-CBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOA0","description":"ICD-LGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOE0","description":"ICD-KEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQB1","description":"ICD-HGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgigraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4183","description":"Surgigraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33746","description":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal_ subcutaneous cardiac rhythm monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33286","description":"Removal_ subcutaneous cardiac rhythm monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incontinence garment anytype","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4520","description":"Incontinence garment anytype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBB0","description":"ICD-CEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFE0","description":"ICD-OKFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGA0","description":"ICD-KHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC15","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immntx 5 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95134","description":"Immntx 5 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc forearm les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25071","description":"Exc forearm les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulse gen sys tx endolymp fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2120","description":"Pulse gen sys tx endolymp fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKC0","description":"ICD-GIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC130","description":"Reduced Physical Function _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0541T","description":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver disease_ 10 biochemical assays (a2-macroglobulin_ haptoglobin_ apolipoprotein A1_ bilirubin_ GGT_ ALT_ AST_ triglycerides_ cholesterol_ fasting glucose) and biometric an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0166U","description":"Liver disease_ 10 biochemical assays (a2-macroglobulin_ haptoglobin_ apolipoprotein A1_ bilirubin_ GGT_ ALT_ AST_ triglycerides_ cholesterol_ fasting glucose) and biometric an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILF0","description":"ICD-MILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXA1","description":"ICD-GEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8910","description":"Mra w/o cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQF1","description":"ICD-PLQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCD0","description":"ICD-OGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIB1","description":"ICD-MHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit cont pain per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9326","description":"Hit cont pain per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); duplication/deletion variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81363","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); duplication/deletion variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISD1","description":"ICD-LISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUD1","description":"ICD-BIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin sub graft f/n/hf/g addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15276","description":"Skin sub graft f/n/hf/g addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No admit req surg rev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9413","description":"No admit req surg rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family homecare train/sessio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5111","description":"Family homecare train/sessio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99156","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement_ aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved con","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33440","description":"Replacement_ aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4399","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","description":"HCPCS-Q4399","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITE1","description":"ICD-FITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEA1","description":"ICD-FDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDF0","description":"ICD-IDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0D","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALC0","description":"ICD-EALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chd risk imt study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0126T","description":"Chd risk imt study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spin/brain pump refil & main","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95990","description":"Spin/brain pump refil & main","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fx rad extra-articul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25607","description":"Treat fx rad extra-articul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sympathectomy supfc palmar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64823","description":"Sympathectomy supfc palmar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDC1","description":"ICD-MDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTE1","description":"ICD-JGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Construct thumb replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26550","description":"Construct thumb replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical home level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9149","description":"Medical home level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Homecare train pt 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5108","description":"Homecare train pt 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFB1","description":"ICD-BFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSD0","description":"ICD-PKSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFD0","description":"ICD-FEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exam of vulva w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56820","description":"Exam of vulva w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE110","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHF0","description":"ICD-GGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGF0","description":"ICD-JDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUC0","description":"ICD-MBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove armpit lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38740","description":"Remove armpit lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQF1","description":"ICD-KGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Water pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0187","description":"Water pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEE1","description":"ICD-KFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBE0","description":"ICD-MHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBE0","description":"ICD-OHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx isodose complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77318","description":"Brachytx isodose complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reclining back add ped w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1014","description":"Reclining back add ped w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCE0","description":"ICD-KHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNF1","description":"ICD-CCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dem severity class severe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1493F","description":"Dem severity class severe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSF0","description":"ICD-KBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sotrovimab_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0247","description":"Injection_ sotrovimab_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMF1","description":"ICD-NIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXC1","description":"ICD-FIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHD1","description":"ICD-KHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGME1","description":"ICD-EGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHB0","description":"ICD-GAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCB1","description":"ICD-EHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYF0","description":"ICD-HEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDD0","description":"ICD-AGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruct premalg les 2-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17003","description":"Destruct premalg les 2-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muramidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85549","description":"Muramidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPB0","description":"ICD-OLPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc prostate prob score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0010M","description":"Onc prostate prob score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lev 3 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0382","description":"Lev 3 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94761","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCF0","description":"ICD-NJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC44","description":"High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNC1","description":"ICD-OLNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36584","description":"Replace picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVB1","description":"ICD-FGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bile acids total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82239","description":"Bile acids total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0666","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","description":"HCPCS-G0666","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab-pvvr_ biosimilar_ (ruxience)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5119","description":"Injection_ rituximab-pvvr_ biosimilar_ (ruxience)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of hip cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29305","description":"Application of hip cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNF1","description":"ICD-CHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEED1","description":"ICD-IEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFB0","description":"ICD-NEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAND0","description":"ICD-NAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lysis of labial lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56441","description":"Lysis of labial lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOB1","description":"ICD-OAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB117","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4353","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","description":"HCPCS-Q4353","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDA1","description":"ICD-BCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20B","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drsg gel filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6248","description":"Hydrogel drsg gel filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls daily mgmt-venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33948","description":"Ecmo/ecls daily mgmt-venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRF1","description":"ICD-LDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUB1","description":"ICD-JAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQB0","description":"ICD-CEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMF1","description":"ICD-JAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGF0","description":"ICD-KIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBD1","description":"ICD-NJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAE0","description":"ICD-GAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","description":"HCPCS-J1171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sperm pouch lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55680","description":"Remove sperm pouch lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmprsburngarment glove-wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6504","description":"Cmprsburngarment glove-wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AJCC Breast Cancer Stage I: T1mic_ T1a or T1b (tumor size <= 1 cm) documented (ONC)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3372F","description":"AJCC Breast Cancer Stage I: T1mic_ T1a or T1b (tumor size <= 1 cm) documented (ONC)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBC1","description":"ICD-KFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin k phytonadione inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3430","description":"Vitamin k phytonadione inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGC1","description":"ICD-NJGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0594U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","description":"CPT-0594U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCD0","description":"ICD-GDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pressure pneum appl half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0673","description":"Pressure pneum appl half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1073","description":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE213","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVD0","description":"ICD-NCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTF0","description":"ICD-OKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUD0","description":"ICD-NCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 1 visit p mo <2yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90953","description":"Esrd serv 1 visit p mo <2yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGF1","description":"ICD-GFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intent pot remv time placemt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9539","description":"Intent pot remv time placemt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYE1","description":"ICD-HCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUF0","description":"ICD-MEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0992T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","description":"CPT-0992T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYD0","description":"ICD-OAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of angiotensin ii","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82163","description":"Assay of angiotensin ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUE0","description":"ICD-OKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYD1","description":"ICD-GGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61526","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adenosine inj 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0153","description":"Adenosine inj 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDD0","description":"ICD-MLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27138","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAA0","description":"ICD-GAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALA0","description":"ICD-JALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1404","description":"HCPCS-A1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27676","description":"Repair lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64659","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","description":"CPT-64659","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunofix e-phoresis serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86334","description":"Immunofix e-phoresis serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18F","description":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX03","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50130","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36906","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seat lift for pt furn-non-el","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0629","description":"Seat lift for pt furn-non-el","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove femur lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27355","description":"Remove femur lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMA1","description":"ICD-MDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKF0","description":"ICD-OGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSE0","description":"ICD-PKSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4345","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","description":"HCPCS-Q4345","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lipoprotein(a)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83695","description":"Assay of lipoprotein(a)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESC1","description":"ICD-KESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALE1","description":"ICD-EALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYD1","description":"ICD-GFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQC1","description":"ICD-DGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWD0","description":"ICD-HAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNF1","description":"ICD-CFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastroenterology (irritable bowel syndrome [IBS])_ immunoassay for anti-CdtB and anti-vinculin antibodies_ utilizing plasma_ algorithm for elevated or not elevated qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164U","description":"Gastroenterology (irritable bowel syndrome [IBS])_ immunoassay for anti-CdtB and anti-vinculin antibodies_ utilizing plasma_ algorithm for elevated or not elevated qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTE0","description":"ICD-MKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr adpt pneum vad_ rep veh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0504","description":"Pwr adpt pneum vad_ rep veh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMB1","description":"ICD-NIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJF0","description":"ICD-OEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILE1","description":"ICD-KILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUB0","description":"ICD-BAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXB0","description":"ICD-OEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resolve Matrix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2024","description":"Resolve Matrix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALF1","description":"ICD-GALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9898","description":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB241","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA32","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7529","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7529","description":"HCPCS-J7529","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLC1","description":"ICD-MJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXB0","description":"ICD-JIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0563U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","description":"CPT-0563U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj follitropin alfa 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0126","description":"Inj follitropin alfa 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Robot lin-radsurg com_ first","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0339","description":"Robot lin-radsurg com_ first","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dysphag test done b/4 eating","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6015F","description":"Dysphag test done b/4 eating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive care for joint replacement model_ home visit for patient assemssment performed by clinical staff for an individual not considered homebound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9490","description":"Comprehensive care for joint replacement model_ home visit for patient assemssment performed by clinical staff for an individual not considered homebound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQD0","description":"ICD-KAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSB1","description":"ICD-CBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACA1","description":"ICD-AACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25915","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj test 11-12 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95912","description":"Nrv cndj test 11-12 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peristomal hernia supprt blt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4396","description":"Peristomal hernia supprt blt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHE1","description":"ICD-MBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCID1","description":"ICD-NCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGD0","description":"ICD-OIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHF0","description":"ICD-CCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26560","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_hdr ir-192","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1717","description":"Brachytx_ non-str_hdr ir-192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0919T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","description":"CPT-0919T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQA1","description":"ICD-HCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQF0","description":"ICD-LIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIA0","description":"ICD-KGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAC0","description":"ICD-EAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWB0","description":"ICD-OKWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagus n eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64570","description":"Remove vagus n eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIA0","description":"ICD-CBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLE0","description":"ICD-AGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOA0","description":"ICD-PIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAF1","description":"ICD-GGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSF0","description":"ICD-GGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30430","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gluc monitor rental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1031","description":"Gluc monitor rental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC144","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0A","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLD1","description":"ICD-EBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBF1","description":"ICD-OCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC41","description":"Medium Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOC0","description":"ICD-KDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAE1","description":"ICD-ECAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUA1","description":"ICD-IDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB23","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1063T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1063T","description":"CPT-1063T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWC1","description":"ICD-HCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair single ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33617","description":"Repair single ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIE1","description":"ICD-CFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc sed rate automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85652","description":"Rbc sed rate automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVC1","description":"ICD-NHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tonsil tags","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42860","description":"Excision of tonsil tags","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLC0","description":"ICD-KDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB111","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sterile_ gloves per pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4930","description":"Sterile_ gloves per pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Semiquantitative Analysis Of 32 Phosphoproteins And Protein Analytes_ Includes Laser Capture Microdissection_ With Algorithmic Analysis And Interpretative R","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0249U","description":"Oncology (Breast)_ Semiquantitative Analysis Of 32 Phosphoproteins And Protein Analytes_ Includes Laser Capture Microdissection_ With Algorithmic Analysis And Interpretative R","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAA0","description":"ICD-MHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ plasminogen_ human-tvmh_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2998","description":"Injection_ plasminogen_ human-tvmh_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDD0","description":"ICD-FGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALB0","description":"ICD-OALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of finger/thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26952","description":"Amputation of finger/thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBA1","description":"ICD-GFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKA0","description":"ICD-NDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGC1","description":"ICD-BAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pres/absn hmrhg/lesion docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3110F","description":"Pres/absn hmrhg/lesion docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXB0","description":"ICD-KGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITB1","description":"ICD-BITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHD0","description":"ICD-CIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOA1","description":"ICD-HBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYA0","description":"ICD-PDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJA1","description":"ICD-BAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJE1","description":"ICD-BFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAD0","description":"ICD-MBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLC0","description":"ICD-BHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARE0","description":"ICD-CARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKA0","description":"ICD-FGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; common variant(s) (eg_ A_ A-)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81247","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; common variant(s) (eg_ A_ A-)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise lumb artif disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0165T","description":"Revise lumb artif disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1029T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1029T","description":"CPT-1029T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECB1","description":"ICD-OECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ transluminal intravascular lesion preparation device_ bladed_ sheathed (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1600","description":"Catheter_ transluminal intravascular lesion preparation device_ bladed_ sheathed (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen skin test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3031","description":"Collagen skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stereoisomer analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80374","description":"Stereoisomer analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion or replacement of permanent leadless pacemaker_ right ventricular_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ ventriculography_ fe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33274","description":"Transcatheter insertion or replacement of permanent leadless pacemaker_ right ventricular_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ ventriculography_ fe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVE0","description":"ICD-FHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unexplained constitutional or other heritable disorders or syndromes_ tissue-specific gene expression by whole-transcriptome and next-generation sequencing_ blood_ formalin-fi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0266U","description":"Unexplained constitutional or other heritable disorders or syndromes_ tissue-specific gene expression by whole-transcriptome and next-generation sequencing_ blood_ formalin-fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I131 max 100uci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9531","description":"I131 max 100uci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for hip x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27095","description":"Injection for hip x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENE0","description":"ICD-OENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWD1","description":"ICD-CHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJA0","description":"ICD-KAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC241","description":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBE0","description":"ICD-EEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWD0","description":"ICD-OHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+ cell percentage <15%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3497F","description":"Cd4+ cell percentage <15%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including MR guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10012","description":"Fine needle aspiration biopsy_ including MR guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBND0","description":"ICD-NBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCC1","description":"ICD-NKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNB0","description":"ICD-JFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUB1","description":"ICD-OEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDED0","description":"ICD-JDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcv hedia outpt dyls fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8956","description":"Pt rcv hedia outpt dyls fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSD1","description":"ICD-DDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPE0","description":"ICD-NLPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX07","description":"Low Rehab plus Extensive _ ADL Index 2-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQE1","description":"ICD-DIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0305","description":"HCPCS-B0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; incarcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49622","description":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; incarcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5164","description":"HCPCS-Q5164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFE0","description":"ICD-OLFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUA0","description":"ICD-MCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIF1","description":"ICD-KDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cep72 (Centrosomal Protein_ 72-Kda)_ Nudt15 (Nudix Hydrolase 15) And Tpmt (Thiopurine S-Methyltransferase) (Eg_ Drug Metabolism) Gene Analysis_ Common Variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0286U","description":"Cep72 (Centrosomal Protein_ 72-Kda)_ Nudt15 (Nudix Hydrolase 15) And Tpmt (Thiopurine S-Methyltransferase) (Eg_ Drug Metabolism) Gene Analysis_ Common Variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMA0","description":"ICD-EHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14C","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/2-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34802","description":"Endovas aaa repr w/2-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOC1","description":"ICD-GFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0617U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","description":"CPT-0617U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient is not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in whee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9719","description":"Patient is not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in whee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUD0","description":"ICD-NIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYC0","description":"ICD-HDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ drainage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1729","description":"Cath_ drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62220","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILF1","description":"ICD-NILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid repair/modifying","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5014","description":"Hearing aid repair/modifying","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNC1","description":"ICD-JHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXE0","description":"ICD-GBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC110","description":"Special Care High _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPD1","description":"ICD-JBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bartonella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86611","description":"Bartonella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESA0","description":"ICD-GESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSA0","description":"ICD-KFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft sclp/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15220","description":"Skin full graft sclp/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEE0","description":"ICD-CDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIF0","description":"ICD-MHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped caloric dense>/=0.7kc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4160","description":"Ef ped caloric dense>/=0.7kc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVE1","description":"ICD-NBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEF1","description":"ICD-OIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVB1","description":"ICD-FEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10D","description":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTC1","description":"ICD-NDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flu immuno admind rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4274F","description":"Flu immuno admind rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXD1","description":"ICD-FGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elevat legrst low extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0046","description":"Elevat legrst low extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLD0","description":"ICD-CCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEC1","description":"ICD-FCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB31","description":"ICD-4IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABB1","description":"ICD-CABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLD0","description":"ICD-FFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stnd hemi (low seat) whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0002","description":"Stnd hemi (low seat) whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICE1","description":"ICD-NICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evoked auditory tst complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92588","description":"Evoked auditory tst complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0231","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0231","description":"HCPCS-M0231","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCE0","description":"ICD-OHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68320","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABC1","description":"ICD-AABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84120","description":"Assay of urine porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct scan for therapy guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77014","description":"Ct scan for therapy guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suction lipectomy head&neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15876","description":"Suction lipectomy head&neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDF0","description":"ICD-BHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYF1","description":"ICD-ODYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathogen reduced plasma sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9071","description":"Pathogen reduced plasma sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28112","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQE0","description":"ICD-LBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUB0","description":"ICD-OAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTB1","description":"ICD-AFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"U1nonsealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2364","description":"U1nonsealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDB1","description":"ICD-JFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNE1","description":"ICD-FFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC21","description":"Very High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ ERBB2 (HER2) copy number by FISH_ tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0009U","description":"Oncology (breast cancer)_ ERBB2 (HER2) copy number by FISH_ tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear medicine therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79999","description":"Nuclear medicine therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFA1","description":"ICD-KIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound prep addl 100 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15003","description":"Wound prep addl 100 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rear whl complete solid tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0069","description":"Rear whl complete solid tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILB0","description":"ICD-CILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automated Analysis Of An Existing Computed Tomography Study For Vertebral Fracture(S)_ Including Assessment Of Bone Density When Performed_ Data Preparation_ Interpretation_ A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0691T","description":"Automated Analysis Of An Existing Computed Tomography Study For Vertebral Fracture(S)_ Including Assessment Of Bone Density When Performed_ Data Preparation_ Interpretation_ A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Panoramic x-ray of jaws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70355","description":"Panoramic x-ray of jaws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUD1","description":"ICD-IGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINC0","description":"ICD-FINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0405","description":"HCPCS-C0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUC1","description":"ICD-IEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQA0","description":"ICD-HBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87564","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","description":"CPT-87564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56633","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTB0","description":"ICD-FBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWE1","description":"ICD-HBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJF1","description":"ICD-KEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUB0","description":"ICD-BCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulp cap indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3120","description":"Pulp cap indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rapid desensitization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95180","description":"Rapid desensitization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antithymocyte globuln rabbit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7511","description":"Antithymocyte globuln rabbit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Humate-p_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7187","description":"Humate-p_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harvest stem cell concentrte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38215","description":"Harvest stem cell concentrte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJF1","description":"ICD-GCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKD1","description":"ICD-FFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trnsprnl Impl Prm Adj Balln Cnt Dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9746","description":"Trnsprnl Impl Prm Adj Balln Cnt Dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pmp22 gene dup/delet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81324","description":"Pmp22 gene dup/delet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46080","description":"Incision of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAC0","description":"ICD-AHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABB0","description":"ICD-CABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Etonogestrel implant system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7307","description":"Etonogestrel implant system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCD1","description":"ICD-BHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVD1","description":"ICD-JFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone 80 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1040","description":"Methylprednisolone 80 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEE0","description":"ICD-EEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMA1","description":"ICD-EIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAF0","description":"ICD-GHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remis 6m w/o 6mos phq-9 <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9574","description":"Remis 6m w/o 6mos phq-9 <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGE1","description":"ICD-OFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant mandible for augment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7996","description":"Implant mandible for augment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35091","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRD0","description":"ICD-GHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPA1","description":"ICD-CGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0569U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","description":"CPT-0569U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8B","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDC1","description":"ICD-CFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9378","description":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ aicd_ endo dual coil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1895","description":"Lead_ aicd_ endo dual coil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dementia mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8761","description":"Dementia mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44188","description":"Lap colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEC0","description":"ICD-GIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDD0","description":"ICD-BBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALB0","description":"ICD-FALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albuterol ipratrop non-comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7620","description":"Albuterol ipratrop non-comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASF1","description":"ICD-PASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCA0","description":"ICD-OLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tens four lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0730","description":"Tens four lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBF1","description":"ICD-MIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFA0","description":"ICD-KDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOF1","description":"ICD-LGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYE0","description":"ICD-OJYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Astigmatism-correct function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2787","description":"Astigmatism-correct function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHE0","description":"ICD-CHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBA0","description":"ICD-IDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay for calprotectin fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83993","description":"Assay for calprotectin fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTA0","description":"ICD-NFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRB1","description":"ICD-KFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","description":"CPT-98016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDE1","description":"ICD-OKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIND0","description":"ICD-FIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35005","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand interface joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2321","description":"Hand interface joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJF1","description":"ICD-JIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRA0","description":"ICD-DBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWC0","description":"ICD-PBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJD0","description":"ICD-NBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVA0","description":"ICD-OLVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXB0","description":"ICD-KIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1016T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","description":"CPT-1016T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOA1","description":"ICD-LDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCE0","description":"ICD-NCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29520","description":"Strapping of hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYB0","description":"ICD-LEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Joint device (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1776","description":"Joint device (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIA0","description":"ICD-MAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv vaccine pandemic im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90668","description":"Iiv vaccine pandemic im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQB0","description":"ICD-CAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair ventrl hern reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49565","description":"Rerepair ventrl hern reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12D","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj test 7-8 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95910","description":"Nrv cndj test 7-8 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pouch absorbent material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4422","description":"Ost pouch absorbent material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYA1","description":"ICD-DCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg cerv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22210","description":"Incis 1 vertebral seg cerv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disability examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99456","description":"Disability examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENB0","description":"ICD-FENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67015","description":"Release of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAB0","description":"ICD-ADAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC134","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroretinography (ERG)_ with interpretation and report; multifocal (mfERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92274","description":"Electroretinography (ERG)_ with interpretation and report; multifocal (mfERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAD0","description":"ICD-MKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seat/back cus no dmepdac ver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0669","description":"Seat/back cus no dmepdac ver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPB0","description":"ICD-NEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSF1","description":"ICD-OHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUD0","description":"ICD-KGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAA0","description":"ICD-MJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVF1","description":"ICD-JFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLC0","description":"ICD-MBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27538","description":"Treat knee fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rabies Immune Globulin_ Heat- And Solvent/Detergent-Treated (Rig-Ht S/D)_ Human_ For Intramuscular And/Or Subcutaneous Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90377","description":"Rabies Immune Globulin_ Heat- And Solvent/Detergent-Treated (Rig-Ht S/D)_ Human_ For Intramuscular And/Or Subcutaneous Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23B","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1 quant&revrse trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87536","description":"Hiv-1 quant&revrse trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDC1","description":"ICD-MLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52000","description":"Cystoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinic service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1015","description":"Clinic service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDA1","description":"ICD-ACDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKC1","description":"ICD-OEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXF1","description":"ICD-OCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIF0","description":"ICD-AGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove implant of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65920","description":"Remove implant of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped size pull-on sm/med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4531","description":"Ped size pull-on sm/med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOE1","description":"ICD-ODOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAC1","description":"ICD-GIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26675","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBND0","description":"ICD-GBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJE0","description":"ICD-NKJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRA1","description":"ICD-PJRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWC1","description":"ICD-OAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert bladder catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51701","description":"Insert bladder catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0345U","description":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59852","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQC0","description":"ICD-KFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMB0","description":"ICD-CFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEF1","description":"ICD-ABEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESD0","description":"ICD-OESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suture small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44603","description":"Suture small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99334","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAC0","description":"ICD-OLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNB0","description":"ICD-JCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICB0","description":"ICD-JICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXD0","description":"ICD-NKXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHC1","description":"ICD-FEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressant tricyclic 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80335","description":"Antidepressant tricyclic 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko rigid w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1836","description":"Ko rigid w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEE0","description":"ICD-BGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDA1","description":"ICD-IEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHF0","description":"ICD-IFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rad exp time w/o fluor doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9501","description":"Rad exp time w/o fluor doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Access av dial grft for eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36147","description":"Access av dial grft for eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Renin stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80416","description":"Renin stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNA1","description":"ICD-GHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroscopy_ physician or other qualified health care professional time more than 1 hour_ assisting a nonradiologic physician or other qualified health care professional (eg_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76001","description":"Fluoroscopy_ physician or other qualified health care professional time more than 1 hour_ assisting a nonradiologic physician or other qualified health care professional (eg_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place cath vertebral art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36226","description":"Place cath vertebral art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breath test heart reject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0085T","description":"Breath test heart reject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMD0","description":"ICD-NJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSF1","description":"ICD-PGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Air ambulanc nonemerg fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9960","description":"Air ambulanc nonemerg fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26860","description":"Fusion of finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOE1","description":"ICD-GCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE110","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIB1","description":"ICD-GDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOB0","description":"ICD-DGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRB0","description":"ICD-GBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laiv4 vaccine intranasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90672","description":"Laiv4 vaccine intranasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPF0","description":"ICD-KCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWC0","description":"ICD-GEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEME1","description":"ICD-IEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKC1","description":"ICD-CAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26843","description":"Fusion of hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPA0","description":"ICD-CBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of forehead wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15824","description":"Removal of forehead wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAA1","description":"ICD-JCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGA0","description":"ICD-NDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLE0","description":"ICD-KDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pentastarch 10% solution","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2513","description":"Pentastarch 10% solution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUB0","description":"ICD-IFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIC0","description":"ICD-ECIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24635","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oct brst/node i&r per spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0352T","description":"Oct brst/node i&r per spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Review_ Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0713T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Review_ Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90955","description":"Esrd srv 2-3 vsts p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGA1","description":"ICD-KAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing id_ digit_ mon_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5254","description":"Hearing id_ digit_ mon_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6524","description":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rig ped wc tltnspc w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1233","description":"Rig ped wc tltnspc w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg monitor technol attended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95956","description":"Eeg monitor technol attended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJC0","description":"ICD-BBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUE0","description":"ICD-JBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHA0","description":"ICD-ICHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD113","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0454T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWF0","description":"ICD-OAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFB1","description":"ICD-OAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUE1","description":"ICD-MFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQD1","description":"ICD-LFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIE1","description":"ICD-GDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXE0","description":"ICD-JCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28X","description":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Halo cerv into milwaukee typ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0830","description":"Halo cerv into milwaukee typ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/replace knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27487","description":"Revise/replace knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXD1","description":"ICD-CGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder lock actuator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6647","description":"Shoulder lock actuator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVC1","description":"ICD-BEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dispens fee immunosupressive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0510","description":"Dispens fee immunosupressive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNA0","description":"ICD-KGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anti rheum drugthxpyrxd/gvn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4187F","description":"Anti rheum drugthxpyrxd/gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA51","description":"Low Rehab_ ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post 1 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2391","description":"Post 1 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNB1","description":"ICD-NDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect talus/calcaneus tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27647","description":"Resect talus/calcaneus tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUE0","description":"ICD-OBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCD0","description":"ICD-FCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect scapula tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23210","description":"Resect scapula tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB221","description":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLE1","description":"ICD-FFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; system_ including pulse generat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33278","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; system_ including pulse generat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cad cxr remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0175T","description":"Cad cxr remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBA0","description":"ICD-OKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; interpretation and report only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76989","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; interpretation and report only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Term dev mech hook vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6706","description":"Term dev mech hook vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVB1","description":"ICD-GFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEF1","description":"ICD-NJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEE0","description":"ICD-NFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18I","description":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPD1","description":"ICD-KGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC11","description":"ICD-2IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXD0","description":"ICD-JBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 60 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0149U","description":"Drug assay_ definitive_ 60 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder-vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57320","description":"Repair bladder-vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJF1","description":"ICD-GGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recd cortico >=10mg/day >60d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9467","description":"Recd cortico >=10mg/day >60d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Etidronate disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1436","description":"Etidronate disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWF0","description":"ICD-GGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28G","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home mgmt pprom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9209","description":"Home mgmt pprom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGED0","description":"ICD-GGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBC1","description":"ICD-CCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excursion amplifier lever ty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6642","description":"Excursion amplifier lever ty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFA1","description":"ICD-KGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEE0","description":"ICD-KCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPE1","description":"ICD-OBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVF1","description":"ICD-JGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (accord) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9296","description":"Injection_ pemetrexed (accord) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIE0","description":"ICD-AHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLC0","description":"ICD-EDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of precision att","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5867","description":"Replacement of precision att","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76529","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEA0","description":"ICD-ODEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATE0","description":"ICD-OATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx contour defects 5.1-10cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11952","description":"Tx contour defects 5.1-10cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJB1","description":"ICD-JHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECF1","description":"ICD-JECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUD1","description":"ICD-GFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQC0","description":"ICD-GIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMD1","description":"ICD-IHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGD0","description":"ICD-JEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periph field stimul trial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0282T","description":"Periph field stimul trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOA1","description":"ICD-OJOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Portable liquid 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0434","description":"Portable liquid 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65205","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise anal ext tag/papilla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46220","description":"Excise anal ext tag/papilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9577","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVF1","description":"ICD-NJVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISC0","description":"ICD-DISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXE1","description":"ICD-BBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61320","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stocking sup grips 4 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0982","description":"Stocking sup grips 4 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; known familial sequence variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81337","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; known familial sequence variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert aqueous drain device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0253T","description":"Insert aqueous drain device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOB1","description":"ICD-CDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJND1","description":"ICD-OJND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYB0","description":"ICD-KHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSF0","description":"ICD-PBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGND1","description":"ICD-CGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVF0","description":"ICD-KEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown full cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2792","description":"Crown full cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carbon graphite lamination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2755","description":"Carbon graphite lamination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Molded inner boot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2280","description":"Molded inner boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDE0","description":"ICD-OIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kcentra_ per i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9132","description":"Kcentra_ per i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETA0","description":"ICD-FETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21B","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEB0","description":"ICD-CIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55831","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCE1","description":"ICD-GFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interscapular-thor switch ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6970","description":"Interscapular-thor switch ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision gastroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43848","description":"Revision gastroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration behind upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31040","description":"Exploration behind upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36248","description":"Ins cath abd/l-ext art addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDA0","description":"ICD-KGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKF1","description":"ICD-GEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBED0","description":"ICD-BBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59130","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periodic orthodontc tx visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8670","description":"Periodic orthodontc tx visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sutures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0630","description":"Removal of sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLE1","description":"ICD-AHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFD1","description":"ICD-KCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37272","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","description":"CPT-37272","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1039T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1039T","description":"CPT-1039T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant (fresenius kabi) not therapeutically equivalent to j9395_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9394","description":"Injection_ fulvestrant (fresenius kabi) not therapeutically equivalent to j9395_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJND1","description":"ICD-NJND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHA1","description":"ICD-GFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0162","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","description":"HCPCS-J0162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRE1","description":"ICD-DHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald_ tv amplifier_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5270","description":"Ald_ tv amplifier_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRC1","description":"ICD-GGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conn tiss_ non-human","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1763","description":"Conn tiss_ non-human","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUA1","description":"ICD-CAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote therapeutic monitoring (eg_ therapy adherence_ therapy response); device(s) supply with scheduled (eg_ daily) recording(s) and/or programmed alert(s) transmission to mo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98978","description":"Remote therapeutic monitoring (eg_ therapy adherence_ therapy response); device(s) supply with scheduled (eg_ daily) recording(s) and/or programmed alert(s) transmission to mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWA1","description":"ICD-CDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0510","description":"Non-prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHA1","description":"ICD-CDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBD0","description":"ICD-IEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVF0","description":"ICD-FBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJF1","description":"ICD-NDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24430","description":"Repair of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC21","description":"ICD-2KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJC1","description":"ICD-BAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid dispensing fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5090","description":"Hearing aid dispensing fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHD1","description":"ICD-NKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEC1","description":"ICD-KFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis training incompl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90993","description":"Dialysis training incompl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Toc tool incl elem not used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9658","description":"Toc tool incl elem not used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARE1","description":"ICD-LARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound exam aaa screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0389","description":"Ultrasound exam aaa screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVB1","description":"ICD-CBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXF1","description":"ICD-OIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABA1","description":"ICD-OABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABD1","description":"ICD-IABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC234","description":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC150","description":"Clinically Complex _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMB1","description":"ICD-JEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28200","description":"Repair of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOF1","description":"ICD-GBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRF0","description":"ICD-OLRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD140","description":"Clinically Complex _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPD1","description":"ICD-GGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Man w/c push-rim powr system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0986","description":"Man w/c push-rim powr system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJA0","description":"ICD-FBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd diagnostic brush wash","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43235","description":"Egd diagnostic brush wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supply/ext inf pump syr type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0552","description":"Supply/ext inf pump syr type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBC1","description":"ICD-FFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE250","description":"Special Care High _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Positioning cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0190","description":"Positioning cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQE0","description":"ICD-KAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCC1","description":"ICD-GHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL07","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/plcmt stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45347","description":"Sigmoidoscopy w/plcmt stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXB0","description":"ICD-CFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARD0","description":"ICD-GARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-2 antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86702","description":"Hiv-2 antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIB0","description":"ICD-NEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair paravag defect vag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57285","description":"Repair paravag defect vag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOF1","description":"ICD-PLOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBB0","description":"ICD-NJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUE1","description":"ICD-AIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neg press wound tx >50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97608","description":"Neg press wound tx >50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; complete acute abdomen series_ including supine_ erect_ and/or decubitus views_ single view chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74022","description":"Radiologic examination_ abdomen; complete acute abdomen series_ including supine_ erect_ and/or decubitus views_ single view chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRA0","description":"ICD-GFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correct skn color 6.1-20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11921","description":"Correct skn color 6.1-20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corf related serv 15 mins ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0409","description":"Corf related serv 15 mins ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98006","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","description":"CPT-98006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Thyroid)_ Mrna_ Gene Expression Analysis Of 10_196 Genes_ Utilizing Fine Needle Aspirate_ Algorithm Reported As A Categorical Result (Eg_ Benign Or Suspicious)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81546","description":"Oncology (Thyroid)_ Mrna_ Gene Expression Analysis Of 10_196 Genes_ Utilizing Fine Needle Aspirate_ Algorithm Reported As A Categorical Result (Eg_ Benign Or Suspicious)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIED0","description":"ICD-MIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0205","description":"HCPCS-B0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUC0","description":"ICD-KCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTA0","description":"ICD-CHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMB0","description":"ICD-MKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1053T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1053T","description":"CPT-1053T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hg a1c level 7.0-9.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3045F","description":"Hg a1c level 7.0-9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA31","description":"ICD-1AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mast mod rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19307","description":"Mast mod rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25C","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBE0","description":"ICD-OLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC21","description":"ICD-2IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1481","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","description":"HCPCS-M1481","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35189","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIC1","description":"ICD-NIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test one limb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95860","description":"Muscle test one limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo sling operation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51992","description":"Laparo sling operation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB144","description":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intensive outpatient services; weekly bundle_ minimum of 9 services over a 7 contiguous day period_ which can include individual and group therapy with physicians or psycholog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0137","description":"Intensive outpatient services; weekly bundle_ minimum of 9 services over a 7 contiguous day period_ which can include individual and group therapy with physicians or psycholog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMA1","description":"ICD-NGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear rx intra-articular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79440","description":"Nuclear rx intra-articular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair penis and bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54390","description":"Repair penis and bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74270","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Static or dynami afo pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4397","description":"Static or dynami afo pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza immunization was not administered for reasons documented by clinician (e.g._ patient allergy or other medical reasons_ patient declined or other patient reasons_ vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1300","description":"Influenza immunization was not administered for reasons documented by clinician (e.g._ patient allergy or other medical reasons_ patient declined or other patient reasons_ vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDC0","description":"ICD-CIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELE0","description":"ICD-IELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy soft tissue of back","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21920","description":"Biopsy soft tissue of back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTA0","description":"ICD-GCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk thigh lacer non-molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5680","description":"Bk thigh lacer non-molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNA0","description":"ICD-NDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23C","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5139","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5139","description":"HCPCS-Q5139","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67318","description":"Revise eye muscle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCB1","description":"ICD-AGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0105","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0105","description":"CDT-D0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Panitumumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9303","description":"Panitumumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCC0","description":"ICD-OLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTE1","description":"ICD-KCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31805","description":"Repair of windpipe injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRD1","description":"ICD-HDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21421","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25270","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAA0","description":"ICD-JGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILF1","description":"ICD-KILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA11","description":"ICD-1KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJF1","description":"ICD-CDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC22","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of prolactin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84146","description":"Assay of prolactin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heparin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85520","description":"Heparin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOD0","description":"ICD-LHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLA0","description":"ICD-FDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKC0","description":"ICD-CFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0702","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0702","description":"CDT-D0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBE1","description":"ICD-CCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2_ or each additional 1% of body surface area of infants a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0480T","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2_ or each additional 1% of body surface area of infants a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33786","description":"Repair arterial trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngeal function studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92520","description":"Laryngeal function studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC21","description":"ICD-3BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair multi-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54408","description":"Repair multi-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWD1","description":"ICD-LHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTD1","description":"ICD-CBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKD0","description":"ICD-FIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDE0","description":"ICD-IIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDE0","description":"ICD-MIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDA0","description":"ICD-MFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug outreach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0023","description":"Alcohol and/or drug outreach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQC1","description":"ICD-PLQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone sodium phos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1100","description":"Dexamethasone sodium phos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIB1","description":"ICD-BAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSE0","description":"ICD-HFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20520","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation handling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77790","description":"Radiation handling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAA0","description":"ICD-FDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUB0","description":"ICD-GCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTE1","description":"ICD-MHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX05","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing 1 locus hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81380","description":"Hla i typing 1 locus hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscope_ single-use (i.e. disposable)_ upper GI_ imaging/illumination device (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1748","description":"Endoscope_ single-use (i.e. disposable)_ upper GI_ imaging/illumination device (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYD1","description":"ICD-DDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pharm ther osteo rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8633","description":"Pharm ther osteo rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; preparation_ screening and interpretation (List separately in addition to code for primary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0833T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; preparation_ screening and interpretation (List separately in addition to code for primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aortobi-iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35538","description":"Art byp grft aortobi-iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manipulate elbow w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24300","description":"Manipulate elbow w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection Factor IX_ (antihemophilic factor_ recombinant)_ glycopegylated_ (Rebinyn)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7203","description":"Injection Factor IX_ (antihemophilic factor_ recombinant)_ glycopegylated_ (Rebinyn)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intradermal Cancer Immunotherapy; Preparation And Initial Injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0708T","description":"Intradermal Cancer Immunotherapy; Preparation And Initial Injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBD0","description":"ICD-NCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKB0","description":"ICD-OLKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80204","description":"Methotrexate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUC1","description":"ICD-OIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHC0","description":"ICD-CAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Posaconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80187","description":"Posaconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVC0","description":"ICD-GIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1418","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","description":"HCPCS-M1418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plan 2 main dr by 1 month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5050F","description":"Plan 2 main dr by 1 month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient education materials","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99071","description":"Patient education materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11A","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVF1","description":"ICD-OIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis B virus (HBV) status not assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9913","description":"Hepatitis B virus (HBV) status not assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEE1","description":"ICD-FAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ceftriaxone sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0696","description":"Ceftriaxone sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWD0","description":"ICD-OCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPB0","description":"ICD-GEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFE0","description":"ICD-GFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft axill-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35521","description":"Art byp grft axill-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKD1","description":"ICD-NLKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRB1","description":"ICD-LDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23A","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLE1","description":"ICD-BFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53025","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33020","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (baxter)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9059","description":"Injection_ bendamustine hydrochloride (baxter)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser surgery of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57513","description":"Laser surgery of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGND1","description":"ICD-BGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPF1","description":"ICD-NGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRE1","description":"ICD-LCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIA0","description":"ICD-IGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMC1","description":"ICD-OEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPB0","description":"ICD-BIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCA0","description":"ICD-ICCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Paraffin bath unit portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0235","description":"Paraffin bath unit portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wbc antibody identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86021","description":"Wbc antibody identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43135","description":"Removal of esophagus pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPC0","description":"ICD-NKPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUD1","description":"ICD-EGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHF1","description":"ICD-JHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile_ tandem mass spectrometry (MS/MS)_ urine_ with algorithmic analysis and interpretive report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0256U","description":"Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile_ tandem mass spectrometry (MS/MS)_ urine_ with algorithmic analysis and interpretive report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHD1","description":"ICD-MIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAE0","description":"ICD-MJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Probe nl duct w/balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68816","description":"Probe nl duct w/balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable with carotid sinus baroreceptor stimulation lead(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1825","description":"Generator_ neurostimulator (implantable)_ non-rechargeable with carotid sinus baroreceptor stimulation lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCF1","description":"ICD-ACCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQA0","description":"ICD-GGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVE1","description":"ICD-CAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIC0","description":"ICD-FBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBB0","description":"ICD-AEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRF1","description":"ICD-CHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary’s home.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0246","description":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary’s home.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0816T","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJD0","description":"ICD-KEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18H","description":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDE1","description":"ICD-FIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genet virus isolate hsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87255","description":"Genet virus isolate hsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASE0","description":"ICD-PASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33470","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXF1","description":"ICD-CIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1250","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLF0","description":"ICD-EBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phq-9 >9 during 12m time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9511","description":"Phq-9 >9 during 12m time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auditory function 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92620","description":"Auditory function 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker leg extenders set of4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0158","description":"Walker leg extenders set of4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0043U","description":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9054","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","description":"HCPCS-J9054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXB1","description":"ICD-GCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEID0","description":"ICD-GEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLA1","description":"ICD-ECLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laminotomy (Hemilaminectomy)_ With Decompression Of Nerve Root(S)_ Including Partial Facetectomy_ Foraminotomy And Excision Of Herniated Intervertebral Disc_ And Repair Of Ann","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9757","description":"Laminotomy (Hemilaminectomy)_ With Decompression Of Nerve Root(S)_ Including Partial Facetectomy_ Foraminotomy And Excision Of Herniated Intervertebral Disc_ And Repair Of Ann","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLF0","description":"ICD-FHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diazepam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3360","description":"Diazepam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srs cranial lesion simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61796","description":"Srs cranial lesion simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Posturography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92548","description":"Posturography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDE0","description":"ICD-ABDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLD0","description":"ICD-ICLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test 4 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95864","description":"Muscle test 4 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFA0","description":"ICD-FBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQE0","description":"ICD-OGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc no comp or mort w in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9270","description":"Doc no comp or mort w in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSC1","description":"ICD-DDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk pain & fxn assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1130F","description":"Bk pain & fxn assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25120","description":"Removal of forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYE0","description":"ICD-KEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 7-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4176","description":"Parenteral sol amino acid 7-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPB1","description":"ICD-NCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISC1","description":"ICD-LISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMA0","description":"ICD-IFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lower jaw bone graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21215","description":"Lower jaw bone graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; column (eg_ gas liquid or hplc)_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82486","description":"Chromatography_ qualitative; column (eg_ gas liquid or hplc)_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASB0","description":"ICD-HASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28A","description":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFC0","description":"ICD-KDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 16 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0347U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 16 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull & explore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61253","description":"Pierce skull & explore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX43","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-H0052","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","description":"HCPCS-H0052","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPC0","description":"ICD-FBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","description":"HCPCS-E1033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl bifo 7.25-12/2.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2212","description":"Lens sphcyl bifo 7.25-12/2.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADE0","description":"ICD-NADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIC0","description":"ICD-OKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQC0","description":"ICD-LGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVE0","description":"ICD-GHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Pembrolizumab_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9027","description":"Injection_ Pembrolizumab_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEC0","description":"ICD-KCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDD1","description":"ICD-CGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQC0","description":"ICD-DDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTF0","description":"ICD-IHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEC1","description":"ICD-ECEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASA1","description":"ICD-CASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVD0","description":"ICD-KIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBD0","description":"ICD-MFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea stimj ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0430T","description":"Rmvl nstim apnea stimj ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26370","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISA1","description":"ICD-LISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAB0","description":"ICD-NFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2050","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2050","description":"HCPCS-A2050","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMF1","description":"ICD-CFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ini phq9 >9 remiss <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9393","description":"Ini phq9 >9 remiss <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMD1","description":"ICD-CIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00740","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00740","description":"CPT-00740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKB0","description":"ICD-OJKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of wrist bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25210","description":"Removal of wrist bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOF1","description":"ICD-GEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLC1","description":"ICD-GBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVF0","description":"ICD-FFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temp fml iu valve-pmp rplcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0597T","description":"Temp fml iu valve-pmp rplcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIF1","description":"ICD-KFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCD1","description":"ICD-KFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25900","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1 or more neuropsych","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8947","description":"1 or more neuropsych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSF0","description":"ICD-HGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/chemicl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86970","description":"Rbc pretx incubatj w/chemicl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55845","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLB1","description":"ICD-NLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBD0","description":"ICD-MKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of low back nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64862","description":"Repair of low back nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHC0","description":"ICD-EIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB245","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq lamot/lam crv/thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0274T","description":"Perq lamot/lam crv/thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0654","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","description":"HCPCS-J0654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHC1","description":"ICD-FAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAME0","description":"ICD-NAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEA1","description":"ICD-ECEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18B","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPB0","description":"ICD-NDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immune globulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90399","description":"Immune globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHE1","description":"ICD-MKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWD0","description":"ICD-CFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Create passage to kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52334","description":"Create passage to kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARF1","description":"ICD-GARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18G","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAD0","description":"ICD-FEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLF0","description":"ICD-OJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debridement & contouring","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6102","description":"Debridement & contouring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64553","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Long qt syn gene dup/dlt var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81282","description":"Long qt syn gene dup/dlt var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00934","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","description":"CPT-00934","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIE0","description":"ICD-JIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVF0","description":"ICD-NEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTD1","description":"ICD-OLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMA1","description":"ICD-EAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney & ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50234","description":"Removal of kidney & ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVD0","description":"ICD-FDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVE0","description":"ICD-KGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE235","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreservation sperm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89259","description":"Cryopreservation sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEA0","description":"ICD-NBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elect stim wound care not pd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0282","description":"Elect stim wound care not pd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26418","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rad w/backup non inv intrfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0471","description":"Rad w/backup non inv intrfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC141","description":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITA0","description":"ICD-BITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVA1","description":"ICD-NAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15B","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention On The Date Of The Encounter Or Within The Previous 12 Months (Counseling_ Pharmacotherapy_ Or Bot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0030","description":"Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention On The Date Of The Encounter Or Within The Previous 12 Months (Counseling_ Pharmacotherapy_ Or Bot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSC0","description":"ICD-OKSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFC0","description":"ICD-FDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDF1","description":"ICD-MKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXC1","description":"ICD-OIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt no elg phar ther osteo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8634","description":"Pt no elg phar ther osteo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5271","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEA1","description":"ICD-OCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQB1","description":"ICD-KHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLA0","description":"ICD-JCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXE0","description":"ICD-KEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHC0","description":"ICD-EHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVB1","description":"ICD-NAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCE1","description":"ICD-JHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTE0","description":"ICD-EDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laboratory processing of microbial specimen to include culture and sensitivity studies_ preparation and transmission of written report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0414","description":"Laboratory processing of microbial specimen to include culture and sensitivity studies_ preparation and transmission of written report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic passive restor comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6360","description":"Thoracic passive restor comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPE0","description":"ICD-BEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUE1","description":"ICD-OIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEC0","description":"ICD-KEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECD1","description":"ICD-CECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASC1","description":"ICD-CASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0010","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of interbody biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performed_ to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22853","description":"Insertion of interbody biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performed_ to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD105","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJF0","description":"ICD-GBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWB1","description":"ICD-CIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPC1","description":"ICD-OLPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRD1","description":"ICD-GBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKF0","description":"ICD-JGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHA0","description":"ICD-IFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHE1","description":"ICD-IGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Miroderm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4175","description":"Miroderm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUD1","description":"ICD-IIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARD0","description":"ICD-CARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspa gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81200","description":"Aspa gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening tests dm done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3754F","description":"Screening tests dm done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIB1","description":"ICD-KDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA35","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILD1","description":"ICD-KILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81406","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOB1","description":"ICD-OHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing 1 allele hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81381","description":"Hla i typing 1 allele hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suction susp ak/knee disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5652","description":"Suction susp ak/knee disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWA0","description":"ICD-PIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6540","description":"Gc stocking waistlngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWD1","description":"ICD-HEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRE0","description":"ICD-HGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glucose test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82950","description":"Glucose test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE130","description":"Reduced Physical Function _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTA0","description":"ICD-OGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0520U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","description":"CPT-0520U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUA0","description":"ICD-NIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWD1","description":"ICD-DIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj open reduct-dislocation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7810","description":"Tmj open reduct-dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFB1","description":"ICD-KBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18E","description":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg art-vein six or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33523","description":"Cabg art-vein six or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","description":"HCPCS-Q4382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trilaciclib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9078","description":"Injection_ trilaciclib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thrombin time plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85670","description":"Thrombin time plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93930","description":"Upper extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit new age 40-64","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99386","description":"Prev visit new age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHC1","description":"ICD-GFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUE0","description":"ICD-JIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin most rapid 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5551","description":"Insulin most rapid 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bl smear w/diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85007","description":"Bl smear w/diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC50","description":"Ultra High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABD1","description":"ICD-MABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHD1","description":"ICD-IBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINE1","description":"ICD-GINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYF1","description":"ICD-DHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ fresh or frozen tissue or cells_ report of specific gene rearra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013U","description":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ fresh or frozen tissue or cells_ report of specific gene rearra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDF0","description":"ICD-NLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOC1","description":"ICD-DCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGB1","description":"ICD-CEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPE0","description":"ICD-NAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection Bezlotoxumab 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9490","description":"Injection Bezlotoxumab 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEB1","description":"ICD-ECEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTE1","description":"ICD-BFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIA1","description":"ICD-ECIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCC1","description":"ICD-ADCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISF0","description":"ICD-CISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASD1","description":"ICD-HASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin pneum swg frct exo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5722","description":"Knee-shin pneum swg frct exo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGB1","description":"ICD-NJGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLF0","description":"ICD-IHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METF0","description":"ICD-METF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAME1","description":"ICD-KAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNC1","description":"ICD-FBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8G","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Angina absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1012F","description":"Angina absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFE1","description":"ICD-JDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lipoprotein bld hr fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83701","description":"Lipoprotein bld hr fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQA1","description":"ICD-DIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician_ reason not","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1002","description":"Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician_ reason not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sermorelin acetate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0515","description":"Sermorelin acetate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"KLF1 TARGETED SEQUENCING","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0195U","description":"KLF1 TARGETED SEQUENCING","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITC0","description":"ICD-MITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15940","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1448","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","description":"HCPCS-M1448","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDA1","description":"ICD-OJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Delivery/set up/dispensing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9901","description":"Delivery/set up/dispensing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA31","description":"ICD-2EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUC1","description":"ICD-BCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54205","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg artery-vein four","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33521","description":"Cabg artery-vein four","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24D","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOA0","description":"ICD-HCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43820","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDA0","description":"ICD-CFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50782","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTB0","description":"ICD-NCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA30","description":"Medium Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVA0","description":"ICD-KBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEA0","description":"ICD-BFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLC0","description":"ICD-KCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1071","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAD1","description":"ICD-JCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIB0","description":"ICD-FHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28153","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKE0","description":"ICD-GDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair dura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61619","description":"Repair dura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES105","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEA0","description":"ICD-IHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDF1","description":"ICD-BIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALC1","description":"ICD-EALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC156","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect nasopharynx skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61586","description":"Resect nasopharynx skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHA1","description":"ICD-OEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRE1","description":"ICD-HCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place duod/jej tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49441","description":"Place duod/jej tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair clitoris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56805","description":"Repair clitoris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA150","description":"Reduced Physical Function _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYA0","description":"ICD-KDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychoanalysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90845","description":"Psychoanalysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLD1","description":"ICD-OBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPC0","description":"ICD-ODPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unusual physician travel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99082","description":"Unusual physician travel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB121","description":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBE1","description":"ICD-KBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digit nerve surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64778","description":"Digit nerve surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJA0","description":"ICD-BDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide villus sampling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76945","description":"Echo guide villus sampling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1404","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1404","description":"CDT-D1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asp therp used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8598","description":"Asp therp used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIC1","description":"ICD-JAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caster fork","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2396","description":"Caster fork","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUA1","description":"ICD-FBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD105","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0D","description":"Medium Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQC0","description":"ICD-CDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0955T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","description":"CPT-0955T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1275","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had an intravitreal or periocular corticosteroid injection (e.g._ triamcinolone_ preservative-free triamcinolone_ dexamethasone_ dexamethasone intravitreal implan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1324","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g._ triamcinolone_ preservative-free triamcinolone_ dexamethasone_ dexamethasone intravitreal implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHF0","description":"ICD-GAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUC1","description":"ICD-BIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tendon excision palm/finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26145","description":"Tendon excision palm/finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDB1","description":"ICD-JCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9725","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45300","description":"Proctosigmoidoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYC1","description":"ICD-KEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEB1","description":"ICD-EFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA21","description":"ICD-1DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4C","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Streptomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3000","description":"Streptomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cran surg hemotoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21151","description":"Anesth cran surg hemotoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDE0","description":"ICD-OLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Creation of arteriovenous fistula_ percutaneous; direct_ any site_ including all imaging and radiologic supervision and interpr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9754","description":"Creation of arteriovenous fistula_ percutaneous; direct_ any site_ including all imaging and radiologic supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stimulation of spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63610","description":"Stimulation of spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38700","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCD0","description":"ICD-JBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFF1","description":"ICD-BHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQB0","description":"ICD-PDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCE1","description":"ICD-ODCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace socket hip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5702","description":"Replace socket hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHE0","description":"ICD-CBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGD0","description":"ICD-JAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCD0","description":"ICD-EDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI lwr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73720","description":"MRI lwr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33234","description":"Removal of pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27252","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDA0","description":"ICD-NEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC11","description":"ICD-1AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1640","description":"Hemin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBID1","description":"ICD-BBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of gonadotropin (lh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83002","description":"Assay of gonadotropin (lh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35341","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINC1","description":"ICD-CINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodener muscle larynx emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64617","description":"Chemodener muscle larynx emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCA0","description":"ICD-EDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRF1","description":"ICD-PBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mobility cart pneum vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0502","description":"Mobility cart pneum vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECF0","description":"ICD-FECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51570","description":"Removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUB0","description":"ICD-JGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUD0","description":"ICD-AEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIE0","description":"ICD-BDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26123","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84586","description":"Assay of vip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHF1","description":"ICD-MEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOD1","description":"ICD-DDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHB1","description":"ICD-FAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radium/radioisotope therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77799","description":"Radium/radioisotope therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cranial cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61001","description":"Remove cranial cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18I","description":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of toe lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28092","description":"Removal of toe lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWC1","description":"ICD-KCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5B","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESB1","description":"ICD-GESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Had Prior Adverse Reaction Caused By Zoster Vaccine Or Its Components Any Time During Or Before The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2161","description":"Patient Had Prior Adverse Reaction Caused By Zoster Vaccine Or Its Components Any Time During Or Before The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBC1","description":"ICD-GGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIE0","description":"ICD-NDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1302","description":"HCPCS-A1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDC1","description":"ICD-NEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX55","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSB1","description":"ICD-OBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0801","description":"HCPCS-B0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1031T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1031T","description":"CPT-1031T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gardner vag dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87511","description":"Gardner vag dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inner skull vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61702","description":"Inner skull vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brca1&2 185&5385&6174 var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81212","description":"Brca1&2 185&5385&6174 var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5277","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy flexible brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43200","description":"Esophagoscopy flexible brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBD0","description":"ICD-CFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA54","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDC0","description":"ICD-AEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC255","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; coronary sinus (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93586","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; coronary sinus (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJB0","description":"ICD-GFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTA0","description":"ICD-JDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX60","description":"Medium Rehab plus Extensive_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHD1","description":"ICD-GDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iv hanger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0105","description":"Iv hanger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOE0","description":"ICD-CDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPB0","description":"ICD-GIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQC0","description":"ICD-PAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPF1","description":"ICD-FCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKA0","description":"ICD-OAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEE0","description":"ICD-GDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8C","description":"High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEA1","description":"ICD-GCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUF0","description":"ICD-CGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIF1","description":"ICD-EDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBE1","description":"ICD-GGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult day care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5102","description":"Adult day care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFC1","description":"ICD-OKFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEE1","description":"ICD-GFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPA0","description":"ICD-NLPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glasses bone conduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5080","description":"Glasses bone conduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIB1","description":"ICD-IFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTC1","description":"ICD-ADTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9883","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLE1","description":"ICD-NGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calcitonin stimul panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80410","description":"Calcitonin stimul panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Infinx_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1018","description":"Clinical decision support mechanism Infinx_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDC0","description":"ICD-CGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pet image w/ct full body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78816","description":"Pet image w/ct full body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUE0","description":"ICD-NGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFF1","description":"ICD-NAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTF1","description":"ICD-JDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shrinker above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8460","description":"Shrinker above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bypass graft patency/patch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35685","description":"Bypass graft patency/patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOB1","description":"ICD-GEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney imaging morphol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78700","description":"Kidney imaging morphol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCF1","description":"ICD-ODCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFC0","description":"ICD-NFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFB0","description":"ICD-NHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled air analysis o2/co2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94681","description":"Exhaled air analysis o2/co2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBA1","description":"ICD-KBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFED1","description":"ICD-AFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB21","description":"ICD-2CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATF0","description":"ICD-MATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close mastoid fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69700","description":"Close mastoid fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18I","description":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINA0","description":"ICD-NINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXA0","description":"ICD-NHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHC0","description":"ICD-JDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDF1","description":"ICD-OJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEE0","description":"ICD-OIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDE1","description":"ICD-JFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYB0","description":"ICD-LFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko immob canvas long pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1830","description":"Ko immob canvas long pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKB1","description":"ICD-ODKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOD0","description":"ICD-CIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHE0","description":"ICD-NFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDD0","description":"ICD-BCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27193","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Developmental screen w/score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96110","description":"Developmental screen w/score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCB1","description":"ICD-JGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26720","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKD0","description":"ICD-BGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOF0","description":"ICD-HAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pegaspargase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9266","description":"Pegaspargase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch clsd w/o bar w filtr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4418","description":"Ost pch clsd w/o bar w filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVB1","description":"ICD-FCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMD0","description":"ICD-EAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aminolevulinic acid hcl top","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7308","description":"Aminolevulinic acid hcl top","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAE1","description":"ICD-MLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52317","description":"Remove bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral med adm direct observe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0033","description":"Oral med adm direct observe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMB1","description":"ICD-NCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41000","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA226","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18I","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disconnect insert locking wr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6616","description":"Disconnect insert locking wr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKB0","description":"ICD-OHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng warf thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4300F","description":"Pt rcvng warf thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply long leg cast brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29358","description":"Apply long leg cast brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dyspnea mngmnt plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0535F","description":"Dyspnea mngmnt plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ with specimen verification including DNA authentication in comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0020U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ with specimen verification including DNA authentication in comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/ foot r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1180","description":"Wheelchair amputee w/ foot r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTE0","description":"ICD-GBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEF0","description":"ICD-MBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9798","description":"Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; anomalous or persistent superior vena cava when it ex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93584","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; anomalous or persistent superior vena cava when it ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQF0","description":"ICD-KHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1303","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1303","description":"CDT-D1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophys map 3d add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93613","description":"Electrophys map 3d add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIA0","description":"ICD-IEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPA1","description":"ICD-NHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNB1","description":"ICD-OGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQA0","description":"ICD-CFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJE1","description":"ICD-NGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryo embryo transf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4037","description":"Cryo embryo transf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLE0","description":"ICD-GGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xenograft implantation into the articular surface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0737T","description":"Xenograft implantation into the articular surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSB1","description":"ICD-DBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46922","description":"Excision of anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHE1","description":"ICD-NBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEF0","description":"ICD-MGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Hot Entrée","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1759","description":"Home Delivered Meals-Hot Entrée","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTE1","description":"ICD-EDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOB1","description":"ICD-KDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAD0","description":"ICD-BAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHE1","description":"ICD-GDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N-et; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2002","description":"N-et; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCC1","description":"ICD-FDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMA0","description":"ICD-GCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARD1","description":"ICD-LARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWD1","description":"ICD-CDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOC0","description":"ICD-PGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft iliofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35565","description":"Art byp grft iliofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOB0","description":"ICD-LFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBC0","description":"ICD-IDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens lenticular bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2115","description":"Lens lenticular bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYB1","description":"ICD-GIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko w/adj jt rot cntrl molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1844","description":"Ko w/adj jt rot cntrl molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEC1","description":"ICD-BGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elevat proximal arm support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2631","description":"Elevat proximal arm support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPC1","description":"ICD-BEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLE0","description":"ICD-NBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCE0","description":"ICD-MLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCA1","description":"ICD-GCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITA0","description":"ICD-JITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"2vhpv vaccine 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90650","description":"2vhpv vaccine 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXD0","description":"ICD-KAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22B","description":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder/create pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51596","description":"Remove bladder/create pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHB0","description":"ICD-JGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOB0","description":"ICD-HFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not conducting a search for DICOM format images for prior patient CT imaging studies completed at non-affiliated external healthcare facili","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9753","description":"Documentation of medical reason for not conducting a search for DICOM format images for prior patient CT imaging studies completed at non-affiliated external healthcare facili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKB0","description":"ICD-FDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVC0","description":"ICD-NHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped critical care subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99472","description":"Ped critical care subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vaccine toxoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90749","description":"Vaccine toxoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOB0","description":"ICD-OBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq tx malar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21355","description":"Perq tx malar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIC1","description":"ICD-AFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracranial bilat study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93880","description":"Extracranial bilat study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert heyman uteri capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58346","description":"Insert heyman uteri capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other carot sten 120 days/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9007F","description":"Other carot sten 120 days/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA35","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No filt remov w/in 3mos plcm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9544","description":"No filt remov w/in 3mos plcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-rays at surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74301","description":"X-rays at surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQA0","description":"ICD-DBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFE0","description":"ICD-JCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D7259","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D7259","description":"CDT-D7259","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIC0","description":"ICD-IHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ first evalua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0835T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ first evalua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMC0","description":"ICD-ODMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUA1","description":"ICD-JFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5C","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISC0","description":"ICD-HISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTE0","description":"ICD-MHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4369","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","description":"HCPCS-Q4369","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKD0","description":"ICD-JDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHE1","description":"ICD-JHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cine/video x-rays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76120","description":"Cine/video x-rays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHC0","description":"ICD-AGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFC1","description":"ICD-KIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0502","description":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper gi endo shows barrtts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3140F","description":"Upper gi endo shows barrtts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNB0","description":"ICD-CDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEB0","description":"ICD-OIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTA1","description":"ICD-EBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA40","description":"Very High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leukocyte assessment fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89055","description":"Leukocyte assessment fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium (hikma) not therapeutically equivalent to j0650_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0652","description":"Injection_ levothyroxine sodium (hikma) not therapeutically equivalent to j0650_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKA0","description":"ICD-GAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (diabetic chronic kidney disease [CKD])_ multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1)_ soluble tumor n","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0407U","description":"Nephrology (diabetic chronic kidney disease [CKD])_ multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1)_ soluble tumor n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lith-ion batt elec/pneum vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0506","description":"Lith-ion batt elec/pneum vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular disease_ quantification of advanced serum or plasma lipoprotein profile_ by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0377U","description":"Cardiovascular disease_ quantification of advanced serum or plasma lipoprotein profile_ by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHC0","description":"ICD-GDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-fpgk (stimufend)_ biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5127","description":"Injection_ pegfilgrastim-fpgk (stimufend)_ biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPF1","description":"ICD-GBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11622","description":"Exc s/n/h/f/g mal+mrg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous catheter anchor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5200","description":"Percutaneous catheter anchor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23670","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5930","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5930","description":"CDT-D5930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Procarbazine_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0182","description":"Procarbazine_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28I","description":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; Without Mediastinal Lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21602","description":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; Without Mediastinal Lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEE0","description":"ICD-MAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQF1","description":"ICD-CHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Derm autograft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15130","description":"Derm autograft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUD0","description":"ICD-JIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAED1","description":"ICD-KAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Perdominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6121","description":"Implant Supported Retainer For Metal Fpd - Perdominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQB0","description":"ICD-CDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUE1","description":"ICD-NAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert bladder cath complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51703","description":"Insert bladder cath complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transapical mitral valve repair_ including transthoracic echocardiography_ when performed_ with placement of artificial chordae tendineae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0543T","description":"Transapical mitral valve repair_ including transthoracic echocardiography_ when performed_ with placement of artificial chordae tendineae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLD1","description":"ICD-ADLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXB0","description":"ICD-NBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB126","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEE1","description":"ICD-CCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLA1","description":"ICD-MDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDF0","description":"ICD-MCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1601","description":"HCPCS-B1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL60","description":"Very High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA110","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flex-walk sys low ext prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5981","description":"Flex-walk sys low ext prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLF1","description":"ICD-JHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nhl stg 3-4 not relap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9135","description":"Onc dx nhl stg 3-4 not relap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFA1","description":"ICD-BCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES213","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLA0","description":"ICD-KDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB46","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJE1","description":"ICD-OAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Col chromotography qual/quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82542","description":"Col chromotography qual/quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29840","description":"Wrist arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHF0","description":"ICD-JDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPC1","description":"ICD-CBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYC0","description":"ICD-KCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIE1","description":"ICD-JGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBA0","description":"ICD-OGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJC0","description":"ICD-NFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0526T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSA0","description":"ICD-DGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISF1","description":"ICD-OISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALD0","description":"ICD-BALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIC1","description":"ICD-BEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ total hysterectomy for resection of malignancy (tumor debulking)_ with omentectomy including salpingo-oophorectomy_ unilateral or bilateral_ when perfor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58575","description":"Laparoscopy_ surgical_ total hysterectomy for resection of malignancy (tumor debulking)_ with omentectomy including salpingo-oophorectomy_ unilateral or bilateral_ when perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iadna-dna/rna probe tq 12-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87507","description":"Iadna-dna/rna probe tq 12-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay total hydroxyproline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83505","description":"Assay total hydroxyproline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECE0","description":"ICD-JECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKE1","description":"ICD-GHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote physiologic monitoring treatment management services_ 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99457","description":"Remote physiologic monitoring treatment management services_ 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIA0","description":"ICD-BCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate arrhythmia add on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93655","description":"Ablate arrhythmia add on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hrdtry brst ca-rlatd dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81433","description":"Hrdtry brst ca-rlatd dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKE1","description":"ICD-OLKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTA0","description":"ICD-KDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKD1","description":"ICD-OCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9175","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9175","description":"HCPCS-C9175","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunofluor antb addl stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88350","description":"Immunofluor antb addl stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVB1","description":"ICD-CDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; each additional 30 minutes (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96139","description":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; each additional 30 minutes (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hmatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4134","description":"Hmatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0505","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0505","description":"CDT-D0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPA0","description":"ICD-NHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB236","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB105","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANE1","description":"ICD-GANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKD0","description":"ICD-GBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGF0","description":"ICD-NJGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCD1","description":"ICD-CFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc medrsn no hist type rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9288","description":"Doc medrsn no hist type rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0931T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","description":"CPT-0931T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"GYPA GNOTYP NTRNS 1 5 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0189U","description":"GYPA GNOTYP NTRNS 1 5 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWD0","description":"ICD-KEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add pwr joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0983","description":"Add pwr joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILF1","description":"ICD-FILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDD1","description":"ICD-NBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC136","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psori tool doc/no bnchmk met","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9651","description":"Psori tool doc/no bnchmk met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFE1","description":"ICD-GFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/o manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21310","description":"Closed tx nose fx w/o manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB125","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ definitive_ utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0659","description":"Drug test(s)_ definitive_ utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXE0","description":"ICD-JIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home ventilator_ multi-function respiratory device_ also performs any or all of the additional functions of oxygen concentratio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0467","description":"Home ventilator_ multi-function respiratory device_ also performs any or all of the additional functions of oxygen concentratio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXE0","description":"ICD-CCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electric stimulation therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97014","description":"Electric stimulation therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHA0","description":"ICD-FFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC244","description":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERC1","description":"ICD-CERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUF0","description":"ICD-EEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEA1","description":"ICD-BEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJC0","description":"ICD-FGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0589","description":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYF0","description":"ICD-DHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFA1","description":"ICD-GDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMD1","description":"ICD-FIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYE0","description":"ICD-OBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTF1","description":"ICD-MGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore orbit/remove lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61333","description":"Explore orbit/remove lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTF0","description":"ICD-KGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with no clinical indications for imaging of the head","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1031","description":"Patients with no clinical indications for imaging of the head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no statin med disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8817","description":"Doc reas no statin med disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69805","description":"Explore inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIE0","description":"ICD-KAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENF0","description":"ICD-NENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFE1","description":"ICD-NFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQF1","description":"ICD-GIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYA0","description":"ICD-GFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOD0","description":"ICD-HAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKA1","description":"ICD-JHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXB1","description":"ICD-OLXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQE1","description":"ICD-DCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKA1","description":"ICD-OIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth head nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22251","description":"Anesth head nerve surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIC1","description":"ICD-KFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELE1","description":"ICD-EELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGC1","description":"ICD-KFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00103","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","description":"CPT-00103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMF0","description":"ICD-JCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI)_ administered by a computer_ wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96103","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI)_ administered by a computer_ wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMF1","description":"ICD-MDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC251","description":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFME1","description":"ICD-KFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCD0","description":"ICD-FGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBD1","description":"ICD-EBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETD1","description":"ICD-EETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADC1","description":"ICD-KADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYA1","description":"ICD-HIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8000","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8000","description":"HCPCS-C8000","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLF0","description":"ICD-KGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIC1","description":"ICD-CEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDF0","description":"ICD-JCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHC1","description":"ICD-CDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARC1","description":"ICD-OARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anthrax vaccine sc or im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90581","description":"Anthrax vaccine sc or im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWF0","description":"ICD-LBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDD1","description":"ICD-EGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0675","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0675","description":"HCPCS-G0675","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert needle bone cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36680","description":"Insert needle bone cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary bladder retention","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78730","description":"Urinary bladder retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAE1","description":"ICD-GDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEC0","description":"ICD-EBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBB0","description":"ICD-OHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction_ including interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9786","description":"Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction_ including interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKB0","description":"ICD-CGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0181","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKF1","description":"ICD-CGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSC1","description":"ICD-PHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJC1","description":"ICD-JGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"System reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9192","description":"System reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL44","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ non-coa/non-cov w/del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1876","description":"Stent_ non-coa/non-cov w/del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin barrier powder per oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4371","description":"Skin barrier powder per oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24A","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEA1","description":"ICD-NJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10C","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEC0","description":"ICD-OGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40844","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast add lesion mr imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19086","description":"Bx breast add lesion mr imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Budesonide comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7634","description":"Budesonide comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMB1","description":"ICD-JHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB21","description":"ICD-3DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXE1","description":"ICD-CCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spine disk surgery thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63077","description":"Spine disk surgery thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGD1","description":"ICD-GGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILF1","description":"ICD-CILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAC1","description":"ICD-ODAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00100","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","description":"CPT-00100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDF0","description":"ICD-CCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frame typ socket shoulder di","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6689","description":"Frame typ socket shoulder di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC54","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ilr device eval progr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93285","description":"Ilr device eval progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBB1","description":"ICD-NEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA154","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1247","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/ch access anti-rollback","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0974","description":"W/ch access anti-rollback","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBC1","description":"ICD-JIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14B","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/repair hearing aid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69711","description":"Remove/repair hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQD1","description":"ICD-PLQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Of Ventricular Assist Device_ Percutaneous_ Including Radiological Supervision And Interpretation; Right Heart_ Venous Access Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33995","description":"Insertion Of Ventricular Assist Device_ Percutaneous_ Including Radiological Supervision And Interpretation; Right Heart_ Venous Access Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9171","description":"HCPCS-C9171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANA0","description":"ICD-CANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee disarticulat leather so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5640","description":"Knee disarticulat leather so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXB1","description":"ICD-GHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHB0","description":"ICD-IIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLB1","description":"ICD-FBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analyze neurostim simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95971","description":"Analyze neurostim simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMD0","description":"ICD-IHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC34","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKF1","description":"ICD-NJKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC22","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBB0","description":"ICD-NDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with guided transhepatic cholangiography with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47561","description":"Laparoscopy_ surgical; with guided transhepatic cholangiography with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise nerve back of head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64744","description":"Incise nerve back of head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPF1","description":"ICD-FEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTF0","description":"ICD-NGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10D","description":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disp fee inhal drugs/90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0514","description":"Disp fee inhal drugs/90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC21","description":"ICD-2DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj foramen epidural c/t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64479","description":"Inj foramen epidural c/t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMA1","description":"ICD-IHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESF1","description":"ICD-OESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBF1","description":"ICD-ACBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPC0","description":"ICD-FIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTF0","description":"ICD-CFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEB0","description":"ICD-AFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28C","description":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tear film img uni/bi w/i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0330T","description":"Tear film img uni/bi w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL36","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29888","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPC0","description":"ICD-KDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lomustine 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0178","description":"Lomustine 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr angio pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72198","description":"Mr angio pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct angiograph pelv w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72191","description":"Ct angiograph pelv w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBC0","description":"ICD-BFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYC0","description":"ICD-CCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBD0","description":"ICD-OKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYB1","description":"ICD-CEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elb disart prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6450","description":"Elb disart prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUC0","description":"ICD-GIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDE1","description":"ICD-BGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostoma hmes filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7504","description":"Tracheostoma hmes filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXD0","description":"ICD-CAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASD1","description":"ICD-CASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMA0","description":"ICD-GDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trabeculoplasty laser surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65855","description":"Trabeculoplasty laser surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mlh1 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81294","description":"Mlh1 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHA0","description":"ICD-NBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKE1","description":"ICD-BFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo dbl solid stirrup band/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2020","description":"Kafo dbl solid stirrup band/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKC1","description":"ICD-GCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0672","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0672","description":"HCPCS-G0672","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB116","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert brain-fluid device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61215","description":"Insert brain-fluid device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lipid panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80061","description":"Lipid panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUA0","description":"ICD-MFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQF0","description":"ICD-KCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX32","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOE0","description":"ICD-KFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photochemotherapy with uv-b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96910","description":"Photochemotherapy with uv-b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amantadine hcl oral brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9033","description":"Amantadine hcl oral brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIC0","description":"ICD-BBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped hospital bed_ manual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0328","description":"Ped hospital bed_ manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMC1","description":"ICD-MKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"L/s ratio fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83661","description":"L/s ratio fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGA1","description":"ICD-KDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOD0","description":"ICD-KAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001M","description":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilated macular exam was not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9893","description":"Dilated macular exam was not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEF1","description":"ICD-JFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB24","description":"High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECE1","description":"ICD-EECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDF0","description":"ICD-ABDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUC1","description":"ICD-GBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPB1","description":"ICD-NKPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDB0","description":"ICD-KEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC46","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQD1","description":"ICD-DGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVE0","description":"ICD-JGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Born 1945-1965","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9448","description":"Born 1945-1965","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSF1","description":"ICD-LCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec size w/ leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1222","description":"Wheelchair spec size w/ leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKF1","description":"ICD-GCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML24","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOE0","description":"ICD-GIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSE0","description":"ICD-LBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQD1","description":"ICD-DDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74742","description":"X-ray fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35216","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD245","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWA0","description":"ICD-OFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove neuroreceiver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61888","description":"Revise/remove neuroreceiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22600","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFD0","description":"ICD-OFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMB1","description":"ICD-KEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement nasal cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7032","description":"Replacement nasal cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWC0","description":"ICD-CEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect inferior turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30140","description":"Resect inferior turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ sch team conf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9007","description":"Mccd_ sch team conf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAC1","description":"ICD-IEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial angioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61630","description":"Intracranial angioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84578","description":"Test urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chloroquine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0390","description":"Chloroquine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFE1","description":"ICD-NAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6564","description":"Gradient compression stocking_ waist length_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deb subq tissue add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11045","description":"Deb subq tissue add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In111 ibritumomab_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9542","description":"In111 ibritumomab_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXA0","description":"ICD-ODXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMD0","description":"ICD-MEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection anistreplase 30 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0350","description":"Injection anistreplase 30 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occupational therapy_ in the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9129","description":"Occupational therapy_ in the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLB1","description":"ICD-IDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBF0","description":"ICD-NHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKA1","description":"ICD-FGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXF1","description":"ICD-NIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTE1","description":"ICD-OGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ivig non-lyophilized_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1599","description":"Ivig non-lyophilized_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Positional nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92542","description":"Positional nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4338","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","description":"HCPCS-Q4338","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip canad sing axi cons fric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5250","description":"Hip canad sing axi cons fric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKE1","description":"ICD-BDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std seat elevate cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0831","description":"Pwc gp2 std seat elevate cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Triflupromazine hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3400","description":"Triflupromazine hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE124","description":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMB1","description":"ICD-JAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCE0","description":"ICD-NGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWD0","description":"ICD-PCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0667","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","description":"HCPCS-G0667","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVA0","description":"ICD-GCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19350","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRB0","description":"ICD-HIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOD0","description":"ICD-PCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhcp-svs of s/l path_ea 15mn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0153","description":"Hhcp-svs of s/l path_ea 15mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJD0","description":"ICD-FAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPF1","description":"ICD-CEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sorbent cartridges per 10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1636","description":"Sorbent cartridges per 10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23470","description":"Reconstruct shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGME0","description":"ICD-MGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Granisetron hcl 1 mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0166","description":"Granisetron hcl 1 mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSF1","description":"ICD-OBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFE0","description":"ICD-NDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCA1","description":"ICD-EFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCF1","description":"ICD-OHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKE1","description":"ICD-OEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHB1","description":"ICD-ECHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYB1","description":"ICD-LEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-linked intellectual dblt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81471","description":"X-linked intellectual dblt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUF0","description":"ICD-KDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Testosterone undecanoate 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3145","description":"Testosterone undecanoate 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAF1","description":"ICD-GEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56632","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXA1","description":"ICD-GIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJE0","description":"ICD-OKJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVB1","description":"ICD-CFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSC1","description":"ICD-LCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Testicular imaging w/flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78761","description":"Testicular imaging w/flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ent procedure/service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92700","description":"Ent procedure/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCF1","description":"ICD-NLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt consid poss risk fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3572F","description":"Pt consid poss risk fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARE1","description":"ICD-HARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate esophagus 1/mult pass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43450","description":"Dilate esophagus 1/mult pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDF0","description":"ICD-OHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Singl visn sphere 7.12-20.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2102","description":"Singl visn sphere 7.12-20.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUB0","description":"ICD-MEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lidocaine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2001","description":"Lidocaine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHME0","description":"ICD-KHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56800","description":"Repair of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIC1","description":"ICD-BGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Perfusion Echo Ischm/Viability Assmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0439T","description":"Myocardial Perfusion Echo Ischm/Viability Assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1024T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","description":"CPT-1024T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4318","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","description":"HCPCS-A4318","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVF1","description":"ICD-GHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA11","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOD0","description":"ICD-LAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGA0","description":"ICD-GBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heavy duty battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4611","description":"Heavy duty battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHF1","description":"ICD-MFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRE1","description":"ICD-DFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac event recorder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0616","description":"Cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDC1","description":"ICD-AHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL10","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTF1","description":"ICD-MHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens hydrophilic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2520","description":"Contact lens hydrophilic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRB1","description":"ICD-DIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGF1","description":"ICD-BDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKA1","description":"ICD-GFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interprt fees/laryngeal test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92617","description":"Interprt fees/laryngeal test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Left hrt cath w/ventrclgrphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93452","description":"Left hrt cath w/ventrclgrphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUA1","description":"ICD-FCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73000","description":"X-ray exam of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBF1","description":"ICD-JIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30901","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB13","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFA1","description":"ICD-BAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE236","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASD0","description":"ICD-DASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKF0","description":"ICD-BGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urea injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3350","description":"Urea injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPF0","description":"ICD-NGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Of Anterior Segment Aqueous Drainage Device Into The Trabecular Meshwork_ Without External Reservoir_ And Without Concomitant Cataract Removal_ One Or More","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0671T","description":"Insertion Of Anterior Segment Aqueous Drainage Device Into The Trabecular Meshwork_ Without External Reservoir_ And Without Concomitant Cataract Removal_ One Or More","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVA0","description":"ICD-OIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAB1","description":"ICD-NDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWD0","description":"ICD-KGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9370","description":"Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ peripheral nerve_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64598","description":"Revision or removal of neurostimulator electrode array_ peripheral nerve_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVB1","description":"ICD-NGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVA0","description":"ICD-KIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFID0","description":"ICD-FFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDD0","description":"ICD-KFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drugs unclassified injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3490","description":"Drugs unclassified injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7401","description":"Mometasone furoate sinus implant_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0201","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0201","description":"CDT-D0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6557","description":"Gradient compression stocking_ thigh length_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18X","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revita_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4180","description":"Revita_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPA1","description":"ICD-KAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI w/o fol w/cont_ breast_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8908","description":"MRI w/o fol w/cont_ breast_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYE0","description":"ICD-GGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc tempory vessel occl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61623","description":"Endovasc tempory vessel occl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLC1","description":"ICD-MGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUA1","description":"ICD-AFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1318","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOE0","description":"ICD-DIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLD0","description":"ICD-OLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWB1","description":"ICD-DGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQF0","description":"ICD-CAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect shoulder tumor < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23077","description":"Resect shoulder tumor < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXD0","description":"ICD-KIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYB0","description":"ICD-PDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prothrombin time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85610","description":"Prothrombin time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKC1","description":"ICD-FCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE112","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVB1","description":"ICD-NHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDE0","description":"ICD-OCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXD1","description":"ICD-GEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUA1","description":"ICD-KAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace non-molded thigh lac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4045","description":"Replace non-molded thigh lac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNF0","description":"ICD-OCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcysteine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7608","description":"Acetylcysteine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOB0","description":"ICD-DDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCF1","description":"ICD-KGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSE0","description":"ICD-KCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTD1","description":"ICD-AFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35458","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC215","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKB1","description":"ICD-OFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAF1","description":"ICD-FHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA125","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXA0","description":"ICD-JIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revoshield + amniotic barrier_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4289","description":"Revoshield + amniotic barrier_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0902","description":"HCPCS-B0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPA0","description":"ICD-GBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDC0","description":"ICD-ACDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVE0","description":"ICD-CCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHE1","description":"ICD-JEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXE0","description":"ICD-NLXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOB1","description":"ICD-CEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC204","description":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMA1","description":"ICD-NHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVD1","description":"ICD-KHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12D","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8F","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVA1","description":"ICD-GAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26765","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAF0","description":"ICD-CGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA116","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leuprolide acetate injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9218","description":"Leuprolide acetate injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIA1","description":"ICD-OAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFD0","description":"ICD-BGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot longitudinal arch suppo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3010","description":"Foot longitudinal arch suppo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPD1","description":"ICD-JAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25565","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAE1","description":"ICD-JEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cranial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64716","description":"Revision of cranial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc w ami s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9606","description":"Perc d-e cor revasc w ami s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Humidifier heated used w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0562","description":"Humidifier heated used w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20D","description":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order(prescription)for statin therapy (e.g.patient with adverse effect_ allergy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9668","description":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order(prescription)for statin therapy (e.g.patient with adverse effect_ allergy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg_CT studies performed for radiation treatment)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9323","description":"Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg_CT studies performed for radiation treatment)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1261","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCC1","description":"ICD-IDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAC1","description":"ICD-KIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEF1","description":"ICD-JAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ho post-op hip abduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1686","description":"Ho post-op hip abduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"carePATCH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4236","description":"carePATCH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMA1","description":"ICD-JGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRB1","description":"ICD-PJRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGA1","description":"ICD-NEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIF1","description":"ICD-OGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36015","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHD0","description":"ICD-NGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXA1","description":"ICD-GBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWE0","description":"ICD-HAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES250","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRA1","description":"ICD-CBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQB0","description":"ICD-OLQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67141","description":"Treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imm admin by intramusc injection of  (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 1st dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0021A","description":"Imm admin by intramusc injection of  (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 1st dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin pneum/hydra pneum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5780","description":"Knee-shin pneum/hydra pneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEND0","description":"ICD-NEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUD0","description":"ICD-FHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXC0","description":"ICD-OHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx ovarian unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9117","description":"Onc dx ovarian unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARF0","description":"ICD-LARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj mepivacaine hcl/10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0670","description":"Inj mepivacaine hcl/10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hdr rdncl skn surf brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77768","description":"Hdr rdncl skn surf brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWE1","description":"ICD-DCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45111","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWD0","description":"ICD-KCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry_ formalin-fixed paraffin-embedded (FFPE) tissue_ report for risk o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0387U","description":"Oncology (melanoma)_ autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry_ formalin-fixed paraffin-embedded (FFPE) tissue_ report for risk o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj streptokinase /250000 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2995","description":"Inj streptokinase /250000 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no ann srn hcv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9384","description":"Doc med reas no ann srn hcv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of urinary leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53085","description":"Drainage of urinary leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii (porcine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7191","description":"Factor viii (porcine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUF1","description":"ICD-EFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELA1","description":"ICD-EELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUE0","description":"ICD-IEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOC1","description":"ICD-KIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Demo-smoking cessation coun","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9016","description":"Demo-smoking cessation coun","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKE0","description":"ICD-GGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Y set tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4719","description":"Y set tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxymorphone hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2410","description":"Oxymorphone hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE241","description":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (hospira)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9049","description":"Injection_ bortezomib (hospira)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCD0","description":"ICD-BHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Atomic absorption","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82190","description":"Atomic absorption","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQA1","description":"ICD-LCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec osteogen stim not spine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0747","description":"Elec osteogen stim not spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13C","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2005","description":"HCPCS-A2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Warfarin therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4012F","description":"Warfarin therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTD0","description":"ICD-ACTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker_ battery powered_ wheeled_ folding_ adjustable or fixed height","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0152","description":"Walker_ battery powered_ wheeled_ folding_ adjustable or fixed height","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYE0","description":"ICD-PLYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ibuprofen injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1741","description":"Ibuprofen injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB245","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3D","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC224","description":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mis sup/ac imp vad nopay med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0509","description":"Mis sup/ac imp vad nopay med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icd counseling provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4470F","description":"Icd counseling provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Predominatly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6082","description":"Implant Supported Crown - Porcelain Fused To Predominatly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Als 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0433","description":"Als 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSD0","description":"ICD-HFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOA0","description":"ICD-LDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDD0","description":"ICD-EEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of dibucaine number","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82638","description":"Assay of dibucaine number","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correct skin color ea 20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11922","description":"Correct skin color ea 20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDC1","description":"ICD-MGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCA1","description":"ICD-BBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAA0","description":"ICD-KAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQD0","description":"ICD-CCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTA0","description":"ICD-NKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7040","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Integrated filter & holder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7507","description":"Integrated filter & holder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTB1","description":"ICD-IFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDA0","description":"ICD-MKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDC1","description":"ICD-FFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rx tst def 09+ rx/sbsts ur reprt pres/abs ea rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0082U","description":"Rx tst def 09+ rx/sbsts ur reprt pres/abs ea rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFA0","description":"ICD-FIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWF0","description":"ICD-HAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECE0","description":"ICD-KECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Technetium tc-99m auto wbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9569","description":"Technetium tc-99m auto wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGB0","description":"ICD-FFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Supply","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0702T","description":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBF1","description":"ICD-CEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPE0","description":"ICD-JDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3702","description":"Eo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26600","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEF1","description":"ICD-KHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27086","description":"Remove hip foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML03","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOF0","description":"ICD-PCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist joint implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25449","description":"Remove wrist joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBF1","description":"ICD-MFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMB1","description":"ICD-JCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01112","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","description":"CPT-01112","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom power whlchr base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0013","description":"Custom power whlchr base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGC0","description":"ICD-NAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFD0","description":"ICD-GGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB31","description":"High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Who w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3906","description":"Who w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiolipin antibody ea ig","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86147","description":"Cardiolipin antibody ea ig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFID1","description":"ICD-KFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOC1","description":"ICD-KEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWD0","description":"ICD-OKWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJB1","description":"ICD-GEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYA1","description":"ICD-PCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31002","description":"Irrigation sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27712","description":"Realignment of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC256","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No statin/no order statin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9665","description":"No statin/no order statin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allergy patch tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95044","description":"Allergy patch tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIC0","description":"ICD-FDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1013T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","description":"CPT-1013T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEF0","description":"ICD-GBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXF0","description":"ICD-NLXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse hand bones with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25825","description":"Fuse hand bones with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHA1","description":"ICD-FGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99309","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX16","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9746","description":"Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIC0","description":"ICD-EAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMB0","description":"ICD-BBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sach foot_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5971","description":"Sach foot_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Als defibrillation supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0392","description":"Als defibrillation supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore wound abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20102","description":"Explore wound abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy submucous njx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45381","description":"Colonoscopy submucous njx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVA1","description":"ICD-OKVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6740","description":"Crown porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIF0","description":"ICD-FGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"InnovaMatrix PD_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2023","description":"InnovaMatrix PD_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rep part denture cast frame","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5620","description":"Rep part denture cast frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAC1","description":"ICD-AFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monocyte distribution width_ whole blood (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0427U","description":"Monocyte distribution width_ whole blood (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXF1","description":"ICD-NLXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVD0","description":"ICD-CGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWB1","description":"ICD-GBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTA1","description":"ICD-KFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATA1","description":"ICD-CATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hook/hand_ hvy dty_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6722","description":"Hook/hand_ hvy dty_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABF1","description":"ICD-OABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0999T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","description":"CPT-0999T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX31","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intens cardiac rehab w/exerc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0422","description":"Intens cardiac rehab w/exerc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISA0","description":"ICD-CISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt disch home day #2 cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8834","description":"Pt disch home day #2 cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reticulated platelet assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85055","description":"Reticulated platelet assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMC1","description":"ICD-EIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge porcelain base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6241","description":"Bridge porcelain base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARD1","description":"ICD-HARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0404","description":"HCPCS-B0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYF1","description":"ICD-LAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder prosthesis removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23335","description":"Shoulder prosthesis removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"(Blincyto)Injection_ Blinatumomab_ 1mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9449","description":"(Blincyto)Injection_ Blinatumomab_ 1mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJB0","description":"ICD-OFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWB1","description":"ICD-LCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXD1","description":"ICD-KEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/w resect diag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32668","description":"Thoracoscopy w/w resect diag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDF1","description":"ICD-JHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home Adaptations (<$6_000)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0140","description":"Home Adaptations (<$6_000)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0703","description":"HCPCS-C0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insemination of oocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89268","description":"Insemination of oocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXF1","description":"ICD-NHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAD1","description":"ICD-FDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imported lipodox inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2049","description":"Imported lipodox inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/renal strict","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52346","description":"Cystouretero w/renal strict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLD1","description":"ICD-KBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUC1","description":"ICD-FDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAB0","description":"ICD-NJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apexification/recalc final","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3353","description":"Apexification/recalc final","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIA0","description":"ICD-BDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS B SURFACE ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87340","description":"IAAD IA HEPATITIS B SURFACE ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Golimumab for iv use 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1602","description":"Golimumab for iv use 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18D","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGD1","description":"ICD-ODGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCE0","description":"ICD-NDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBC1","description":"ICD-CDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBF0","description":"ICD-FHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1501","description":"HCPCS-B1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pca3/klk3 antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81313","description":"Pca3/klk3 antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLA0","description":"ICD-FBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUD0","description":"ICD-AGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp 5yrs/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99144","description":"Mod sedat phys/qhp 5yrs/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBD0","description":"ICD-EBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gear reduction drive wheel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2227","description":"Gear reduction drive wheel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUA0","description":"ICD-ADUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNF0","description":"ICD-FFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAE1","description":"ICD-NGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seg pneumatic appl full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0668","description":"Seg pneumatic appl full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whfo w/joint(s) custom fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3806","description":"Whfo w/joint(s) custom fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAE0","description":"ICD-KCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; first target lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76982","description":"Ultrasound_ elastography; first target lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply intrcav radiat simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77761","description":"Apply intrcav radiat simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of intrastromal corneal ring segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0099T","description":"Implantation of intrastromal corneal ring segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54065","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTE0","description":"ICD-CDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1138","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRA0","description":"ICD-PDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24920","description":"Amputation of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tte w or w/o contr_ cont ecg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8930","description":"Tte w or w/o contr_ cont ecg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTE1","description":"ICD-KBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINF1","description":"ICD-JINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUE0","description":"ICD-AFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEE1","description":"ICD-MDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGD1","description":"ICD-NLGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWC1","description":"ICD-CGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNF0","description":"ICD-CBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSA0","description":"ICD-GFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure for cholangiography through an existing catheter(eg_ percutaneous transhepatic or t-tube)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47505","description":"Injection procedure for cholangiography through an existing catheter(eg_ percutaneous transhepatic or t-tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No mrs score in 90d followup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9647","description":"No mrs score in 90d followup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUF0","description":"ICD-AIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ with qualified health care professional in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96119","description":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ with qualified health care professional in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDB1","description":"ICD-FEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sealant repair per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1353","description":"Sealant repair per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE160","description":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHID0","description":"ICD-IHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21C","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALE1","description":"ICD-CALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHE1","description":"ICD-EGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (liver)_ surveillance for hepatocellular carcinoma (HCC) in high-risk patients_ analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0333U","description":"Oncology (liver)_ surveillance for hepatocellular carcinoma (HCC) in high-risk patients_ analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl water chamber_ pap dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7046","description":"Repl water chamber_ pap dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44146","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bl draw <3 yrs scalp vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36405","description":"Bl draw <3 yrs scalp vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDB0","description":"ICD-NKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAE0","description":"ICD-CEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23105","description":"Remove shoulder joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patients with diabetes who have a most recent fasting or direct LDL- C laboratory test result < 70 mg/dl and are not taking statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9783","description":"Documentation of patients with diabetes who have a most recent fasting or direct LDL- C laboratory test result < 70 mg/dl and are not taking statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHED0","description":"ICD-NHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG_ PCA3_ and SPDEF)_ urine_ algorithm reported as risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0005U","description":"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG_ PCA3_ and SPDEF)_ urine_ algorithm reported as risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB21","description":"ICD-2KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4410","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","description":"HCPCS-Q4410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJB0","description":"ICD-KFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALD0","description":"ICD-NALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDB0","description":"ICD-BBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laminotomy addl lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63044","description":"Laminotomy addl lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJD1","description":"ICD-JDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33975","description":"Implant ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemical peel face dermal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15789","description":"Chemical peel face dermal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate bone tumor(s) perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20982","description":"Ablate bone tumor(s) perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA241","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEA0","description":"ICD-MCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath ren art 2nd+ unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36253","description":"Ins cath ren art 2nd+ unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYB1","description":"ICD-PFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHB0","description":"ICD-KEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA224","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0689U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689U","description":"CPT-0689U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXF1","description":"ICD-BCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo fem fx cast thermoplas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2126","description":"Kafo fem fx cast thermoplas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUD1","description":"ICD-MDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Permanent tear duct plug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4263","description":"Permanent tear duct plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pharyngeal walls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42894","description":"Revision of pharyngeal walls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKC1","description":"ICD-NKKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Social work visit_ in the ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9127","description":"Social work visit_ in the ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSE1","description":"ICD-DCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0607","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","description":"HCPCS-J0607","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIC0","description":"ICD-GIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0582","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","description":"HCPCS-J0582","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA117","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRB1","description":"ICD-OCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALE0","description":"ICD-NALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACF1","description":"ICD-IACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0602","description":"HCPCS-A0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUA0","description":"ICD-GIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPE1","description":"ICD-JDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cromolyn sodium comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7632","description":"Cromolyn sodium comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRE1","description":"ICD-PDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMF1","description":"ICD-NKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post 3 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2393","description":"Post 3 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB22","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 6/> vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72084","description":"X-ray exam entire spi 6/> vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABME0","description":"ICD-ABME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPD0","description":"ICD-NHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHF1","description":"ICD-FFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0602U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","description":"CPT-0602U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of iliopsoas muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27111","description":"Transfer of iliopsoas muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCME0","description":"ICD-CCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIB1","description":"ICD-EAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lesion destruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7465","description":"Lesion destruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAC1","description":"ICD-EEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEC1","description":"ICD-OCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBB0","description":"ICD-OCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ golodirsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1429","description":"Injection_ golodirsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infusion pump refill kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4220","description":"Infusion pump refill kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0C","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCC1","description":"ICD-KDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKA1","description":"ICD-GHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy elbow joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24100","description":"Biopsy elbow joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALF1","description":"ICD-EALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCF0","description":"ICD-CCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immediate maxillary partial denture - flexible base (including any clasps_ rests and teeth)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5227","description":"Immediate maxillary partial denture - flexible base (including any clasps_ rests and teeth)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M.pneumon dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87582","description":"M.pneumon dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQE1","description":"ICD-DDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGD0","description":"ICD-BBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bed accessory brd/tbl/supprt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0315","description":"Bed accessory brd/tbl/supprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18A","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFE0","description":"ICD-KIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUF1","description":"ICD-CGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Holotranscobalamin_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0103T","description":"Holotranscobalamin_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin b-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84207","description":"Assay of vitamin b-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65280","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1050","description":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRB0","description":"ICD-KDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMF0","description":"ICD-CFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJF0","description":"ICD-KFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical repair of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43502","description":"Surgical repair of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTF0","description":"ICD-CGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEE0","description":"ICD-OEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBB1","description":"ICD-AHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBF0","description":"ICD-NCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe techniq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87635","description":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe techniq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13C","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTE0","description":"ICD-NDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vendaje ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4279","description":"Vendaje ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUD0","description":"ICD-OJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Serum clotting time tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4771","description":"Serum clotting time tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1461","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","description":"HCPCS-M1461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2A","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88309","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eld mal scrn pos no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8735","description":"Eld mal scrn pos no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE256","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJF1","description":"ICD-NCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHED1","description":"ICD-EHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCF1","description":"ICD-NBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8C","description":"Medium Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCD1","description":"ICD-FHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXA0","description":"ICD-FEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUB1","description":"ICD-AEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA11","description":"ICD-1CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSA0","description":"ICD-CCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBA1","description":"ICD-IBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_ copy number variants_ microsatellite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81459","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_ copy number variants_ microsatellite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply srs headframe add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61800","description":"Apply srs headframe add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMA0","description":"ICD-KEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELB1","description":"ICD-FELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECE0","description":"ICD-GECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARB0","description":"ICD-LARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFE0","description":"ICD-BAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC235","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2002","description":"HCPCS-B2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQD1","description":"ICD-PIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEC0","description":"ICD-FFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICF0","description":"ICD-MICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDE1","description":"ICD-FEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMA1","description":"ICD-AHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-ray each vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75774","description":"Artery x-ray each vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chin cup interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2324","description":"Chin cup interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy remove lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46612","description":"Anoscopy remove lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12B","description":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shortening of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27465","description":"Shortening of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0697U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697U","description":"CPT-0697U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD134","description":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 2.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12011","description":"Rpr f/e/e/n/l/m 2.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multisys ther/juvenile 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2033","description":"Multisys ther/juvenile 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDA0","description":"ICD-JEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ue >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8667","description":"Fun stat score ue >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWF1","description":"ICD-HIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96167","description":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEC0","description":"ICD-KAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL13","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct uppr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73202","description":"Ct uppr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11760","description":"Repair of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp) And Ocular (Ovemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92519","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp) And Ocular (Ovemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGF0","description":"ICD-OIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome karyotype study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88280","description":"Chromosome karyotype study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral antiplatelet therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4011F","description":"Oral antiplatelet therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITC0","description":"ICD-GITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLE0","description":"ICD-FCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOD1","description":"ICD-PDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc stent & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37231","description":"Tib/per revasc stent & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHF1","description":"ICD-GBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYA1","description":"ICD-DFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPF1","description":"ICD-CCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programmer for transient_ orally ingested capsule","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9268","description":"Programmer for transient_ orally ingested capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUF0","description":"ICD-ACUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPB0","description":"ICD-CDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAF1","description":"ICD-CBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of tibia epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27730","description":"Repair of tibia epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYE0","description":"ICD-OIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1096T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1096T","description":"CPT-1096T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ZZZZZ","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ZZZZZ","description":"ICD-ZZZZZ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAA0","description":"ICD-BCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSD0","description":"ICD-PBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENC0","description":"ICD-GENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYC0","description":"ICD-PEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSE0","description":"ICD-HDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOB1","description":"ICD-PJOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11310","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCA1","description":"ICD-MHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMF0","description":"ICD-KGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4D","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood culture for bacteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87040","description":"Blood culture for bacteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of selenium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84255","description":"Assay of selenium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0704","description":"HCPCS-A0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLA1","description":"ICD-KGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whfo electric custom fitted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3904","description":"Whfo electric custom fitted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures adjust cmplt mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5411","description":"Dentures adjust cmplt mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83719","description":"Assay of blood lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 21 Or More Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99423","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 21 Or More Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDA1","description":"ICD-OFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test socket below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5620","description":"Test socket below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine HCL (Belrapzo)_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9042","description":"Injection_ bendamustine HCL (Belrapzo)_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj celiac pelus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64530","description":"N block inj celiac pelus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA14","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemagglutination inhibition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86280","description":"Hemagglutination inhibition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLF0","description":"ICD-NHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKE1","description":"ICD-ODKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDF1","description":"ICD-EEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FY GNOTYP ACKR1 EXONS 1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0187U","description":"FY GNOTYP ACKR1 EXONS 1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLF0","description":"ICD-BCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63704","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA54","description":"Default_ /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOF1","description":"ICD-PHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asthma education","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9441","description":"Asthma education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Administering Pneumococcal Vaccine (E.G._ Adverse Reaction To Vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9989","description":"Documentation Of Medical Reason(S) For Not Administering Pneumococcal Vaccine (E.G._ Adverse Reaction To Vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00320","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","description":"CPT-00320","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMB1","description":"ICD-OJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNB0","description":"ICD-NJNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSA0","description":"ICD-LGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iliac revasc w/stent add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37223","description":"Iliac revasc w/stent add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMF1","description":"ICD-MLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELF1","description":"ICD-EELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25575","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB44","description":"High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMB0","description":"ICD-KBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy thigh soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27324","description":"Biopsy thigh soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDA0","description":"ICD-NFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDF1","description":"ICD-JGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAC1","description":"ICD-MFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWD0","description":"ICD-HEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA11","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of sternum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21740","description":"Reconstruction of sternum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDA0","description":"ICD-KBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDED0","description":"ICD-EDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELB0","description":"ICD-EELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assert comm tx pgm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0040","description":"Assert comm tx pgm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12B","description":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11C","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA_ gene expression profiling by real-time quantit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0119U","description":"Oncology (urothelial)_ mRNA_ gene expression profiling by real-time quantit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEB1","description":"ICD-MJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAC0","description":"ICD-GGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj tendon origin/insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20551","description":"Inj tendon origin/insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained with concurrent CT examination of any structure contained in the c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0722T","description":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained with concurrent CT examination of any structure contained in the c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCB0","description":"ICD-JGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPF0","description":"ICD-BAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68761","description":"Close tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXB0","description":"ICD-OFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAA1","description":"ICD-MEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20C","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCB1","description":"ICD-ICCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGD0","description":"ICD-JCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abatacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0129","description":"Abatacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Probe_ perc lumb disc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2614","description":"Probe_ perc lumb disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTD0","description":"ICD-JCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUB0","description":"ICD-NHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26415","description":"Excision hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOD1","description":"ICD-KHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEC1","description":"ICD-ICEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANB1","description":"ICD-FANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75051","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKE0","description":"ICD-KDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrin degradj d-dimer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85380","description":"Fibrin degradj d-dimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB11","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTE0","description":"ICD-CGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of surface (transcutaneous) neurostimulator (eg_ TENS unit)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64550","description":"Application of surface (transcutaneous) neurostimulator (eg_ TENS unit)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 21 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP21","description":"Auto test panel pricing code_ 21 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINC1","description":"ICD-KINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACD1","description":"ICD-NACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRA0","description":"ICD-OCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAC1","description":"ICD-MDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58920","description":"Partial removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr s/a/l 10.1-30 sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14021","description":"Tis trnfr s/a/l 10.1-30 sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0661U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0661U","description":"CPT-0661U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAD0","description":"ICD-JBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEE0","description":"ICD-ICEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHD1","description":"ICD-KGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIC0","description":"ICD-MCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not prescribing warfarin or another FDA-approved anticoagulation due to patient being currently enrolled in a clinical trial related to A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9927","description":"Documentation of system reason(s) for not prescribing warfarin or another FDA-approved anticoagulation due to patient being currently enrolled in a clinical trial related to A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUE1","description":"ICD-FIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHF0","description":"ICD-ECHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCC1","description":"ICD-NFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIA1","description":"ICD-BIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAD1","description":"ICD-GFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11462","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKB0","description":"ICD-NJKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intervene hlth/behave indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96152","description":"Intervene hlth/behave indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHF1","description":"ICD-AEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHC1","description":"ICD-NIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFB1","description":"ICD-NAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us urine capacity measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51798","description":"Us urine capacity measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDC0","description":"ICD-MEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev soft tiss add imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10036","description":"Perq dev soft tiss add imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIME0","description":"ICD-BIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWA0","description":"ICD-LHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICB0","description":"ICD-NICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWF0","description":"ICD-LCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In morphine preservativ free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2274","description":"In morphine preservativ free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUA1","description":"ICD-CFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral evaluation pt < 3yrs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0145","description":"Oral evaluation pt < 3yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIE0","description":"ICD-EHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14A","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54385","description":"Repair penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJB1","description":"ICD-KDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERD0","description":"ICD-GERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX21","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20A","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33430","description":"Replacement of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOA1","description":"ICD-CGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O shoe convert to sof counte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3590","description":"O shoe convert to sof counte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCID1","description":"ICD-GCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD231","description":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not eligible ace/arb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8936","description":"Pt not eligible ace/arb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERD1","description":"ICD-CERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB42","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"7 field photo interp doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2024F","description":"7 field photo interp doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electro connect btw 2 sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2311","description":"Electro connect btw 2 sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telehealth consultation_ critical care_ subsequent_ physicians typically spend 50 minutes communicating with the patient and providers via telehealth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0509","description":"Telehealth consultation_ critical care_ subsequent_ physicians typically spend 50 minutes communicating with the patient and providers via telehealth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBF0","description":"ICD-AIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYB0","description":"ICD-LAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSF1","description":"ICD-OLSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI fetal ea addl gestation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74713","description":"MRI fetal ea addl gestation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLD1","description":"ICD-EGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJE0","description":"ICD-NHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOE1","description":"ICD-KAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXD1","description":"ICD-BCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMB1","description":"ICD-EDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-96041","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","description":"CPT-96041","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow aspirate &biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0364","description":"Bone marrow aspirate &biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML23","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEB0","description":"ICD-MGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below elbow switch control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6930","description":"Below elbow switch control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1736","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","description":"HCPCS-J1736","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No elig tpa init w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8601","description":"No elig tpa init w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin (fiasp)_ per 5 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1812","description":"Insulin (fiasp)_ per 5 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-auto graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4285","description":"Non-auto graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJF0","description":"ICD-BAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92137","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","description":"CPT-92137","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDC1","description":"ICD-OIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHME1","description":"ICD-IHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYD1","description":"ICD-OJYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOD0","description":"ICD-GIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther cmpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0263T","description":"Im b1 mrw cel ther cmpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine phosphorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84105","description":"Assay of urine phosphorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYA1","description":"ICD-HHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bladder defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51940","description":"Correction of bladder defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect neck thorax tumor<5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21557","description":"Resect neck thorax tumor<5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation cervical mucus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89330","description":"Evaluation cervical mucus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLA1","description":"ICD-MHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTD1","description":"ICD-NLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSC0","description":"ICD-LCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rabies vaccine id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90676","description":"Rabies vaccine id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of bladder neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52500","description":"Revision of bladder neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Image std nomenclature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9318","description":"Image std nomenclature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0852","description":"Pwc gp 3 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESF0","description":"ICD-DESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES345","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESA1","description":"ICD-GESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fo pip dip jnt/sprng pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3925","description":"Fo pip dip jnt/sprng pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIF1","description":"ICD-JBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral appliance therapy (OAT) titration visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9955","description":"Oral appliance therapy (OAT) titration visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion or replacement of permanent leadless pacemaker_ ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0387T","description":"Transcatheter insertion or replacement of permanent leadless pacemaker_ ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOF1","description":"ICD-GHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1002","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1002","description":"CDT-D1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKE1","description":"ICD-GCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBB1","description":"ICD-MJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tonsils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42826","description":"Removal of tonsils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ luspatercept-aamt_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0896","description":"Injection_ luspatercept-aamt_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occlude fallopian tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58615","description":"Occlude fallopian tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL25","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBE0","description":"ICD-MGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28615","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHF0","description":"ICD-FGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMD0","description":"ICD-GBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen IV bin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0280U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen IV bin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIC0","description":"ICD-IBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTD0","description":"ICD-MKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental inlay resin 3/mre sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2652","description":"Dental inlay resin 3/mre sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKA0","description":"ICD-BFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJD0","description":"ICD-KHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOB1","description":"ICD-OLOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDND1","description":"ICD-BDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANE0","description":"ICD-JANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOE0","description":"ICD-LFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUD1","description":"ICD-AIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27429","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACE1","description":"ICD-MACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOB0","description":"ICD-GDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24C","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEC1","description":"ICD-MEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAB1","description":"ICD-BAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMF0","description":"ICD-IHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8G","description":"Very High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDE1","description":"ICD-CFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXF1","description":"ICD-BAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKB0","description":"ICD-KEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBD0","description":"ICD-NGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA03","description":"Default_ /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPF1","description":"ICD-ODPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18H","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWE0","description":"ICD-DBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M.avium-intra dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87561","description":"M.avium-intra dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9154","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","description":"HCPCS-A9154","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCD1","description":"ICD-CCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXC1","description":"ICD-CIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished w/in a bene home)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0083","description":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished w/in a bene home)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing care not possible because the patient self-discharged early (e.g._ financial or insurance reasons_ transportation problems_ or reason unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1148","description":"Ongoing care not possible because the patient self-discharged early (e.g._ financial or insurance reasons_ transportation problems_ or reason unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWD1","description":"ICD-DCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; complex (eg_ leaflet extension_ leaflet resection_ leaflet reconstruction_ or annuloplasty)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33391","description":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; complex (eg_ leaflet extension_ leaflet resection_ leaflet reconstruction_ or annuloplasty)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRD1","description":"ICD-CFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHA0","description":"ICD-IDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXC0","description":"ICD-FIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61760","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRA1","description":"ICD-OCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assess anginal symptom/level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1002F","description":"Assess anginal symptom/level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sgd sftwre prgrm for pc/pda","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2511","description":"Sgd sftwre prgrm for pc/pda","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNA1","description":"ICD-GDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum deep <5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27619","description":"Exc leg/ankle tum deep <5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A5104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5104","description":"HCPCS-A5104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYD1","description":"ICD-OGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHD0","description":"ICD-NAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metaproterenol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7669","description":"Metaproterenol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMF0","description":"ICD-BGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28H","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAD1","description":"ICD-MHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHA0","description":"ICD-MCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAB0","description":"ICD-OGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severeacute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA\u0002LNP_ spike","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0113A","description":"Immunization administration by intramuscular injection of severeacute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA\u0002LNP_ spike","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWE0","description":"ICD-OLWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4336","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","description":"HCPCS-Q4336","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23D","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Im admin 1st/only component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90460","description":"Im admin 1st/only component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJE1","description":"ICD-JGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDB1","description":"ICD-GHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no follow imag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9555","description":"Doc med reas no follow imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50436","description":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCD1","description":"ICD-MDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTE0","description":"ICD-OGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair detachable arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1060","description":"Wheelchair detachable arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUD1","description":"ICD-NJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACC1","description":"ICD-GACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFA0","description":"ICD-OFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLA0","description":"ICD-CBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vessel mapping hemo access","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0365","description":"Vessel mapping hemo access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No photodoc cecal ldmk exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9614","description":"No photodoc cecal ldmk exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estradiol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82670","description":"Assay of estradiol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE217","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepcidin-25_ Enzyme-Linked Immunosorbent Assay (Elisa)_ Serum Or Plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0251U","description":"Hepcidin-25_ Enzyme-Linked Immunosorbent Assay (Elisa)_ Serum Or Plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRE0","description":"ICD-PGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosis Of Seizure Disorders_ Rapid Eye Movement Sleep Behavior Disorder_ Benzodiazepine Withdrawal_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0033","description":"Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosis Of Seizure Disorders_ Rapid Eye Movement Sleep Behavior Disorder_ Benzodiazepine Withdrawal_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTE0","description":"ICD-KDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMF1","description":"ICD-NDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rufinamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80210","description":"Rufinamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEE1","description":"ICD-NFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFE0","description":"ICD-OFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERA1","description":"ICD-HERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38129","description":"Laparoscope proc spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBE1","description":"ICD-MHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9220","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","description":"HCPCS-J9220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMA0","description":"ICD-JAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRB0","description":"ICD-OHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIE0","description":"ICD-GAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove forearm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25145","description":"Remove forearm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1801","description":"HCPCS-A1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE116","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJB0","description":"ICD-KGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPD1","description":"ICD-OHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risperidone (Perseris)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9037","description":"Injection_ risperidone (Perseris)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAD0","description":"ICD-OLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXA0","description":"ICD-KIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28292","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mrs disc pain acquisj data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0609T","description":"Mrs disc pain acquisj data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPB1","description":"ICD-OKPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVF0","description":"ICD-KIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46760","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of somatostatin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84307","description":"Assay of somatostatin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGF0","description":"ICD-GDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot arch support remov prem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3030","description":"Foot arch support remov prem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA254","description":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1B","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Back school visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9117","description":"Back school visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26432","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDE1","description":"ICD-JGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKB0","description":"ICD-OGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUB0","description":"ICD-GAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDC1","description":"ICD-BIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1377","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","description":"HCPCS-M1377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPD0","description":"ICD-JEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIE1","description":"ICD-EFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMA1","description":"ICD-ACMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enlargemnt of eye prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2625","description":"Enlargemnt of eye prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX24","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech therapy_ re-eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9152","description":"Speech therapy_ re-eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"D5w infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7070","description":"D5w infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36482","description":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electromyograph biofeedback","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0746","description":"Electromyograph biofeedback","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess cat in dbase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7020F","description":"Mammo assess cat in dbase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYD0","description":"ICD-PAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMB0","description":"ICD-OFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAD0","description":"ICD-FHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral busulfan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8510","description":"Oral busulfan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC11","description":"ICD-4LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy intracavitary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96440","description":"Chemotherapy intracavitary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGD1","description":"ICD-FCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/stone remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52352","description":"Cystouretero w/stone remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDC1","description":"ICD-KGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWF1","description":"ICD-CCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted for performance of elective carotid intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9689","description":"Patient admitted for performance of elective carotid intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTC0","description":"ICD-CFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whfo nontorsion joint prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3931","description":"Whfo nontorsion joint prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBA0","description":"ICD-CGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cysto laser tx ureteral calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2070","description":"Cysto laser tx ureteral calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHE1","description":"ICD-CHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTC0","description":"ICD-NLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOD1","description":"ICD-PIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHB1","description":"ICD-JGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVE0","description":"ICD-BGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Follow-up angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75898","description":"Follow-up angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery transpose/endovas taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33889","description":"Artery transpose/endovas taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01958","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","description":"CPT-01958","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFF0","description":"ICD-FBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methyldopate hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0210","description":"Methyldopate hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVA1","description":"ICD-JFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXF0","description":"ICD-JDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv3 vacc no prsv 6-35 mo im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90655","description":"Iiv3 vacc no prsv 6-35 mo im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High risk recurrence pro ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8465","description":"High risk recurrence pro ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXF1","description":"ICD-KHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tumor imaging mult areas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78801","description":"Tumor imaging mult areas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBD1","description":"ICD-IGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPF0","description":"ICD-GDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUE1","description":"ICD-AEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBF1","description":"ICD-IBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainable rubber pch w fcplt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4376","description":"Drainable rubber pch w fcplt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57130","description":"Remove vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKF0","description":"ICD-FDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAED0","description":"ICD-FAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 30 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90637","description":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 30 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQF1","description":"ICD-HEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear rx intra-arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79445","description":"Nuclear rx intra-arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adrenal cortical tumor_ biochemical assay of 25 steroid markers_ utilizing 24-hour urine specimen and clinical parameters_ prognostic algorithm reported as a clinical risk and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015M","description":"Adrenal cortical tumor_ biochemical assay of 25 steroid markers_ utilizing 24-hour urine specimen and clinical parameters_ prognostic algorithm reported as a clinical risk and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0573U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","description":"CPT-0573U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHC1","description":"ICD-GAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARF1","description":"ICD-HARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMF0","description":"ICD-OEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Last Colonoscopy Incomplete_ Last Colonoscopy Had Inadequate Prep_ Pi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9998","description":"Documentation Of Medical Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Last Colonoscopy Incomplete_ Last Colonoscopy Had Inadequate Prep_ Pi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDE1","description":"ICD-MDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit cont insulin diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9353","description":"Hit cont insulin diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVB1","description":"ICD-FAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKE0","description":"ICD-JFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCD1","description":"ICD-JDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTC1","description":"ICD-FHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUD0","description":"ICD-BAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apexification/recalc interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3352","description":"Apexification/recalc interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telescop/othr compound lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2615","description":"Telescop/othr compound lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBB0","description":"ICD-OKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGME0","description":"ICD-FGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93317","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visc & infraren abd 3 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34847","description":"Visc & infraren abd 3 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj ferric carboxymaltos 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1439","description":"Inj ferric carboxymaltos 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postsurgical obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5932","description":"Postsurgical obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0559U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","description":"CPT-0559U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXF1","description":"ICD-OBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB17","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSE1","description":"ICD-HHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGC1","description":"ICD-JAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUA0","description":"ICD-JIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNE1","description":"ICD-KCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGF0","description":"ICD-GGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTD1","description":"ICD-MHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair & revise nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64874","description":"Repair & revise nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRE0","description":"ICD-DHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Msh2 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81295","description":"Msh2 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCED0","description":"ICD-NCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAA0","description":"ICD-KBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTA1","description":"ICD-ECTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0592U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","description":"CPT-0592U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERC0","description":"ICD-KERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ crizanlizumab-tmca_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9053","description":"Injection_ crizanlizumab-tmca_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8X","description":"Very High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00910","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","description":"CPT-00910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHA0","description":"ICD-KDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUD0","description":"ICD-MLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGD1","description":"ICD-KHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01966","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","description":"CPT-01966","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tibial tubercle hgt w/ toe f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5020","description":"Tibial tubercle hgt w/ toe f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q12h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9501","description":"Hit antibiotic q12h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38525","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9980","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIE1","description":"ICD-NKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50700","description":"Revision of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDD1","description":"ICD-OCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGE0","description":"ICD-OHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1423","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","description":"HCPCS-M1423","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIC1","description":"ICD-ACIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01951","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","description":"CPT-01951","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27446","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFA0","description":"ICD-OEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINB1","description":"ICD-JINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1491","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","description":"HCPCS-M1491","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLE1","description":"ICD-EFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Refill/maint portable pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96521","description":"Refill/maint portable pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42971","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist disart myoelectronic c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6925","description":"Wrist disart myoelectronic c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7514","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","description":"HCPCS-J7514","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEF0","description":"ICD-NBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEE1","description":"ICD-MAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAC1","description":"ICD-OLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDE0","description":"ICD-NBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWE0","description":"ICD-PAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFED1","description":"ICD-CFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No antihist/decong rx/recom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4134F","description":"No antihist/decong rx/recom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJA0","description":"ICD-CCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPA0","description":"ICD-JBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFE1","description":"ICD-OFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Symp aaa urgent repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9600","description":"Symp aaa urgent repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWE1","description":"ICD-KFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-sterile gauze<=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6216","description":"Non-sterile gauze<=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJC1","description":"ICD-GCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTA1","description":"ICD-IDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk imaging tst not ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3331F","description":"Bk imaging tst not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVD1","description":"ICD-BGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Special Meal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1764","description":"Home Delivered Meals-Special Meal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDC0","description":"ICD-GIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Matrl for vocal cord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1878","description":"Matrl for vocal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrogastrography w/test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91133","description":"Electrogastrography w/test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclr rx interstit colloid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79300","description":"Nuclr rx interstit colloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTE1","description":"ICD-NGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44970","description":"Laparoscopy appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resp virus 12-25 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87633","description":"Resp virus 12-25 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECE0","description":"ICD-AECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52281","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0542U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","description":"CPT-0542U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUD1","description":"ICD-NHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ippb all types","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0500","description":"Ippb all types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; simple filter method with interpretation (List separatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0828T","description":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; simple filter method with interpretation (List separatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCA1","description":"ICD-KFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc abdm/per/oment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49329","description":"Laparo proc abdm/per/oment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFC0","description":"ICD-CHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX10","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUB1","description":"ICD-JEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"So 8 ab rstr can/web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3660","description":"So 8 ab rstr can/web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28124","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reopen fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58345","description":"Reopen fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20B","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUF1","description":"ICD-GEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHB0","description":"ICD-NIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAB0","description":"ICD-NKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQC1","description":"ICD-CAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harvest Of Upper Extremity Artery_ 1 Segment_ For Coronary Artery Bypass Procedure_ Endoscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33509","description":"Harvest Of Upper Extremity Artery_ 1 Segment_ For Coronary Artery Bypass Procedure_ Endoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable canister for pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7000","description":"Disposable canister for pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEC1","description":"ICD-GFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gadofosveset trisodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9583","description":"Gadofosveset trisodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGB1","description":"ICD-OJGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIED1","description":"ICD-IIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUF1","description":"ICD-AHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ONC BRST CA AI ASSMT 12 FEAT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0220U","description":"ONC BRST CA AI ASSMT 12 FEAT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCC1","description":"ICD-OHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFA0","description":"ICD-CIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLE1","description":"ICD-JGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC11","description":"ICD-3AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28G","description":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLC0","description":"ICD-NHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67108","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE113","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ercp sphincter pressure meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43263","description":"Ercp sphincter pressure meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAD0","description":"ICD-ABAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatric symptoms not assessed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9743","description":"Psychiatric symptoms not assessed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair rectourethral fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45820","description":"Repair rectourethral fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACC0","description":"ICD-AACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTC1","description":"ICD-NKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDF1","description":"ICD-CBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54324","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc comm risk calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9316","description":"Doc comm risk calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-49187","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","description":"CPT-49187","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJA0","description":"ICD-KDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTF1","description":"ICD-OGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trabeculostomy Ab Interno By Laser; With Use Of Ophthalmic Endoscope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0622T","description":"Trabeculostomy Ab Interno By Laser; With Use Of Ophthalmic Endoscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLE0","description":"ICD-JBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEE1","description":"ICD-ADEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cyclophosphamide 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9070","description":"Cyclophosphamide 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQA1","description":"ICD-HIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAC1","description":"ICD-FDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64620","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMB1","description":"ICD-AIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrmng 4 surg normothermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4250F","description":"Wrmng 4 surg normothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBC0","description":"ICD-FDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41130","description":"Partial removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUC0","description":"ICD-OLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pancreas lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48120","description":"Removal of pancreas lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYA0","description":"ICD-GCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFE0","description":"ICD-OHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHA1","description":"ICD-CBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA53","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHB1","description":"ICD-ICHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEC1","description":"ICD-MFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMB0","description":"ICD-EGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93531","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation syringe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4322","description":"Irrigation syringe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32215","description":"Treat chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide for heart biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76932","description":"Echo guide for heart biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAE1","description":"ICD-CAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNB0","description":"ICD-CGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 65 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0145U","description":"Drug assay_ definitive_ 65 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7525","description":"Tracheostomy mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTF1","description":"ICD-FDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt talk psychsoc&rx oh dpnd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4320F","description":"Pt talk psychsoc&rx oh dpnd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incis w/discectomy cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22220","description":"Incis w/discectomy cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXF0","description":"ICD-KIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEC1","description":"ICD-OLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIF0","description":"ICD-AHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOF0","description":"ICD-CDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHC0","description":"ICD-JIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise reconst elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24371","description":"Revise reconst elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDE0","description":"ICD-KDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHB0","description":"ICD-AAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYE0","description":"ICD-LIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSD1","description":"ICD-KBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart failure composite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001F","description":"Heart failure composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21050","description":"Removal of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMF0","description":"ICD-OAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC14","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQF0","description":"ICD-OHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1C","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with therapeutic injection(s) (eg_ chemodenervation agent or corticosteroid_ injected percutaneous_ transoral_ or via endoscope channel)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31573","description":"Laryngoscopy_ flexible; with therapeutic injection(s) (eg_ chemodenervation agent or corticosteroid_ injected percutaneous_ transoral_ or via endoscope channel)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg_ myotonic dystrophy type 2) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81187","description":"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg_ myotonic dystrophy type 2) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHC0","description":"ICD-GAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIB0","description":"ICD-GCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQD0","description":"ICD-CFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOC0","description":"ICD-DIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25D","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonmed family planning ed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1010","description":"Nonmed family planning ed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEA1","description":"ICD-BAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBB0","description":"ICD-JHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gallium nitrate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1457","description":"Gallium nitrate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neck spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22595","description":"Neck spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABC1","description":"ICD-EABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKE0","description":"ICD-OIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKE0","description":"ICD-CCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYE0","description":"ICD-OAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYB1","description":"ICD-PDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYE1","description":"ICD-PCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Restorative foundation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2949","description":"Restorative foundation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXE0","description":"ICD-GAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAB0","description":"ICD-BHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLF1","description":"ICD-IBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68505","description":"Partial removal tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHC0","description":"ICD-AAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft splenorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35536","description":"Art byp grft splenorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18G","description":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYC0","description":"ICD-LBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stationary liquid 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0439","description":"Stationary liquid 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHA1","description":"ICD-OGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCB0","description":"ICD-AGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18F","description":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX11","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27540","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0602","description":"HCPCS-C0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUD0","description":"ICD-AHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHA1","description":"ICD-BGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC217","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRC1","description":"ICD-OJRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYB1","description":"ICD-DCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISC0","description":"ICD-LISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC260","description":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Unilateral Space Maintainer - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1553","description":"Re-Cement Or Re-Bond Unilateral Space Maintainer - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQC1","description":"ICD-LIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWF0","description":"ICD-CGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUD0","description":"ICD-GCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0806","description":"Replacement of lower extremity joint with Motor <22.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Semi precision attach abut","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6052","description":"Semi precision attach abut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUF0","description":"ICD-KBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethro cut ejacul duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52402","description":"Cystourethro cut ejacul duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMB0","description":"ICD-EEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYC1","description":"ICD-KIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of suture from anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46754","description":"Removal of suture from anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9489","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOC0","description":"ICD-PFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl devital tis 20 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97597","description":"Rmvl devital tis 20 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB224","description":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIID0","description":"ICD-OIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc shoulder tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23076","description":"Exc shoulder tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD255","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4C","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt neurostim radiofq rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8682","description":"Implt neurostim radiofq rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIC0","description":"ICD-IDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bitewings - three films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0273","description":"Bitewings - three films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lung lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32140","description":"Removal of lung lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVF0","description":"ICD-GGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mohs addl stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17312","description":"Mohs addl stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMA0","description":"ICD-AHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJD0","description":"ICD-KCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1412","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","description":"HCPCS-M1412","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; 8 or more vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22837","description":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; 8 or more vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD160","description":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARE0","description":"ICD-LARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIA0","description":"ICD-GBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKD0","description":"ICD-NGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYE0","description":"ICD-PDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9062","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9062","description":"HCPCS-J9062","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pm device progr eval sngl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93279","description":"Pm device progr eval sngl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBF0","description":"ICD-MEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPC0","description":"ICD-BEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDE1","description":"ICD-NKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPB1","description":"ICD-FAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; first 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96138","description":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVC1","description":"ICD-NLVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAE0","description":"ICD-OIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen based wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6010","description":"Collagen based wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHB0","description":"ICD-IFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAD1","description":"ICD-CCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUB0","description":"ICD-ICUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33977","description":"Remove ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0014","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSD0","description":"ICD-PFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKD0","description":"ICD-GGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWD1","description":"ICD-GDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fomepizole_ 15 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1451","description":"Fomepizole_ 15 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16078","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16078","description":"CPT-16078","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBA0","description":"ICD-FCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYB1","description":"ICD-DGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDD0","description":"ICD-NDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDED1","description":"ICD-KDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No strk cabg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8574","description":"No strk cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIE0","description":"ICD-OLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMB0","description":"ICD-OBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTB0","description":"ICD-ECTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam drsg <=16 sq in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6209","description":"Foam drsg <=16 sq in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUA0","description":"ICD-NCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBF0","description":"ICD-BHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDC1","description":"ICD-NIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8I","description":"Very High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81362","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ alemtuzumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0202","description":"Injection_ alemtuzumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQD0","description":"ICD-DCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1492","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","description":"HCPCS-M1492","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA246","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBA1","description":"ICD-OFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBA0","description":"ICD-EGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score le >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8655","description":"Fun stat score le >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX01","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES305","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMC0","description":"ICD-IDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mucormycosis antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86732","description":"Mucormycosis antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDF1","description":"ICD-IHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUA0","description":"ICD-BAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXD0","description":"ICD-GHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lung lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32150","description":"Removal of lung lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKC1","description":"ICD-JIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac mgmt adheres guide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9056","description":"Onc prac mgmt adheres guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasty_ one vertebral body_ unilateral or bilateral injection; cervical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2360","description":"Percutaneous vertebroplasty_ one vertebral body_ unilateral or bilateral injection; cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50080","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTA0","description":"ICD-IDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0629U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","description":"CPT-0629U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJF1","description":"ICD-CFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental saliography","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0310","description":"Dental saliography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNA1","description":"ICD-JCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Axicabtage neciloleucel_ up to 200 million autologous anti-CD19 CAR T Cells_ including leukapheresis and dose preparation procedures_ per infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2041","description":"Axicabtage neciloleucel_ up to 200 million autologous anti-CD19 CAR T Cells_ including leukapheresis and dose preparation procedures_ per infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection intraop add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48400","description":"Injection intraop add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28510","description":"Treatment of toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supply allowance for adjunctive continuous glucose monitor (CGM)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4238","description":"Supply allowance for adjunctive continuous glucose monitor (CGM)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open aortoiliac prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34831","description":"Open aortoiliac prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53431","description":"Reconstruct urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUA0","description":"ICD-NEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWA1","description":"ICD-KBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Betadine/phisohex solution","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4246","description":"Betadine/phisohex solution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRE0","description":"ICD-CGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBA1","description":"ICD-MIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mod or severe osa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8846","description":"Mod or severe osa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLA1","description":"ICD-KFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl vagus nerve pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0315T","description":"Rmvl vagus nerve pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36218","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETD1","description":"ICD-GETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUD0","description":"ICD-IEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWC1","description":"ICD-OIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35355","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISA1","description":"ICD-PISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 50 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91322","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 50 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip clevis/thrust bearing lo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2610","description":"Hip clevis/thrust bearing lo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Full sole/heel wedge btween","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3420","description":"Full sole/heel wedge btween","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFE1","description":"ICD-FFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBC0","description":"ICD-JDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPE0","description":"ICD-OHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAE1","description":"ICD-IAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart muscle imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78459","description":"Heart muscle imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheo-esophagoplasty cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43314","description":"Tracheo-esophagoplasty cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments_ plasma_ prognostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0357U","description":"Oncology (melanoma)_ artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments_ plasma_ prognostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJB0","description":"ICD-GCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCF1","description":"ICD-FGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOD0","description":"ICD-DBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteopath manj 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98925","description":"Osteopath manj 1-2 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHE0","description":"ICD-KBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Er- or pr- breast cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3316F","description":"Er- or pr- breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Had A Prior Influenza Virus Vaccine Adverse Reaction Any Time Before Or During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2164","description":"Patient Had A Prior Influenza Virus Vaccine Adverse Reaction Any Time Before Or During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPE0","description":"ICD-CBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQA1","description":"ICD-PAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Advancing cancer care mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0001","description":"Advancing cancer care mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB225","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAE0","description":"ICD-KBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 11 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0447U","description":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 11 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFE0","description":"ICD-NEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBB1","description":"ICD-MBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUD0","description":"ICD-EGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATB1","description":"ICD-JATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flowcytometry/read 2-8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88187","description":"Flowcytometry/read 2-8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIF0","description":"ICD-IFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0957T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","description":"CPT-0957T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEB1","description":"ICD-GEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73100","description":"X-ray exam of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNC1","description":"ICD-GFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIB1","description":"ICD-NLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB11","description":"ICD-3AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBB0","description":"ICD-NCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical social work mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0066","description":"Clinical social work mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUE1","description":"ICD-AGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICB0","description":"ICD-GICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMB0","description":"ICD-IAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic ring fx treat int fix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0414","description":"Pelvic ring fx treat int fix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3D","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIB0","description":"ICD-MBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1394","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","description":"HCPCS-M1394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ controlled by phone application","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0492","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ controlled by phone application","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Truss add to std pad scrotal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8330","description":"Truss add to std pad scrotal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCD1","description":"ICD-BFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHA1","description":"ICD-GDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFD0","description":"ICD-OJFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24530","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUB1","description":"ICD-MBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUC0","description":"ICD-GBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed fixd ht w/o mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0251","description":"Hosp bed fixd ht w/o mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria w/bypass exten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33256","description":"Ablate atria w/bypass exten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTD1","description":"ICD-MDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMD1","description":"ICD-FHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUB1","description":"ICD-KHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diphtheria_ tetanus toxoids_ and acellular pertussis vaccine andhemophilus influenza b vaccine (dtap-hib)_ for intramsucular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90721","description":"Diphtheria_ tetanus toxoids_ and acellular pertussis vaccine andhemophilus influenza b vaccine (dtap-hib)_ for intramsucular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC31","description":"ICD-4AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHE0","description":"ICD-OCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50976","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX13","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGE0","description":"ICD-FAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQB1","description":"ICD-PFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBE1","description":"ICD-CDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISA0","description":"ICD-OISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (urothelial cancer)_ RNA_ analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie_ p.R248C [c.742C>T]_ p.S249C [c.746C>G]_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0154U","description":"Oncology (urothelial cancer)_ RNA_ analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie_ p.R248C [c.742C>T]_ p.S249C [c.746C>G]_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFC0","description":"ICD-FIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artificial insemination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58321","description":"Artificial insemination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEA1","description":"ICD-IAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37263","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","description":"CPT-37263","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44373","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUF0","description":"ICD-BHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMF0","description":"ICD-KCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYE0","description":"ICD-GBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLE0","description":"ICD-AFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; review_ interpretation_ report by physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0478T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; review_ interpretation_ report by physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGE1","description":"ICD-FCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40652","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJE0","description":"ICD-BCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bone for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20900","description":"Removal of bone for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25B","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21348","description":"Opn tx nasomax fx w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychia sympts assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1181F","description":"Neuropsychia sympts assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cylinder tank carrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2208","description":"Cylinder tank carrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIE1","description":"ICD-EBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC24","description":"Very High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99219","description":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYF0","description":"ICD-GHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWB1","description":"ICD-OKWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subtalar arthro w/deb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29906","description":"Subtalar arthro w/deb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFD0","description":"ICD-JBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE160","description":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPD1","description":"ICD-GEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYD0","description":"ICD-KFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0694U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694U","description":"CPT-0694U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIF1","description":"ICD-CBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elastic garment/covering","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4466","description":"Elastic garment/covering","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (cutaneous squamous cell carcinoma)_ mRNA gene expression profiling by RT-PCR of 40 genes (34 content and 6 housekeeping)_ utilizing formalin-fixed paraffin-embedded","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0315U","description":"Oncology (cutaneous squamous cell carcinoma)_ mRNA gene expression profiling by RT-PCR of 40 genes (34 content and 6 housekeeping)_ utilizing formalin-fixed paraffin-embedded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB26","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUC0","description":"ICD-EGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88014","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0904T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","description":"CPT-0904T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESC1","description":"ICD-LESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Portable gas oxygen system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0738","description":"Portable gas oxygen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLE0","description":"ICD-GFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33863","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWB1","description":"ICD-LHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYE1","description":"ICD-PBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of foot bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28122","description":"Partial removal of foot bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLC0","description":"ICD-NBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOD1","description":"ICD-CGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1243","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTC0","description":"ICD-NHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVB1","description":"ICD-GEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVD0","description":"ICD-CDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainable pch w ex wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4388","description":"Drainable pch w ex wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXA1","description":"ICD-OAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGE1","description":"ICD-CAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical services after hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99050","description":"Medical services after hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16072","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16072","description":"CPT-16072","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWB0","description":"ICD-CFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFF1","description":"ICD-JBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE235","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51720","description":"Treatment of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12018","description":"Rpr f/e/e/n/l/m >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 2-12 Channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77786","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 2-12 Channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBA1","description":"ICD-MDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQE0","description":"ICD-HIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant maintenance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6080","description":"Implant maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJA1","description":"ICD-CIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCD1","description":"ICD-CGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEE1","description":"ICD-CFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB111","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD251","description":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFE0","description":"ICD-NIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFE1","description":"ICD-FGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13100","description":"Cmplx rpr trunk 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXB1","description":"ICD-GIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy oocyte polar body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89290","description":"Biopsy oocyte polar body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31530","description":"Laryngoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD101","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA11","description":"ICD-2CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOF1","description":"ICD-OJOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALB1","description":"ICD-IALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHD1","description":"ICD-KEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull & remove clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61154","description":"Pierce skull & remove clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUB0","description":"ICD-KEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD216","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAB0","description":"ICD-CGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLB0","description":"ICD-EFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ during operative procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73530","description":"Radiologic examination_ hip_ during operative procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC117","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPC1","description":"ICD-OFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECED0","description":"ICD-ECED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAE0","description":"ICD-OCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31610","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8X","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMD0","description":"ICD-NGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXF0","description":"ICD-JEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Team evaluation & management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1024","description":"Team evaluation & management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ behind the ear (BTE)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5181","description":"Hearing aid_ contralateral routing device_ monaural_ behind the ear (BTE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOB0","description":"ICD-CHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0403","description":"HCPCS-A0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMC1","description":"ICD-MHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0669U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0669U","description":"CPT-0669U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJA0","description":"ICD-KBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01120","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","description":"CPT-01120","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC254","description":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43611","description":"Excision of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admini on the same date of service_ 5 to 15 minutes time Medicaid only.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0310","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admini on the same date of service_ 5 to 15 minutes time Medicaid only.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk/ak locking mechanism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5671","description":"Bk/ak locking mechanism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of free testosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84402","description":"Assay of free testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinician Determines Patient Does Not Require Referral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0038","description":"Clinician Determines Patient Does Not Require Referral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMC0","description":"ICD-MAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC11","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage(s)_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7510","description":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage(s)_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPA1","description":"ICD-BDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE234","description":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64581","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNB1","description":"ICD-FBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58210","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGC0","description":"ICD-BDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27502","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9187","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9187","description":"HCPCS-J9187","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amphotericin b liposome inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0289","description":"Amphotericin b liposome inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dyphylline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1180","description":"Dyphylline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of breast open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19101","description":"Biopsy of breast open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemical cauterization of granulation tissue (ie_ proud flesh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17250","description":"Chemical cauterization of granulation tissue (ie_ proud flesh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vaginectomy w/nodes compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57112","description":"Vaginectomy w/nodes compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQF0","description":"ICD-HGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27846","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSF1","description":"ICD-HCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBF0","description":"ICD-FBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHF0","description":"ICD-AIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBD1","description":"ICD-ACBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genvisc_ inj_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9980","description":"Genvisc_ inj_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESA0","description":"ICD-DESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEB0","description":"ICD-CEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPD0","description":"ICD-KBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQB0","description":"ICD-OFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYE1","description":"ICD-PKYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDB0","description":"ICD-JHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7030","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQE0","description":"ICD-CGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESF1","description":"ICD-DESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial vaginosis and vaginitis)_ multiplex amplified probe technique_ for detection of bacterial vaginosis-associated bacteria (BVAB-2_ Atopobium vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0352U","description":"Infectious disease (bacterial vaginosis and vaginitis)_ multiplex amplified probe technique_ for detection of bacterial vaginosis-associated bacteria (BVAB-2_ Atopobium vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20525","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sperm evaluation test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89329","description":"Sperm evaluation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFD0","description":"ICD-JHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDC0","description":"ICD-IBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91451","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLD0","description":"ICD-EDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOA0","description":"ICD-PGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCF1","description":"ICD-CFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Throat x-ray & fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70370","description":"Throat x-ray & fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNA1","description":"ICD-KBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQE1","description":"ICD-DAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBA1","description":"ICD-NDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENF0","description":"ICD-OENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rectal control system for vaginal insertion_ for long term use_ includes pump and all supplies and accessories_ any type each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4563","description":"Rectal control system for vaginal insertion_ for long term use_ includes pump and all supplies and accessories_ any type each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOD0","description":"ICD-PGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 16 central carbon metabolites (ie_a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ succinat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0263U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 16 central carbon metabolites (ie_a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ succinat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perphenazine 4mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0175","description":"Perphenazine 4mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQD1","description":"ICD-ODQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC60","description":"Very High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB11","description":"ICD-4EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEA1","description":"ICD-NIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHC1","description":"ICD-AAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine infusion device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62365","description":"Remove spine infusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1high risk med ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9365","description":"1high risk med ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFF0","description":"ICD-KGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDB0","description":"ICD-EBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKC0","description":"ICD-CDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAA1","description":"ICD-EDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28I","description":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Desoxycorticosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82633","description":"Desoxycorticosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vit for macular pucker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67041","description":"Vit for macular pucker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIF0","description":"ICD-NGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAF0","description":"ICD-BHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound warming device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0231","description":"Wound warming device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA135","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAF1","description":"ICD-OFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRD1","description":"ICD-OCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEF0","description":"ICD-BAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lang comp current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9159","description":"Lang comp current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sodium fluoride f-18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9580","description":"Sodium fluoride f-18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHE0","description":"ICD-MJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPA1","description":"ICD-BAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUE0","description":"ICD-JAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUD0","description":"ICD-MDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEME0","description":"ICD-NEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQE1","description":"ICD-KBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28737","description":"Revision of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No brst cncr dx min invasive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8877","description":"No brst cncr dx min invasive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable compressor filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7013","description":"Disposable compressor filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m pertechnetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9512","description":"Tc99m pertechnetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath fl nongyn filter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88106","description":"Cytopath fl nongyn filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHE0","description":"ICD-ECHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRA1","description":"ICD-HGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0550","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","description":"HCPCS-G0550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDB0","description":"ICD-FHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLB1","description":"ICD-NHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEA0","description":"ICD-BEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD144","description":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFED1","description":"ICD-OFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26705","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKD0","description":"ICD-GDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng epo thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4090F","description":"Pt rcvng epo thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermal filler injection(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0429","description":"Dermal filler injection(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28D","description":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNB1","description":"ICD-KGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHB1","description":"ICD-IHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Positional change of finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26555","description":"Positional change of finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQA1","description":"ICD-DHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0655U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0655U","description":"CPT-0655U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUE0","description":"ICD-GBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD225","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXE1","description":"ICD-NKXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place needles pelvic for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55920","description":"Place needles pelvic for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRF1","description":"ICD-GGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9976","description":"Documentation of patient reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYD0","description":"ICD-HHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1B","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57720","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVA1","description":"ICD-CFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGD0","description":"ICD-BHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18G","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB231","description":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKF1","description":"ICD-NEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHD1","description":"ICD-MBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31084","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37295","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","description":"CPT-37295","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75870","description":"Vein x-ray skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHA1","description":"ICD-EBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDD1","description":"ICD-MHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0094A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ amisulpride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0184","description":"Injection_ amisulpride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHF1","description":"ICD-OIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alloskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4123","description":"Alloskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUF1","description":"ICD-OKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAF1","description":"ICD-MLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCE1","description":"ICD-FFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open/perq place stent ea add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37239","description":"Open/perq place stent ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complement antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86160","description":"Complement antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8E","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISF1","description":"ICD-LISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kit gene analys d816 variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81273","description":"Kit gene analys d816 variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMA1","description":"ICD-CGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; Without Continuous Oximetry Monitoring (Per Session)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94625","description":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; Without Continuous Oximetry Monitoring (Per Session)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trach supply noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8189","description":"Trach supply noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJF0","description":"ICD-NJJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICF1","description":"ICD-OICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKF0","description":"ICD-KCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay acid phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84060","description":"Assay acid phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nepuitant 300 mg and palonosetron 0.5 mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9978","description":"Nepuitant 300 mg and palonosetron 0.5 mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21246","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Persistent asthma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1038F","description":"Persistent asthma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPE0","description":"ICD-CIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENE0","description":"ICD-JENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63016","description":"Remove spine lamina >2 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Derm autograft f/n/hf/g add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15136","description":"Derm autograft f/n/hf/g add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPC1","description":"ICD-OJPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAE1","description":"ICD-NEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGED0","description":"ICD-FGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal Aneuploidy Short Tandem-Repeat Comparative Analysis_ Fetal Dna From Products Of Conception_ Reported As Normal (Euploidy)_ Monosomy_ Trisomy_ Or Partial Deletion/Duplica","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0252U","description":"Fetal Aneuploidy Short Tandem-Repeat Comparative Analysis_ Fetal Dna From Products Of Conception_ Reported As Normal (Euploidy)_ Monosomy_ Trisomy_ Or Partial Deletion/Duplica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVF0","description":"ICD-BGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0B","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ naloxone hydrochloride (zimhi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2311","description":"Injection_ naloxone hydrochloride (zimhi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIB0","description":"ICD-NFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cvd risk assessment performed_ have a documented calculated risk score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1258","description":"Cvd risk assessment performed_ have a documented calculated risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVA0","description":"ICD-CBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAD1","description":"ICD-OCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fit spectacles multifocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92342","description":"Fit spectacles multifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHD0","description":"ICD-GGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ valoctocogene roxaparvovec-rvox_ per ml_ containing nominal 2 x 10^13 vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1412","description":"Injection_ valoctocogene roxaparvovec-rvox_ per ml_ containing nominal 2 x 10^13 vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPA1","description":"ICD-NIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHB1","description":"ICD-NGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHB1","description":"ICD-ADHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj ocular telescope prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0308T","description":"Insj ocular telescope prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aflibercept hd_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9161","description":"Injection_ aflibercept hd_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD234","description":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity medical tubing/lines enclosure or covering device_ restricts elbow range of motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0711","description":"Upper extremity medical tubing/lines enclosure or covering device_ restricts elbow range of motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFB0","description":"ICD-FHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMC0","description":"ICD-AFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUF1","description":"ICD-OJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGD1","description":"ICD-NGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln part maxil lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5760","description":"Denture reln part maxil lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHA0","description":"ICD-CIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagectomy_ total or near total_ with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43286","description":"Esophagectomy_ total or near total_ with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61510","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHB1","description":"ICD-JBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ftrst upper hanger bracket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0044","description":"Ftrst upper hanger bracket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPD1","description":"ICD-BCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDA0","description":"ICD-MHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA11","description":"ICD-4JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHE1","description":"ICD-FHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10B","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61605","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICD1","description":"ICD-BICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUD0","description":"ICD-FAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYA1","description":"ICD-HBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 60 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90638","description":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 60 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impr vis acuit w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9516","description":"Impr vis acuit w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOF0","description":"ICD-PIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQA1","description":"ICD-KHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHE1","description":"ICD-EDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYF0","description":"ICD-KFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLA0","description":"ICD-MGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHD1","description":"ICD-FAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUB1","description":"ICD-NJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor_ including system activation and patient training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0308","description":"Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor_ including system activation and patient training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKB1","description":"ICD-FBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetics 10-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88273","description":"Cytogenetics 10-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42509","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18F","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology/Hematology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4019","description":"Oncology/Hematology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKC0","description":"ICD-BCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERD0","description":"ICD-OERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB31","description":"ICD-1CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWD0","description":"ICD-PGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSC0","description":"ICD-GBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric bypass incl small i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43847","description":"Gastric bypass incl small i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25290","description":"Incise wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQB0","description":"ICD-PCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCF0","description":"ICD-BFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSF0","description":"ICD-ODSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit chemo per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9329","description":"Hit chemo per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath smear prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0480","description":"Cytopath smear prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMC1","description":"ICD-ICMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIC1","description":"ICD-FDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total kt/v greater than or equal to 1. 7 per week (total clearance of urea [kt] / volume [v])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8718","description":"Total kt/v greater than or equal to 1. 7 per week (total clearance of urea [kt] / volume [v])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQE1","description":"ICD-GCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27498","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC117","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPE0","description":"ICD-NDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cysto/uretero w/up stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52345","description":"Cysto/uretero w/up stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMB1","description":"ICD-IIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colchicine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0760","description":"Colchicine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35082","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78201","description":"Liver imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay resin 4/mre sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2664","description":"Dental onlay resin 4/mre sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29877","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOD0","description":"ICD-OCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA22","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFB1","description":"ICD-NLFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0802","description":"HCPCS-C0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEE0","description":"ICD-BFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood pressure measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2000F","description":"Blood pressure measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54380","description":"Repair penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlamydia trachomatis ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87270","description":"Chlamydia trachomatis ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50557","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOE0","description":"ICD-HCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIC0","description":"ICD-JFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQA1","description":"ICD-HDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mitomycin pyelocalyceal instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9281","description":"Mitomycin pyelocalyceal instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXA0","description":"ICD-OAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXA0","description":"ICD-FAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUE0","description":"ICD-MLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINE0","description":"ICD-BINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dxa bone density axial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77080","description":"Dxa bone density axial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr f/c/c/m/n/a/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14041","description":"Tis trnfr f/c/c/m/n/a/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDF0","description":"ICD-OGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDB1","description":"ICD-EFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXE0","description":"ICD-BFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc abd tum 5 cm or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49203","description":"Exc abd tum 5 cm or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pho doc >1 cecal ldmk com ex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9612","description":"Pho doc >1 cecal ldmk com ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPE0","description":"ICD-GHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45900","description":"Reduction of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOF0","description":"ICD-KHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKD0","description":"ICD-OEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMC1","description":"ICD-ECMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc car modulj atr elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0410T","description":"Insj/rplc car modulj atr elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neox Cord 1K_ Neox Cord RT_ or Clarix Cord 1K_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4148","description":"Neox Cord 1K_ Neox Cord RT_ or Clarix Cord 1K_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virus inoculate tissue addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87253","description":"Virus inoculate tissue addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPC0","description":"ICD-BCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB251","description":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNA0","description":"ICD-KBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALB1","description":"ICD-NALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGA1","description":"ICD-NIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA31","description":"ICD-4GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGE0","description":"ICD-FBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score knee pt noelg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8649","description":"Fun stat score knee pt noelg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQC1","description":"ICD-KEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKB1","description":"ICD-JHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYE1","description":"ICD-KBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGE1","description":"ICD-FEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLF0","description":"ICD-JHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDA0","description":"ICD-IIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Storage/year embryo(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89342","description":"Storage/year embryo(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical Physics Dose Evaluation For Radiation Exposure That Exceeds Institutional Review Threshold_ Including Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76145","description":"Medical Physics Dose Evaluation For Radiation Exposure That Exceeds Institutional Review Threshold_ Including Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWA0","description":"ICD-DGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of a-v fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37607","description":"Ligation of a-v fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWD1","description":"ICD-KGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOD1","description":"ICD-OKOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJD1","description":"ICD-NLJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQD1","description":"ICD-GFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop ren fail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8575","description":"Postop ren fail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCD1","description":"ICD-MLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUC0","description":"ICD-ABUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0968T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","description":"CPT-0968T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIB0","description":"ICD-ECIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAD0","description":"ICD-BIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical foods for noninborn errors of metabolism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9432","description":"Medical foods for noninborn errors of metabolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0239","description":"Intravenous infusion_ bamlanivimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKC0","description":"ICD-JAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXA0","description":"ICD-GDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBE1","description":"ICD-FDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCE1","description":"ICD-NKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTC1","description":"ICD-CDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASA1","description":"ICD-OASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHD0","description":"ICD-BGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-93896","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","description":"CPT-93896","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC204","description":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKE0","description":"ICD-JEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22514","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEB1","description":"ICD-KHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0625T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAC1","description":"ICD-BHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4228","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4228","description":"HCPCS-A4228","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g._ cystic duct_ common bile duct and common hepatic duct) with intravenous administra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9776","description":"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g._ cystic duct_ common bile duct and common hepatic duct) with intravenous administra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDB1","description":"ICD-OEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJF1","description":"ICD-CEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digoxin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1160","description":"Digoxin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open nasoethmoid fx w/o fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21338","description":"Open nasoethmoid fx w/o fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHD0","description":"ICD-AHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc disc tx choices","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9399","description":"Doc disc tx choices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGC1","description":"ICD-GBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWF1","description":"ICD-PLWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWF0","description":"ICD-PCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMF1","description":"ICD-OHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0902","description":"HCPCS-A0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMC1","description":"ICD-JBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHE0","description":"ICD-FGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIC0","description":"ICD-GDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMC0","description":"ICD-BAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33468","description":"Revision of tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEC0","description":"ICD-NHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLB1","description":"ICD-FGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18F","description":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHB1","description":"ICD-GBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE254","description":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELF0","description":"ICD-FELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1495","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","description":"HCPCS-M1495","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27810","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXA1","description":"ICD-NGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFD1","description":"ICD-NEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxaliplatin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9263","description":"Oxaliplatin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Above knee manual lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5925","description":"Above knee manual lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB45","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shoulder cast fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4004","description":"Cast sup shoulder cast fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCF1","description":"ICD-BCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFID1","description":"ICD-OFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28E","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMD1","description":"ICD-GGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc biliary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47579","description":"Laparoscope proc biliary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVD0","description":"ICD-NFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXF0","description":"ICD-NKXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In111 satumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4642","description":"In111 satumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJC0","description":"ICD-KIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC150","description":"Reduced Physical Function _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc renal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50549","description":"Laparoscope proc renal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2193","description":"Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio upr extrm w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73206","description":"Ct angio upr extrm w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8G","description":"Medium Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc cryo ablate renal tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50593","description":"Perc cryo ablate renal tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAE1","description":"ICD-NHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACE1","description":"ICD-OACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73115","description":"Contrast x-ray of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUD1","description":"ICD-FEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQE0","description":"ICD-KEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intensive outpatient psychia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9480","description":"Intensive outpatient psychia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laa closure w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0281T","description":"Laa closure w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOD1","description":"ICD-DGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1088T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1088T","description":"CPT-1088T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Online service by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98969","description":"Online service by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37276","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","description":"CPT-37276","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC36","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0546","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","description":"HCPCS-G0546","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHE1","description":"ICD-OHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extrnl bleaching per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9973","description":"Extrnl bleaching per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUA1","description":"ICD-BGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental prophylaxis child","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1120","description":"Dental prophylaxis child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTF0","description":"ICD-GHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELB0","description":"ICD-CELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam sacrum tailbone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72220","description":"X-ray exam sacrum tailbone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch drain for barrier fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4425","description":"Ost pch drain for barrier fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUE0","description":"ICD-FBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCE1","description":"ICD-NBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDE1","description":"ICD-OHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYC1","description":"ICD-OAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implnt/abut fixed dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6114","description":"Implnt/abut fixed dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCF1","description":"ICD-NJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC251","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYB0","description":"ICD-OKYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The MDPP b eneficiary achieved at least 5% weight loss (WL) from his/he r baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9880","description":"The MDPP b eneficiary achieved at least 5% weight loss (WL) from his/he r baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGA1","description":"ICD-OLGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBD1","description":"ICD-BGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision malig lesion>1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7414","description":"Excision malig lesion>1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMF0","description":"ICD-GFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC156","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of arsenic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82175","description":"Assay of arsenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tun ip cath w/port","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49419","description":"Insert tun ip cath w/port","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ monaural_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5242","description":"Hearing aid_ monaural_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 160 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0144U","description":"Drug assay_ definitive_ 160 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNA0","description":"ICD-KFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJB0","description":"ICD-KDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHE0","description":"ICD-AAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFA1","description":"ICD-FCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHC1","description":"ICD-MCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray of mammary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77053","description":"X-ray of mammary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise head/neck of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27179","description":"Revise head/neck of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHD0","description":"ICD-BDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX53","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTD1","description":"ICD-MFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXC1","description":"ICD-BGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYC1","description":"ICD-DDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDD1","description":"ICD-OLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","description":"CPT-76016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx laryngoscopy newborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31520","description":"Dx laryngoscopy newborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTB1","description":"ICD-OFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rna tstng hep c docd done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3218F","description":"Rna tstng hep c docd done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX23","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phototherapy light w/ photom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0202","description":"Phototherapy light w/ photom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHC1","description":"ICD-IDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUE0","description":"ICD-EEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOC1","description":"ICD-CEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVC1","description":"ICD-BAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBA1","description":"ICD-AFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICD0","description":"ICD-KICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/drug screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0049","description":"Alcohol/drug screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxacillin sodium injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2700","description":"Oxacillin sodium injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB131","description":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvef <40%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8694","description":"Lvef <40%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change stent via transureth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50385","description":"Change stent via transureth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIC0","description":"ICD-MFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMC1","description":"ICD-OCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCE1","description":"ICD-EBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of chest wall respiratory sensor electrode or electrode array_ including connection to pulse generator (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0466T","description":"Insertion of chest wall respiratory sensor electrode or electrode array_ including connection to pulse generator (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjust toe ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1830","description":"Adjust toe ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reposition vad diff session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33993","description":"Reposition vad diff session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVC0","description":"ICD-BCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ irinotecan liposome_ 1 mg (Onivyde)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9474","description":"Injection_ irinotecan liposome_ 1 mg (Onivyde)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_Nivolumab_ 1mg (Opdivo)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9453","description":"Injection_Nivolumab_ 1mg (Opdivo)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMD1","description":"ICD-EAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGB1","description":"ICD-FFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIB0","description":"ICD-KHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGB0","description":"ICD-GBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGE1","description":"ICD-BDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRB1","description":"ICD-DDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAB0","description":"ICD-GHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Legg perthes orth scottish r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1730","description":"Legg perthes orth scottish r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med reas antibiotic pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8709","description":"Med reas antibiotic pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CROM GNOTYP CD55 EXONS 1-10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0182U","description":"CROM GNOTYP CD55 EXONS 1-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKC0","description":"ICD-CIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9809","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj fem single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64447","description":"N block inj fem single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABF0","description":"ICD-IABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; multi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36466","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; multi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture interm part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5820","description":"Denture interm part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB221","description":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct soft tissue neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70490","description":"Ct soft tissue neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx beta-lactam abx therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9558","description":"Tx beta-lactam abx therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remov/replc penis pros comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54411","description":"Remov/replc penis pros comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5C","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAB1","description":"ICD-OHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assessment of and care planning for a patient with cognitive impairment_ requiring an independent historian_ in the office or other outpatient_ home or domiciliary or rest hom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99483","description":"Assessment of and care planning for a patient with cognitive impairment_ requiring an independent historian_ in the office or other outpatient_ home or domiciliary or rest hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVD0","description":"ICD-NEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXC1","description":"ICD-NEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPB1","description":"ICD-KHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSE0","description":"ICD-GBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Visco-3_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7333","description":"Hyaluronan or derivative_ Visco-3_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTA0","description":"ICD-NDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBD1","description":"ICD-NLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTF1","description":"ICD-ICTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGD0","description":"ICD-OJGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of iliopsoas muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27110","description":"Transfer of iliopsoas muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD134","description":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSA0","description":"ICD-PDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWD1","description":"ICD-HGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSE0","description":"ICD-OFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18H","description":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISA1","description":"ICD-KISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0936T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","description":"CPT-0936T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBF0","description":"ICD-CCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34702","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSE1","description":"ICD-KBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endocerv curettage w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57456","description":"Endocerv curettage w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQA0","description":"ICD-CEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQF1","description":"ICD-GGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diskectomy_ anterior_ with d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2350","description":"Diskectomy_ anterior_ with d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCB1","description":"ICD-GCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYF0","description":"ICD-KHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext h rate sz 14 day ri only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0382T","description":"Ext h rate sz 14 day ri only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXD0","description":"ICD-JDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20692","description":"Apply bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA23","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEID0","description":"ICD-BEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Betamethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7624","description":"Betamethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFE0","description":"ICD-BGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9329","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","description":"HCPCS-J9329","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXF1","description":"ICD-JIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFF0","description":"ICD-FDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALB0","description":"ICD-CALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estriol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82677","description":"Assay of estriol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOE1","description":"ICD-OGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel dsg<=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6231","description":"Hydrogel dsg<=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKC1","description":"ICD-BCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUC0","description":"ICD-NAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g._ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9776","description":"Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g._ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reattach tooth fragment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2921","description":"Reattach tooth fragment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAF1","description":"ICD-OEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64584","description":"Removal Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXC1","description":"ICD-JDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg ordered rvwd reqstd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3650F","description":"Eeg ordered rvwd reqstd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTC1","description":"ICD-MBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWE0","description":"ICD-DGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX40","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Portable 02 contents_ gas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0443","description":"Portable 02 contents_ gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosphate (baxter)_ not therapeutically equivalent to j0736_ 300 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0737","description":"Injection_ clindamycin phosphate (baxter)_ not therapeutically equivalent to j0736_ 300 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tantalum ring application","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8030","description":"Tantalum ring application","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc comp or mort w in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9268","description":"Doc comp or mort w in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEF0","description":"ICD-IGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHE1","description":"ICD-JAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0528U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","description":"CPT-0528U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28G","description":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFE0","description":"ICD-BHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOC0","description":"ICD-HDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIC0","description":"ICD-AHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen specific nucleic acid (DNA or RNA)_ 33 targets_ real-time semi-quantitative PCR_ bronchoalveolar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0151U","description":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen specific nucleic acid (DNA or RNA)_ 33 targets_ real-time semi-quantitative PCR_ bronchoalveolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit corticosteroid/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9490","description":"Hit corticosteroid/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ire abltj 1+tumors open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0601T","description":"Ire abltj 1+tumors open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRA0","description":"ICD-LGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJB1","description":"ICD-OAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92326","description":"Replacement of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetic study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88299","description":"Cytogenetic study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGA1","description":"ICD-JDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc no burn prior to d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8909","description":"Pt doc no burn prior to d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRF0","description":"ICD-GHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEB1","description":"ICD-JHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB156","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD150","description":"Special Care Low _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCND0","description":"ICD-CCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fracture frame attachmnts ce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0948","description":"Fracture frame attachmnts ce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Powered pres-redu air mattrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0277","description":"Powered pres-redu air mattrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice respite care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2044","description":"Hospice respite care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNA1","description":"ICD-JFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood product/irradiation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86945","description":"Blood product/irradiation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMA0","description":"ICD-KBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44377","description":"Small bowel endoscopy/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHE1","description":"ICD-FDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insitu hybridization manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88368","description":"Insitu hybridization manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0163","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","description":"HCPCS-J0163","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOA0","description":"ICD-LHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replcmnt breastpump lok ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4286","description":"Replcmnt breastpump lok ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABE0","description":"ICD-KABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33955","description":"Ecmo/ecls insj ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOB0","description":"ICD-OKOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed; with enterocele repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57265","description":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed; with enterocele repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC21","description":"ICD-4IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81401","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGC1","description":"ICD-KHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMB0","description":"ICD-OHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit inj interferon diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9559","description":"Hit inj interferon diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove penis & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54135","description":"Remove penis & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert subq exten to ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49435","description":"Insert subq exten to ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWD0","description":"ICD-PLWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tilt table evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93660","description":"Tilt table evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33952","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGD1","description":"ICD-OCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCE1","description":"ICD-FGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKD0","description":"ICD-OAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Not Been Ordered Or Performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2120","description":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Not Been Ordered Or Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual therapy 1/> regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97140","description":"Manual therapy 1/> regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spec stains not for microorg","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0477","description":"Spec stains not for microorg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shrt leg ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4039","description":"Cast sup shrt leg ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAC1","description":"ICD-BDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDD0","description":"ICD-CEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med service out of office","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99056","description":"Med service out of office","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Creation of arteriovenous fistula_ percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9755","description":"Creation of arteriovenous fistula_ percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXB1","description":"ICD-KCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB212","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Airways surgical procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31899","description":"Airways surgical procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPA1","description":"ICD-JEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Separate eyelid adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68340","description":"Separate eyelid adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSE1","description":"ICD-OGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEE0","description":"ICD-NAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQB0","description":"ICD-GDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJC1","description":"ICD-JIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA250","description":"Clinically Complex _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTC1","description":"ICD-OHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB10","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of sex hormone globul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84270","description":"Assay of sex hormone globul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSF1","description":"ICD-KDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVC1","description":"ICD-JIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of salivary cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42408","description":"Excision of salivary cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAB0","description":"ICD-IBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red cell mass multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78121","description":"Red cell mass multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQE0","description":"ICD-PEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1456","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","description":"HCPCS-M1456","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27745","description":"Reinforce tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17106","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNE1","description":"ICD-KFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEE1","description":"ICD-FIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dent therapeutic drug inject","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9610","description":"Dent therapeutic drug inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQA0","description":"ICD-DDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEF0","description":"ICD-NAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor viii vw antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85246","description":"Clot factor viii vw antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33251","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMF1","description":"ICD-ADMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITF1","description":"ICD-CITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJB1","description":"ICD-GDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB211","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vascular Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4038","description":"Vascular Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11B","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69605","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXC1","description":"ICD-OHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLD1","description":"ICD-IFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone mineral single photon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78350","description":"Bone mineral single photon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4364","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","description":"HCPCS-Q4364","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWE0","description":"ICD-HDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1240","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAA1","description":"ICD-EHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autologous Platelet Rich Plasma (Prp) For Diabetic Chronic Wounds/Ulcers_ Using An Fda-Cleared Device (Includes Administration_ Dressings_ Phlebotomy_ Centrifug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0465","description":"Autologous Platelet Rich Plasma (Prp) For Diabetic Chronic Wounds/Ulcers_ Using An Fda-Cleared Device (Includes Administration_ Dressings_ Phlebotomy_ Centrifug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gi wireless capsule measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91112","description":"Gi wireless capsule measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOC0","description":"ICD-LAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11305","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal sinus therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30210","description":"Nasal sinus therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic caster tire tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2215","description":"Pneumatic caster tire tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDA0","description":"ICD-NCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHD1","description":"ICD-FBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45388","description":"Colonoscopy w/ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visc & infraren abd 4+ prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34848","description":"Visc & infraren abd 4+ prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGD1","description":"ICD-NKGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITD0","description":"ICD-IITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEE0","description":"ICD-CAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA121","description":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement nasal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5926","description":"Replacement nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infuse radioactive materials","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77750","description":"Infuse radioactive materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOB1","description":"ICD-KAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSC0","description":"ICD-OCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPE0","description":"ICD-KCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cciiv3 vac im cult prsv free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90661","description":"Cciiv3 vac im cult prsv free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18B","description":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWB1","description":"ICD-LEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ace/arb not rxd; doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8474","description":"Ace/arb not rxd; doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace blood leak detector","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1560","description":"Replace blood leak detector","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTC1","description":"ICD-JBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE104","description":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOE0","description":"ICD-LEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drop lock retainer each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2785","description":"Drop lock retainer each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPE0","description":"ICD-GBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8G","description":"High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37256","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","description":"CPT-37256","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXD1","description":"ICD-NKXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDB1","description":"ICD-OLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAA1","description":"ICD-MLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9304","description":"HCPCS-C9304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUB0","description":"ICD-MIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPD1","description":"ICD-FHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTA0","description":"ICD-BHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAE0","description":"ICD-OBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISA0","description":"ICD-HISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUE1","description":"ICD-JDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral solution hepatic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5100","description":"Parenteral solution hepatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVC0","description":"ICD-KEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTD0","description":"ICD-OLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35188","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0911T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","description":"CPT-0911T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUA1","description":"ICD-NEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEA0","description":"ICD-EIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPE1","description":"ICD-GFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0691U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691U","description":"CPT-0691U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGE1","description":"ICD-GAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcath emboliz microspher","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2095","description":"Transcath emboliz microspher","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIB0","description":"ICD-OHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amphotericin b lipid complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0287","description":"Amphotericin b lipid complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIA0","description":"ICD-CGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA05","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAD1","description":"ICD-NEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWC0","description":"ICD-GCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEC0","description":"ICD-GBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWF1","description":"ICD-KBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASE0","description":"ICD-DASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPA1","description":"ICD-KEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients With Moderate Or Severe Mitral Stenosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0044","description":"Patients With Moderate Or Severe Mitral Stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1403","description":"HCPCS-C1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC53","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDA1","description":"ICD-CFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKF1","description":"ICD-OFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retrieval of oocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58970","description":"Retrieval of oocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQE1","description":"ICD-KCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of hip socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27122","description":"Reconstruction of hip socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTB1","description":"ICD-IGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIA0","description":"ICD-EAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Isoproterenol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7657","description":"Isoproterenol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIB1","description":"ICD-FCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLC1","description":"ICD-GDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYC0","description":"ICD-GBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOF1","description":"ICD-LDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25110","description":"Remove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pancreas removal/transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48160","description":"Pancreas removal/transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA21","description":"Very High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surg lower abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84051","description":"Anesth surg lower abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQD0","description":"ICD-PJQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJF1","description":"ICD-JFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILB1","description":"ICD-MILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antibody_ Treponema pallidum_ total and rapid plasma reagin (RPR)_ immunoassay_ qualitativ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0064U","description":"Antibody_ Treponema pallidum_ total and rapid plasma reagin (RPR)_ immunoassay_ qualitativ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAA1","description":"ICD-BAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9738","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy w/bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45305","description":"Proctosigmoidoscopy w/bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cnslng epi spec sfty issues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4330F","description":"Cnslng epi spec sfty issues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGD0","description":"ICD-CHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27507","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIC1","description":"ICD-AGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMB0","description":"ICD-BIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIF1","description":"ICD-MIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBF0","description":"ICD-GGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-sterile gauze > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6218","description":"Non-sterile gauze > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46040","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj common digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64632","description":"N block inj common digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFME1","description":"ICD-MFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSC0","description":"ICD-PBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVA0","description":"ICD-GIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-explore parathyroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60502","description":"Re-explore parathyroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87802","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged service inpatient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99357","description":"Prolonged service inpatient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAED1","description":"ICD-JAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of support implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20670","description":"Removal of support implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult size brief/diaper xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4524","description":"Adult size brief/diaper xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOE0","description":"ICD-HIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2C","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Polycarb lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0580","description":"Polycarb lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXB1","description":"ICD-CDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Polarization_ any lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2762","description":"Polarization_ any lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBA0","description":"ICD-JBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAA1","description":"ICD-NCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEC0","description":"ICD-GDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure of eyelid by suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67875","description":"Closure of eyelid by suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht care plan doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4050F","description":"Ht care plan doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Team conf w/o pat by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99368","description":"Team conf w/o pat by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAD0","description":"ICD-OKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1327","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suction lipectomy lwr extrem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15879","description":"Suction lipectomy lwr extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screen depression performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3725F","description":"Screen depression performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBA1","description":"ICD-BBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWE0","description":"ICD-GIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADE0","description":"ICD-GADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMC1","description":"ICD-NAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXD1","description":"ICD-KIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVC1","description":"ICD-OJVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICD1","description":"ICD-OICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUE0","description":"ICD-JCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cftr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81220","description":"Cftr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPA0","description":"ICD-FDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC246","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUC0","description":"ICD-GCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow adolescent myoelectron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7190","description":"Elbow adolescent myoelectron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIF0","description":"ICD-ACIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28715","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate (Glyrx-PF)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1597","description":"Injection_ glycopyrrolate (Glyrx-PF)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRF1","description":"ICD-ODRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of fascia for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20922","description":"Removal of fascia for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTF1","description":"ICD-ABTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ggt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82977","description":"Assay of ggt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPC1","description":"ICD-FBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth procedure on mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17051","description":"Anesth procedure on mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sewhfo cap design w/o jnt cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3975","description":"Sewhfo cap design w/o jnt cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTC0","description":"ICD-MFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBC1","description":"ICD-GFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUA0","description":"ICD-AEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"History of or active diagnosis of familial or pure hypercholesterolemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9782","description":"History of or active diagnosis of familial or pure hypercholesterolemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUF1","description":"ICD-FDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQD1","description":"ICD-PHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diphenhydramine hcl 50mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0163","description":"Diphenhydramine hcl 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70015","description":"Contrast x-ray of brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction maxilla total","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7946","description":"Reconstruction maxilla total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrical bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20975","description":"Electrical bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ plasminogen_ human-tvmh_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9090","description":"Injection_ plasminogen_ human-tvmh_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0505","description":"HCPCS-C0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMD0","description":"ICD-BCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISE1","description":"ICD-LISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted e&m service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99499","description":"Unlisted e&m service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m gluceptate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9550","description":"Tc99m gluceptate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGED0","description":"ICD-OGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2108","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retr bone flap to fix skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62148","description":"Retr bone flap to fix skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJE0","description":"ICD-OEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft fem-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35556","description":"Art byp grft fem-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTC0","description":"ICD-ADTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAA0","description":"ICD-OHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore wound extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20103","description":"Explore wound extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61312","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug admin & hemodynmic meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93463","description":"Drug admin & hemodynmic meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8E","description":"Medium Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWB1","description":"ICD-PGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transab or transvag us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8806","description":"Transab or transvag us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter for hysterography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58340","description":"Catheter for hysterography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of bioprosthetic valve_ open_ femoral vein_ including duplex ultrasound imaging guidance_ when performed_ including autogenous or nonautogenous patch graft (eg_ poly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0744T","description":"Insertion of bioprosthetic valve_ open_ femoral vein_ including duplex ultrasound imaging guidance_ when performed_ including autogenous or nonautogenous patch graft (eg_ poly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61304","description":"Open skull for exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9303","description":"HCPCS-C9303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCD1","description":"ICD-MHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33401","description":"Valvuloplasty open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES131","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBD1","description":"ICD-EHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; first 30 minutes of technician time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0366T","description":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; first 30 minutes of technician time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast gap flap reconst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2066","description":"Breast gap flap reconst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL30","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJF0","description":"ICD-CAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41105","description":"Biopsy of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disconnect locking wrist uni","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6615","description":"Disconnect locking wrist uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWC1","description":"ICD-GFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGD1","description":"ICD-OEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLB1","description":"ICD-EFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gel pressure mattress pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0185","description":"Gel pressure mattress pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOC1","description":"ICD-HIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0406","description":"Inpt/tele follow up 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94851","description":"Anesth repair of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amniotic membrane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2790","description":"Amniotic membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADF0","description":"ICD-FADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grafix Prime and GrafixPL Prime_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4133","description":"Grafix Prime and GrafixPL Prime_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA11","description":"ICD-3HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srn clin dep doc no f/u pln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8940","description":"Srn clin dep doc no f/u pln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDD1","description":"ICD-MBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES120","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEF1","description":"ICD-IGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAD0","description":"ICD-KFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBC1","description":"ICD-FEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQB1","description":"ICD-DIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic outlet reduction_ gastric pouch application_ with endoscopy and intraluminal tube insertion_ if performed_ including all system and tissue anchoring components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9785","description":"Endoscopic outlet reduction_ gastric pouch application_ with endoscopy and intraluminal tube insertion_ if performed_ including all system and tissue anchoring components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance (eg_ vibration) elastography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76391","description":"Magnetic resonance (eg_ vibration) elastography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHD0","description":"ICD-JIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES155","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBD1","description":"ICD-AEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMC0","description":"ICD-KHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNE0","description":"ICD-BHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHE1","description":"ICD-CDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact layer > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6208","description":"Contact layer > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Regadenoson injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2785","description":"Regadenoson injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAA0","description":"ICD-BFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBB0","description":"ICD-FCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGA1","description":"ICD-CFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection into spinal artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62294","description":"Injection into spinal artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVC0","description":"ICD-KBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAB0","description":"ICD-OCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUE0","description":"ICD-GEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83251","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2004","description":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62192","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHA1","description":"ICD-BEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVC1","description":"ICD-FEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXF0","description":"ICD-JCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telethx isodose plan simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77306","description":"Telethx isodose plan simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15C","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair muscles of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26591","description":"Repair muscles of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENB1","description":"ICD-NENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21282","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hip joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27054","description":"Removal of hip joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXB1","description":"ICD-BGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression wrap with adjustable straps_ below knee_ 30-50 mmhg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6583","description":"Gradient compression wrap with adjustable straps_ below knee_ 30-50 mmhg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lower Esophageal Myotomy_ Transoral (Ie_ Peroral Endoscopic Myotomy [Poem])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43497","description":"Lower Esophageal Myotomy_ Transoral (Ie_ Peroral Endoscopic Myotomy [Poem])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMF1","description":"ICD-OJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull for surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61450","description":"Incise skull for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEB1","description":"ICD-FBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repositioning of phrenic nerve stimulator transvenous lead(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33281","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEB0","description":"ICD-GFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17274","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES135","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRA1","description":"ICD-KCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Riv3 vaccine no preserv im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90673","description":"Riv3 vaccine no preserv im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMA1","description":"ICD-MKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRC0","description":"ICD-LGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISD0","description":"ICD-LISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMB1","description":"ICD-IAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCB0","description":"ICD-KHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBE1","description":"ICD-KGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15C","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ipratropium bromide non-comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7644","description":"Ipratropium bromide non-comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amines vaginal fluid qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82120","description":"Amines vaginal fluid qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQA1","description":"ICD-PEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDE1","description":"ICD-NBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKF1","description":"ICD-BHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAB1","description":"ICD-NKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81271","description":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore neck vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35800","description":"Explore neck vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast bath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97034","description":"Contrast bath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rimantadine hcl 100mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9020","description":"Rimantadine hcl 100mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECA0","description":"ICD-MECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMA1","description":"ICD-FHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53260","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDE1","description":"ICD-KDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sleep study attended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95807","description":"Sleep study attended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJD0","description":"ICD-FFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous or minimally invasive (indirect visualization)_ with image guidance_ placement of transfixing device(s) and intra-articular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0809T","description":"Arthrodesis_ sacroiliac joint_ percutaneous or minimally invasive (indirect visualization)_ with image guidance_ placement of transfixing device(s) and intra-articular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental coronoidectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7991","description":"Dental coronoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81189","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hammertoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28285","description":"Repair of hammertoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasm)_ genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm_ quantification of dominant clonal sequence(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0364U","description":"Oncology (hematolymphoid neoplasm)_ genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm_ quantification of dominant clonal sequence(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo w/o joint multi-axis an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2038","description":"Kafo w/o joint multi-axis an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHA1","description":"ICD-JEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTD1","description":"ICD-OGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50940","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLC0","description":"ICD-NKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Primatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4110","description":"Primatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAC0","description":"ICD-MLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8D","description":"Low Rehab_ ADL Index 0-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTB0","description":"ICD-BFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX30","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sex transformation f to m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55980","description":"Sex transformation f to m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFC1","description":"ICD-GFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWB0","description":"ICD-PDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLC0","description":"ICD-OKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk waist belt webbing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5688","description":"Bk waist belt webbing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMD0","description":"ICD-IIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Instillation_ Bupivacaine And Meloxicam_ 1 Mg/0.03 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9088","description":"Instillation_ Bupivacaine And Meloxicam_ 1 Mg/0.03 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extraction erupted tooth/exr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7140","description":"Extraction erupted tooth/exr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFA1","description":"ICD-FHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICA0","description":"ICD-OICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33425","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of facial/other nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64866","description":"Fusion of facial/other nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30120","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay phosphatidylglycerol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84081","description":"Assay phosphatidylglycerol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment_ sensor placement_ hook-u","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95249","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment_ sensor placement_ hook-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco-use counsel 3-10 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0436","description":"Tobacco-use counsel 3-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Each Additional Prosthesis During Same Session (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0570T","description":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Each Additional Prosthesis During Same Session (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHF1","description":"ICD-OKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBF0","description":"ICD-CEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10B","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29819","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWF0","description":"ICD-PKWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Distal shoe space maintainer - fixed - unilateral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1575","description":"Distal shoe space maintainer - fixed - unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINF0","description":"ICD-FINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Locm 100-199mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9965","description":"Locm 100-199mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTD0","description":"ICD-BGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDE1","description":"ICD-KFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGC0","description":"ICD-FCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDID0","description":"ICD-CDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRD1","description":"ICD-DBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHID0","description":"ICD-GHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNF1","description":"ICD-NJNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/90d mrs 0-2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9646","description":"Pt w/90d mrs 0-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBE1","description":"ICD-BIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii recomb novoeight","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7182","description":"Factor viii recomb novoeight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photorefractive keratectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0810","description":"Photorefractive keratectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVD0","description":"ICD-JEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18G","description":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX44","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of paste boot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29580","description":"Application of paste boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQA0","description":"ICD-HGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTE1","description":"ICD-BCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2003","description":"Moderate (45 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWB1","description":"ICD-DCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Breast Diagnostic Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0619","description":"Hospital Special Treatment Room Support Component (Hstrsc) Breast Diagnostic Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB42","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDD1","description":"ICD-BIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tofersen_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9157","description":"Injection_ tofersen_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWE1","description":"ICD-OBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy bronch stents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31636","description":"Bronchoscopy bronch stents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHD0","description":"ICD-CEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWC0","description":"ICD-OIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIF0","description":"ICD-OLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9876","description":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ gene expression profiling by next-generation sequencing of 101 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as a tripl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0153U","description":"Oncology (breast)_ mRNA_ gene expression profiling by next-generation sequencing of 101 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as a tripl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision pericoronal gingiva","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7971","description":"Excision pericoronal gingiva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABF0","description":"ICD-OABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ans parasymp & symp w/tilt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95924","description":"Ans parasymp & symp w/tilt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUE0","description":"ICD-MAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCA0","description":"ICD-AFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No qual card diag prior12mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1461F","description":"No qual card diag prior12mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cur meds not document","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8428","description":"Cur meds not document","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33422","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wedge biopsy of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47100","description":"Wedge biopsy of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28X","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGF0","description":"ICD-KGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTA0","description":"ICD-JFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGE1","description":"ICD-JAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride_ (Belrapzo)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9036","description":"Injection_ bendamustine hydrochloride_ (Belrapzo)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pm device interrogate remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93294","description":"Pm device interrogate remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAC0","description":"ICD-JGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDF1","description":"ICD-JCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBME0","description":"ICD-EBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELE1","description":"ICD-IELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam abdom complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76700","description":"Us exam abdom complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18H","description":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQB1","description":"ICD-OBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid dispensing fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5110","description":"Hearing aid dispensing fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cus elbo skt in not con/atyp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6697","description":"Cus elbo skt in not con/atyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Residential Habilitation 4-8 Supp 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0103","description":"Residential Habilitation 4-8 Supp 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXA1","description":"ICD-NIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair maxillofacial prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8049","description":"Repair maxillofacial prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hepatic shunt (tips)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37183","description":"Remove hepatic shunt (tips)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of jaw bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21044","description":"Removal of jaw bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDD0","description":"ICD-NFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDE1","description":"ICD-ICDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pump for water circulating p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0236","description":"Pump for water circulating p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC134","description":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKC0","description":"ICD-NAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lifestyle mod 4th stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0342","description":"Lifestyle mod 4th stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFE0","description":"ICD-NJFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microprocessor control uplmb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6882","description":"Microprocessor control uplmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lo sag ri an/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0627","description":"Lo sag ri an/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wc van mileage per mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0209","description":"Wc van mileage per mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQE0","description":"ICD-LCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHE0","description":"ICD-JGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB31","description":"Medium Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9486","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of histamine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83088","description":"Assay of histamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj progesterone per 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2675","description":"Inj progesterone per 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ONC THYR MRNA XPRSN ALYS 593","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0204U","description":"ONC THYR MRNA XPRSN ALYS 593","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physical performance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97750","description":"Physical performance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISE0","description":"ICD-GISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSA0","description":"ICD-LDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo sng solid stirrup w/o j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2010","description":"Kafo sng solid stirrup w/o j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply multlay comprs upr leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29582","description":"Apply multlay comprs upr leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAD1","description":"ICD-IAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEE0","description":"ICD-GGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEA0","description":"ICD-NEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frontier extended stay demo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9140","description":"Frontier extended stay demo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open tx compl front sinus fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21344","description":"Open tx compl front sinus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEF0","description":"ICD-GGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45113","description":"Partial proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIA1","description":"ICD-OLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILB0","description":"ICD-MILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Water circ cold pad w pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0218","description":"Water circ cold pad w pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alveoplasty w/o extraction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7320","description":"Alveoplasty w/o extraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWC1","description":"ICD-CIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42205","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; each additional 30 minutes (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96548","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; each additional 30 minutes (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Miscellaneous component_ supply or accessory for use with total artificial heart system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8698","description":"Miscellaneous component_ supply or accessory for use with total artificial heart system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXF0","description":"ICD-GBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQF1","description":"ICD-CFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBC0","description":"ICD-ODBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATE1","description":"ICD-MATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMF0","description":"ICD-GAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYC0","description":"ICD-GAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt cat and thck on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9294","description":"Pt cat and thck on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWA0","description":"ICD-CBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27630","description":"Removal of tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test def 1-7 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0480","description":"Drug test def 1-7 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTE1","description":"ICD-MLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1239","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-38227","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","description":"CPT-38227","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILA0","description":"ICD-GILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHA1","description":"ICD-NCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8919","description":"Mra w/o cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFA0","description":"ICD-BIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost urine pch w b/bltin conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4430","description":"Ost urine pch w b/bltin conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDF1","description":"ICD-JFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDA0","description":"ICD-NDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPA0","description":"ICD-OEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHA1","description":"ICD-GIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External recharg sys extern","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8695","description":"External recharg sys extern","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputate hand at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25920","description":"Amputate hand at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJB1","description":"ICD-JGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBD0","description":"ICD-KIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antibody; Zika virus_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86794","description":"Antibody; Zika virus_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Matrion_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4201","description":"Matrion_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJC0","description":"ICD-NIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ft arch suprt premold longit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3040","description":"Ft arch suprt premold longit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBME0","description":"ICD-CBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC145","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens aniseikonic single","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2118","description":"Lens aniseikonic single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPC0","description":"ICD-NCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 20.1-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12036","description":"Intmd rpr s/a/t/ext 20.1-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0666","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","description":"HCPCS-J0666","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12D","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreservation oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0357T","description":"Cryopreservation oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92312","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBD0","description":"ICD-MDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery-vein autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36825","description":"Artery-vein autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amitriptyline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1320","description":"Amitriptyline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGD0","description":"ICD-OFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHD1","description":"ICD-NDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of neck vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37565","description":"Ligation of neck vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIF0","description":"ICD-MFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1306","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBA1","description":"ICD-KEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTE1","description":"ICD-GGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hc pro phone call 21-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98968","description":"Hc pro phone call 21-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52224","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip socket fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27222","description":"Treat hip socket fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHB0","description":"ICD-GFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed semi-elect w/ mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0294","description":"Hosp bed semi-elect w/ mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icg angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92240","description":"Icg angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJF1","description":"ICD-JAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSC0","description":"ICD-GGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA201","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFF0","description":"ICD-OLFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc foot/toe tum sc < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28043","description":"Exc foot/toe tum sc < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dschrg med/current med merge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1111F","description":"Dschrg med/current med merge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCF0","description":"ICD-OLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose in lac ringers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7121","description":"5% dextrose in lac ringers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAB0","description":"ICD-BIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mlh1 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81292","description":"Mlh1 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHA1","description":"ICD-IGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTC0","description":"ICD-MHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81248","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIC0","description":"ICD-FGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0595","description":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antibio rx w in 10d of sympt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9286","description":"Antibio rx w in 10d of sympt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of fascia for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20920","description":"Removal of fascia for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTF0","description":"ICD-OJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHC1","description":"ICD-JDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBD0","description":"ICD-JGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANB1","description":"ICD-NANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ho w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3919","description":"Ho w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interferon gamma 1-b inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9216","description":"Interferon gamma 1-b inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sperm washing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58323","description":"Sperm washing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCB0","description":"ICD-EDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHB0","description":"ICD-FGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGB0","description":"ICD-FGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25515","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKC0","description":"ICD-BHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip flex inner socket ext fr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5643","description":"Hip flex inner socket ext fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD111","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUB0","description":"ICD-NJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetate conc sol per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4708","description":"Acetate conc sol per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMD0","description":"ICD-KBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3D","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB01","description":"High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40700","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arbutamine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0395","description":"Arbutamine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFB1","description":"ICD-GGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18B","description":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35231","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7571","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7571","description":"HCPCS-C7571","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin cartridge 150 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5565","description":"Insulin cartridge 150 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICD0","description":"ICD-BICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIB0","description":"ICD-IGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human Health Factor 10 Amniotic Patch (HHF10-P)_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4224","description":"Human Health Factor 10 Amniotic Patch (HHF10-P)_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35256","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA214","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21433","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-op service lvrs complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0302","description":"Pre-op service lvrs complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUA0","description":"ICD-BCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAID0","description":"ICD-MAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWC1","description":"ICD-PCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-evaluation of occupational therapy established plan of care_ requiring these components: An assessment of changes in patient functional or medical status with revised plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97168","description":"Re-evaluation of occupational therapy established plan of care_ requiring these components: An assessment of changes in patient functional or medical status with revised plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGA0","description":"ICD-NBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISA0","description":"ICD-GISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUB1","description":"ICD-ODUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOF1","description":"ICD-KBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES311","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEA1","description":"ICD-CBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maxilla open reduct compound","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7710","description":"Maxilla open reduct compound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECB1","description":"ICD-FECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCC0","description":"ICD-OGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of g6pd enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82955","description":"Assay of g6pd enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOA1","description":"ICD-PJOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYA1","description":"ICD-HDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHF1","description":"ICD-MJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant_ including fluoroscopy_ transseptal puncture_ catheter placement(s)_ left atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33340","description":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant_ including fluoroscopy_ transseptal puncture_ catheter placement(s)_ left atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug scrn quant oxcarbazepin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80183","description":"Drug scrn quant oxcarbazepin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDE0","description":"ICD-IDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14B","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQD0","description":"ICD-OGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTF1","description":"ICD-ODTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGME1","description":"ICD-MGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of skull lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61500","description":"Removal of skull lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66150","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 3 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34843","description":"Endovasc visc aorta 3 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1398","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","description":"HCPCS-M1398","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17272","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99251","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABF0","description":"ICD-EABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLB0","description":"ICD-MHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Accessories for patient inserted indwelling intraurethral drainage device with valve_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4342","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph endoscopy dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43226","description":"Esoph endoscopy dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immune globulin_ powder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1566","description":"Immune globulin_ powder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD214","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35286","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINE1","description":"ICD-OINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDF1","description":"ICD-CCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/tumr remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45338","description":"Sigmoidoscopy w/tumr remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g._ prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1172","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g._ prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open tx nose & septal fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21335","description":"Open tx nose & septal fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXB0","description":"ICD-JCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Musc tst done w/n tst nonext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95887","description":"Musc tst done w/n tst nonext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA56","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair commode seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0968","description":"Wheelchair commode seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ polyvalent_ intramuscular_ for children from five years to nine years of age who have not previously received the vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0195","description":"Pneumococcal conjugate vaccine_ polyvalent_ intramuscular_ for children from five years to nine years of age who have not previously received the vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB21","description":"ICD-1EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive prostate cancer estimation map_ derived from augmentative analysis of image-guided fusion biopsy and pathology_ including visualization of margin volume and locati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0898T","description":"Noninvasive prostate cancer estimation map_ derived from augmentative analysis of image-guided fusion biopsy and pathology_ including visualization of margin volume and locati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWB0","description":"ICD-OHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHB1","description":"ICD-KIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMF0","description":"ICD-FHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy w/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31535","description":"Laryngoscopy w/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE220","description":"Special Care Low _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary leg or abdomen bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4358","description":"Urinary leg or abdomen bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qty act mcc mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9670","description":"Qty act mcc mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sperm antibody test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89325","description":"Sperm antibody test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYB0","description":"ICD-DCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFA1","description":"ICD-CAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCC1","description":"ICD-GCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGND1","description":"ICD-FGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert vad art&vein access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33991","description":"Insert vad art&vein access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADC0","description":"ICD-FADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amalgam two surfaces permane","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2150","description":"Amalgam two surfaces permane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of arm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24320","description":"Repair of arm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECC1","description":"ICD-EECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal fb skin/areolar tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7530","description":"Removal fb skin/areolar tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93642","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ furosemide (furoscix)_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1941","description":"Injection_ furosemide (furoscix)_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55650","description":"Remove sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVA1","description":"ICD-JEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28140","description":"Removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKB0","description":"ICD-CIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLC1","description":"ICD-OLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of caries arresting medicament-per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1354","description":"Application of caries arresting medicament-per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Io map of sent lymph node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38900","description":"Io map of sent lymph node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMD1","description":"ICD-CHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Overdenture complete mandib","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5865","description":"Overdenture complete mandib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA11","description":"ICD-2FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRB1","description":"ICD-OIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTD1","description":"ICD-FFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48140","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct larynx & pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31395","description":"Reconstruct larynx & pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rozanolixizumab-noli_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9333","description":"Injection_ rozanolixizumab-noli_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD216","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerv semi-rig adj molded chn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0150","description":"Cerv semi-rig adj molded chn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRE1","description":"ICD-LFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERE0","description":"ICD-GERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXB1","description":"ICD-FFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMD0","description":"ICD-JGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Friction dampening arm supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2629","description":"Friction dampening arm supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diast bp >/= 90 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3080F","description":"Diast bp >/= 90 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAD0","description":"ICD-GEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKC0","description":"ICD-OAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHD1","description":"ICD-FEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rigid ped wc adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1235","description":"Rigid ped wc adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIE1","description":"ICD-MIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQC1","description":"ICD-GEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor xiii fibrin stab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85290","description":"Clot factor xiii fibrin stab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEC0","description":"ICD-KGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVA1","description":"ICD-OCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHF0","description":"ICD-OKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ASPERGILLUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87305","description":"IAAD IA ASPERGILLUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAME1","description":"ICD-FAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frame typ sock interscap-tho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6690","description":"Frame typ sock interscap-tho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCD1","description":"ICD-IFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECB1","description":"ICD-JECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICA0","description":"ICD-GICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33120","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Larynx surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31599","description":"Larynx surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDF1","description":"ICD-OCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTB1","description":"ICD-EFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNC1","description":"ICD-FHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLA0","description":"ICD-JDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBB1","description":"ICD-JHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYE1","description":"ICD-GIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj repair of joint disc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7852","description":"Tmj repair of joint disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6084","description":"Implant Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCD1","description":"ICD-OJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBF0","description":"ICD-MGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQE0","description":"ICD-GHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice home care in hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5010","description":"Hospice home care in hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPF1","description":"ICD-BIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMA0","description":"ICD-OJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHF0","description":"ICD-OGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5141","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","description":"HCPCS-Q5141","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUF1","description":"ICD-KBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLC0","description":"ICD-GCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryptococcus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86641","description":"Cryptococcus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBC1","description":"ICD-MJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Not initial eval for cond","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1501F","description":"Not initial eval for cond","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC244","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8G","description":"Low Rehab_ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXB0","description":"ICD-BDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydroxyurea 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0176","description":"Hydroxyurea 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allowrap ds or dry 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4150","description":"Allowrap ds or dry 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Power adapter_ combo vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0478","description":"Power adapter_ combo vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal monitor/interpret only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59051","description":"Fetal monitor/interpret only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIF1","description":"ICD-NIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOA1","description":"ICD-HHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score le pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8657","description":"Fun stat score le pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWA1","description":"ICD-DIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin electrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83020","description":"Hemoglobin electrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (warfarin drug response)_ targeted sequence analysis (ie_ CYP2C9_ CYP4F2_ VKORC1_ rs12777823)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0030U","description":"Drug metabolism (warfarin drug response)_ targeted sequence analysis (ie_ CYP2C9_ CYP4F2_ VKORC1_ rs12777823)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGD1","description":"ICD-OKGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBE0","description":"ICD-CCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of bile duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47425","description":"Incision of bile duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKE0","description":"ICD-NDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0657U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0657U","description":"CPT-0657U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 5 genotyping (HPA-5)_ ITGA2 (integrin_ alpha 2 [CD49B_ alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81109","description":"Human Platelet Antigen 5 genotyping (HPA-5)_ ITGA2 (integrin_ alpha 2 [CD49B_ alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy_ by abdominal or retroperitoneal incision_ unilateral (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34820","description":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy_ by abdominal or retroperitoneal incision_ unilateral (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seat upholstery_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0981","description":"Seat upholstery_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXB0","description":"ICD-NIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTF1","description":"ICD-KBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHE0","description":"ICD-KGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXE1","description":"ICD-NGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stress tte only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93350","description":"Stress tte only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFD1","description":"ICD-GGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJA1","description":"ICD-BFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMA1","description":"ICD-FAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWB1","description":"ICD-PFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYB0","description":"ICD-ODYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23D","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63267","description":"Excise intrspinl lesion lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67950","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8F","description":"Low Rehab_ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient is not currently on a daily aspirin or other antiplatelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9795","description":"Patient is not currently on a daily aspirin or other antiplatelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHND0","description":"ICD-GHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOB1","description":"ICD-DFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tongue mouth jaw surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41150","description":"Tongue mouth jaw surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAE0","description":"ICD-NJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTA1","description":"ICD-NHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast 1st mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19287","description":"Perq dev breast 1st mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decitabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0894","description":"Decitabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2313","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","description":"HCPCS-J2313","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXC1","description":"ICD-KBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64561","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSB0","description":"ICD-CBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDC0","description":"ICD-KFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair wide w/ leg rests","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1092","description":"Wheelchair wide w/ leg rests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve stimulator for tx n&v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0765","description":"Nerve stimulator for tx n&v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXB1","description":"ICD-BEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mobile arm support supinator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2633","description":"Mobile arm support supinator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of spinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63172","description":"Drainage of spinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2007","description":"Limited (30 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; singl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36465","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; singl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81188","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert electrd/pm cath sngl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33210","description":"Insert electrd/pm cath sngl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKC1","description":"ICD-KGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJE0","description":"ICD-OFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neomatrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2021","description":"Neomatrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMB0","description":"ICD-OGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gait training therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97116","description":"Gait training therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOD0","description":"ICD-HHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary rubber pouch w fcplt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4380","description":"Urinary rubber pouch w fcplt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMB0","description":"ICD-EDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIF0","description":"ICD-EEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE215","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4A","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCA1","description":"ICD-NGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26608","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydration iv infusion init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96360","description":"Hydration iv infusion init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Init ak ischal plstr direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5505","description":"Init ak ischal plstr direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMD1","description":"ICD-GAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAE1","description":"ICD-JDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL15","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHB1","description":"ICD-BDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCA0","description":"ICD-AGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB101","description":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHB1","description":"ICD-KDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSF0","description":"ICD-DFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBC0","description":"ICD-GFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX03","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDB0","description":"ICD-JGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIB1","description":"ICD-BGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFD1","description":"ICD-FFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDA1","description":"ICD-JFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/thymus resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32673","description":"Thoracoscopy w/thymus resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Salivary gland function exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78232","description":"Salivary gland function exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cangrelor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9460","description":"Injection_ cangrelor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Piperacillin/tazobactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2543","description":"Piperacillin/tazobactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNB1","description":"ICD-NFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pvb thoracic cont infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64463","description":"Pvb thoracic cont infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23B","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLE1","description":"ICD-BBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of sternum separation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21750","description":"Repair of sternum separation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX36","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRC1","description":"ICD-OHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVB0","description":"ICD-JEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINA1","description":"ICD-JINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYD0","description":"ICD-GIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5274","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKD1","description":"ICD-GCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 1 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3384F","description":"Ajcc cln cncr stage 1 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of arm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24134","description":"Removal of arm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOD1","description":"ICD-KCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIF1","description":"ICD-KHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBA0","description":"ICD-FDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBC0","description":"ICD-IEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMC1","description":"ICD-BCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver & spleen image/flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78216","description":"Liver & spleen image/flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"2d tte w or w/o fol w/con_fu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8924","description":"2d tte w or w/o fol w/con_fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0543U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","description":"CPT-0543U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPB1","description":"ICD-NJPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap remove rectum w/pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45397","description":"Lap remove rectum w/pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC231","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mepolizumab_ 1 mg (Nucala)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9473","description":"Injection_ mepolizumab_ 1 mg (Nucala)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Midfacial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8041","description":"Midfacial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGD1","description":"ICD-BGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJA0","description":"ICD-NJJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incis w/discectomy lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22224","description":"Incis w/discectomy lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of transcortin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84449","description":"Assay of transcortin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC21","description":"ICD-2HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSE0","description":"ICD-OBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYB0","description":"ICD-GHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impreg gauze no h20/sal/yard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6266","description":"Impreg gauze no h20/sal/yard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8X","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBC0","description":"ICD-KEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9247","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9247","description":"CDT-D9247","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84300","description":"Assay of urine sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1019T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","description":"CPT-1019T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-heu tc-99m add-on/dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9969","description":"Non-heu tc-99m add-on/dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove maxilla cyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21048","description":"Remove maxilla cyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Splint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4570","description":"Splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthesis modification","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5875","description":"Prosthesis modification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAF1","description":"ICD-OBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4411","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","description":"HCPCS-Q4411","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFE0","description":"ICD-BBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBD0","description":"ICD-BHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth bladder tumor surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91251","description":"Anesth bladder tumor surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occult blood feces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82270","description":"Occult blood feces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology colon mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81525","description":"Oncology colon mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQA0","description":"ICD-PAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28D","description":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0545U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","description":"CPT-0545U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUC1","description":"ICD-AHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onlay porc/crmc 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6608","description":"Onlay porc/crmc 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc thigh/knee les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27327","description":"Exc thigh/knee les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01938","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","description":"CPT-01938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYC1","description":"ICD-HHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise finger joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26140","description":"Revise finger joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPC0","description":"ICD-OFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59409","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRB1","description":"ICD-GHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVB0","description":"ICD-BBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMF0","description":"ICD-KIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot insert plastazote or eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3002","description":"Foot insert plastazote or eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp preop assess cat surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014F","description":"Comp preop assess cat surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSE1","description":"ICD-PFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ intraspinal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1755","description":"Catheter_ intraspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bartonella dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87470","description":"Bartonella dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDF0","description":"ICD-MEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB112","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells_ per day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0537T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells_ per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAF1","description":"ICD-BHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB160","description":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWE1","description":"ICD-KGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATA0","description":"ICD-JATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enlarge breast with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19325","description":"Enlarge breast with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O2 saturation</=88%/pao</=55","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3035F","description":"O2 saturation</=88%/pao</=55","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBA0","description":"ICD-KBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJF0","description":"ICD-FAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indium in-111 auto wbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9570","description":"Indium in-111 auto wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No rsk fac or 1 mod risk te","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8970","description":"No rsk fac or 1 mod risk te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5B","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens bifocal speciality","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2299","description":"Lens bifocal speciality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHID0","description":"ICD-CHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove lumb artif disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164T","description":"Remove lumb artif disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Candida dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87481","description":"Candida dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMA0","description":"ICD-CFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTB1","description":"ICD-BDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0588U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","description":"CPT-0588U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFB1","description":"ICD-OHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFE0","description":"ICD-NAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXF0","description":"ICD-KCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPA1","description":"ICD-FIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKF0","description":"ICD-BAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDC0","description":"ICD-CBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43130","description":"Removal of esophagus pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCA0","description":"ICD-FGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54620","description":"Suspension of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sc r pos/lat pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0649","description":"Lso sc r pos/lat pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHC0","description":"ICD-FDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHC1","description":"ICD-MIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYF0","description":"ICD-DCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove groin lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38760","description":"Remove groin lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27390","description":"Incision of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWE1","description":"ICD-CAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32_ 33_ 34_ 54_ or 56 for more than 90 consecutive days during","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1284","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32_ 33_ 34_ 54_ or 56 for more than 90 consecutive days during","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long arm adult fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4006","description":"Cast sup long arm adult fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANE0","description":"ICD-GANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gauze >16<=48 sq in watr/sal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6229","description":"Gauze >16<=48 sq in watr/sal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with destruction by radiofrequency ablation_ posterior nasal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31242","description":"Nasal/sinus endoscopy_ surgical; with destruction by radiofrequency ablation_ posterior nasal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBF1","description":"ICD-OLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINB0","description":"ICD-NINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL21","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNE0","description":"ICD-GHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEE0","description":"ICD-OLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIC1","description":"ICD-NJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYB0","description":"ICD-OAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31367","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30410","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit diuretic infus diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9361","description":"Hit diuretic infus diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATB0","description":"ICD-JATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNF1","description":"ICD-OBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIC0","description":"ICD-OLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35001","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHB1","description":"ICD-NCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99225","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIB0","description":"ICD-BEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1291","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0960T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","description":"CPT-0960T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCA1","description":"ICD-JBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXE1","description":"ICD-OIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cranial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5924","description":"Cranial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35141","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antiepileptics nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80341","description":"Antiepileptics nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEE1","description":"ICD-KDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release inner ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69960","description":"Release inner ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28B","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger)_ including ultrasound guidance_ when performed_ unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34713","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger)_ including ultrasound guidance_ when performed_ unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSF0","description":"ICD-GHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMC1","description":"ICD-NJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pm device progr eval dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93280","description":"Pm device progr eval dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24B","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVD0","description":"ICD-GGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKC0","description":"ICD-NEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEB1","description":"ICD-OBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery-vein nonautograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36830","description":"Artery-vein nonautograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1144","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2080","description":"Laup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pelvic structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51597","description":"Removal of pelvic structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYE1","description":"ICD-GHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIB1","description":"ICD-CGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PermeaDerm glove_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2017","description":"PermeaDerm glove_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heavyduty/wide commode chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0168","description":"Heavyduty/wide commode chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPF0","description":"ICD-JEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28496","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIA1","description":"ICD-IFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5877","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5877","description":"CDT-D5877","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC05","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPC1","description":"ICD-KBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indiv pdc > 0.8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9512","description":"Indiv pdc > 0.8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol 52-73 gm prot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4193","description":"Parenteral sol 52-73 gm prot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJD0","description":"ICD-ODJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB151","description":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEE1","description":"ICD-KHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50561","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJB1","description":"ICD-FFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj sciatic sng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64445","description":"N block inj sciatic sng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDF1","description":"ICD-EFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFB0","description":"ICD-FFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relocation of testis(es)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54680","description":"Relocation of testis(es)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOD1","description":"ICD-LAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXB1","description":"ICD-KIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laps rmvl nstim array vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0313T","description":"Laps rmvl nstim array vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCC0","description":"ICD-NKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGE1","description":"ICD-KGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam stability fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83662","description":"Foam stability fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01500","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","description":"CPT-01500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWB1","description":"ICD-KGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTF1","description":"ICD-IFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPA0","description":"ICD-OIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALD0","description":"ICD-AALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYB1","description":"ICD-KEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmprsburngarment glove-elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6505","description":"Cmprsburngarment glove-elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRB1","description":"ICD-CFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGA0","description":"ICD-CBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA02","description":"High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0104","description":"HCPCS-A0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBB0","description":"ICD-GBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium_ not otherwise specified_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0650","description":"Injection_ levothyroxine sodium_ not otherwise specified_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYE0","description":"ICD-OCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJA1","description":"ICD-KEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRA1","description":"ICD-CFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUD1","description":"ICD-FFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGD1","description":"ICD-OHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEE1","description":"ICD-OGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAF1","description":"ICD-JAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGE1","description":"ICD-OIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES154","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0101","description":"HCPCS-A0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial thyroid excision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60210","description":"Partial thyroid excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHE0","description":"ICD-EEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEC1","description":"ICD-ODEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUE1","description":"ICD-MAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15D","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41252","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUB1","description":"ICD-OBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEID1","description":"ICD-AEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRB1","description":"ICD-KBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4D","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt lithium 4.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0605","description":"Repl batt lithium 4.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHC0","description":"ICD-MFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACA1","description":"ICD-IACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGF0","description":"ICD-NBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us guidance fetal reduct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8055","description":"Us guidance fetal reduct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AJCC breast cancer stage I: T1 mic or T1a documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9704","description":"AJCC breast cancer stage I: T1 mic or T1a documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 2.6-7.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12032","description":"Intmd rpr s/a/t/ext 2.6-7.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFE1","description":"ICD-OHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone replce graft first site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4263","description":"Bone replce graft first site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXC1","description":"ICD-FDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOC1","description":"ICD-ODOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng arm splint fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4018","description":"Cast sup lng arm splint fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt silver oxide 1.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0601","description":"Repl batt silver oxide 1.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of calcium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82330","description":"Assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVF0","description":"ICD-CHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSC1","description":"ICD-KFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBD0","description":"ICD-KEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX14","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Woundplus membrane or e-graft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4277","description":"Woundplus membrane or e-graft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth skin ext/per/atrunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40051","description":"Anesth skin ext/per/atrunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFD1","description":"ICD-OKFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWE1","description":"ICD-PDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFID1","description":"ICD-JFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ilr device interrogat remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93298","description":"Ilr device interrogat remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXC0","description":"ICD-FEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gjb2 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81252","description":"Gjb2 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOF1","description":"ICD-OGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAND1","description":"ICD-JAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATA0","description":"ICD-NATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA43","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1B","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8I","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sputum specimen collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89220","description":"Sputum specimen collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCID1","description":"ICD-FCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50785","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALE0","description":"ICD-AALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDD0","description":"ICD-ADDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20600","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDC0","description":"ICD-EBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRA1","description":"ICD-DCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder passive restor cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6320","description":"Shoulder passive restor cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTC0","description":"ICD-OGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63281","description":"Bx/exc idrl spine lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTF0","description":"ICD-EHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc surveillance for disease","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9052","description":"Onc surveillance for disease","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ BICROS_ in the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5210","description":"Hearing aid_ BICROS_ in the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6076","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJC1","description":"ICD-CBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove skin nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64774","description":"Remove skin nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBC1","description":"ICD-MFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATB0","description":"ICD-AATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAD1","description":"ICD-ADAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCD1","description":"ICD-OKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBF1","description":"ICD-GDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3C","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOB1","description":"ICD-DDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGB0","description":"ICD-OHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYA1","description":"ICD-KAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAB0","description":"ICD-AEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCD0","description":"ICD-EHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIE1","description":"ICD-ABIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOB1","description":"ICD-PLOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office visit after hours","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9440","description":"Office visit after hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy splenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38120","description":"Laparoscopy splenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDA1","description":"ICD-FCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ctlso infant immobilizer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1001","description":"Ctlso infant immobilizer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove transplanted kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50370","description":"Remove transplanted kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albuterol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7610","description":"Albuterol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSE0","description":"ICD-PBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clean out mastoid cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69220","description":"Clean out mastoid cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ hemodialysis_long-term","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1750","description":"Cath_ hemodialysis_long-term","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18A","description":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion 29-31 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2266","description":"Induced abortion 29-31 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay nonantibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83516","description":"Immunoassay nonantibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDD0","description":"ICD-IFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCF0","description":"ICD-OGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCA0","description":"ICD-BDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ 5 DNA regulatory markers by quantitative PCR_ whole blood_ algorithm_ including prostate-specific antigen_ reported as likelihood of cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0433U","description":"Oncology (prostate)_ 5 DNA regulatory markers by quantitative PCR_ whole blood_ algorithm_ including prostate-specific antigen_ reported as likelihood of cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of extremity artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37618","description":"Ligation of extremity artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKF1","description":"ICD-BFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78830","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECB0","description":"ICD-FECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWB1","description":"ICD-KIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBC0","description":"ICD-NCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCME0","description":"ICD-KCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSC0","description":"ICD-HGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUA1","description":"ICD-JCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"repair resin partial denture base_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5611","description":"repair resin partial denture base_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHA1","description":"ICD-MKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHA0","description":"ICD-KGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJE0","description":"ICD-BIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1113","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNC1","description":"ICD-KBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYF1","description":"ICD-KHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1083","description":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuromuscular stim for scoli","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0744","description":"Neuromuscular stim for scoli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ imipenem 4mg_ cilastatin 4 mg and relebactam 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0742","description":"Injection_ imipenem 4mg_ cilastatin 4 mg and relebactam 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIC0","description":"ICD-AFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA15","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCA0","description":"ICD-EGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 25MCG/0.25ML2ND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0112A","description":"ADM SARSCOV2 25MCG/0.25ML2ND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHB1","description":"ICD-MJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBA1","description":"ICD-BDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKD0","description":"ICD-OBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRB0","description":"ICD-KHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knuckle with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26852","description":"Fusion of knuckle with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHD1","description":"ICD-OHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIB1","description":"ICD-MLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJE1","description":"ICD-BEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ (sinuva)_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7402","description":"Mometasone furoate sinus implant_ (sinuva)_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00936","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","description":"CPT-00936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXF1","description":"ICD-KCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOF0","description":"ICD-LIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (Cuvitru)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1555","description":"Injection_ immune globulin (Cuvitru)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWD1","description":"ICD-HBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dressing change not for burn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15852","description":"Dressing change not for burn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPF0","description":"ICD-OAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAA1","description":"ICD-NHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHC1","description":"ICD-ADHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0401","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0401","description":"CDT-D0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Granulocytes_ pheresis unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9050","description":"Granulocytes_ pheresis unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSF0","description":"ICD-HDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRA0","description":"ICD-KDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBB0","description":"ICD-CIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ belinostat_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9032","description":"Injection_ belinostat_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOF1","description":"ICD-LHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red cell mass single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78120","description":"Red cell mass single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELE0","description":"ICD-BELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMC0","description":"ICD-JHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJE1","description":"ICD-NLJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct midface no graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7948","description":"Reconstruct midface no graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC53","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUD0","description":"ICD-EDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHD1","description":"ICD-IDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTB0","description":"ICD-ODTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5B","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthovisc inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7324","description":"Orthovisc inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Term dev mech hand vol close","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6709","description":"Term dev mech hand vol close","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBME1","description":"ICD-MBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBB0","description":"ICD-OBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58960","description":"Exploration of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24A","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2638","description":"Brachytx_ stranded_ i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWF1","description":"ICD-DEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCB1","description":"ICD-KHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKB1","description":"ICD-KCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFF0","description":"ICD-NDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDD0","description":"ICD-OFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDE1","description":"ICD-JCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR MoAb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9841","description":"RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR MoAb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21A","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of hand bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25820","description":"Fusion of hand bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNB1","description":"ICD-BHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFC0","description":"ICD-CFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Or Replacement Of Implantable Cardioverter-Defibrillator System With Substernal Electrode(S)_ Including All Imaging Guidance And Electrophysiological Evaluation (Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0571T","description":"Insertion Or Replacement Of Implantable Cardioverter-Defibrillator System With Substernal Electrode(S)_ Including All Imaging Guidance And Electrophysiological Evaluation (Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOC0","description":"ICD-KBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHB0","description":"ICD-EIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGE1","description":"ICD-GDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDD1","description":"ICD-EBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27831","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITF0","description":"ICD-FITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJE0","description":"ICD-FEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC14","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC22","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLE1","description":"ICD-ICLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTE0","description":"ICD-MJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylindr 4.00d/12-2.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2103","description":"Spherocylindr 4.00d/12-2.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKA0","description":"ICD-KCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSD0","description":"ICD-GCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUC0","description":"ICD-NIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remov vert xdrl bdy lmbr/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63303","description":"Remov vert xdrl bdy lmbr/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputate hand at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25922","description":"Amputate hand at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Current percep threshold tst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0255","description":"Current percep threshold tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPE1","description":"ICD-NDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endomysial Antibody (Ema)_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86231","description":"Endomysial Antibody (Ema)_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB36","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37257","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","description":"CPT-37257","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ercp remove forgn body duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43275","description":"Ercp remove forgn body duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOE0","description":"ICD-KCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMF1","description":"ICD-IDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bile duct tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47711","description":"Excision of bile duct tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACD1","description":"ICD-FACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIF1","description":"ICD-OCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42106","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services for patient provided any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9718","description":"Hospice services for patient provided any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQD1","description":"ICD-OBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDC1","description":"ICD-ICDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDF1","description":"ICD-FBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEA0","description":"ICD-IAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69601","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIC0","description":"ICD-MAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28A","description":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel dsg>16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6232","description":"Hydrogel dsg>16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of major vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37650","description":"Revision of major vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUD1","description":"ICD-JEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYB0","description":"ICD-OBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXF0","description":"ICD-CCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of skull arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61711","description":"Fusion of skull arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0674U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674U","description":"CPT-0674U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55060","description":"Repair of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKF0","description":"ICD-NEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD106","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEA0","description":"ICD-EBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Uveal Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 15 Genes (12 Content And 3 Housekeeping)_ Utilizing Fine Needle Aspirate Or Formalin-Fixed Pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81552","description":"Oncology (Uveal Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 15 Genes (12 Content And 3 Housekeeping)_ Utilizing Fine Needle Aspirate Or Formalin-Fixed Pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Completion pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32488","description":"Completion pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 30MCG/0.3 ML BST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004A","description":"ADM SARSCOV2 30MCG/0.3 ML BST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Unilateral Study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93986","description":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Unilateral Study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo-vag hyst w/t/o compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58554","description":"Laparo-vag hyst w/t/o compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75860","description":"Vein x-ray neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGB1","description":"ICD-KFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext ecg review and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0298T","description":"Ext ecg review and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQE1","description":"ICD-HHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1338","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADME1","description":"ICD-ADME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dc power adapter_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1358","description":"Dc power adapter_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1301","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","description":"HCPCS-M1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPF1","description":"ICD-CFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD136","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTD0","description":"ICD-MDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair elbow perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24357","description":"Repair elbow perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Swallow goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8997","description":"Swallow goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRA1","description":"ICD-ODRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFED0","description":"ICD-FFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHB1","description":"ICD-FIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKC1","description":"ICD-OCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWA1","description":"ICD-PLWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocortisone acetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1700","description":"Hydrocortisone acetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFB0","description":"ICD-NBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42835","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHE1","description":"ICD-IFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXA1","description":"ICD-CHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin stability screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83068","description":"Hemoglobin stability screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRE1","description":"ICD-KIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHC0","description":"ICD-NIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair rectum/remove sigmoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45550","description":"Repair rectum/remove sigmoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6035","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","description":"HCPCS-L6035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49321","description":"Laparoscopy biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSA1","description":"ICD-PHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1025T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","description":"CPT-1025T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANB0","description":"ICD-NANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76870","description":"Us exam scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCA0","description":"ICD-EFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21B","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFD1","description":"ICD-NKFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo iv push addl drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96411","description":"Chemo iv push addl drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLE1","description":"ICD-JDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB120","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCE0","description":"ICD-BDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Donor pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32850","description":"Donor pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNE0","description":"ICD-FCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAF1","description":"ICD-NJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQB1","description":"ICD-CIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMC1","description":"ICD-IIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genesis Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4198","description":"Genesis Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC231","description":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr epigastric hern blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49572","description":"Rpr epigastric hern blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63277","description":"Bx/exc xdrl spine lesn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIC1","description":"ICD-GFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhcp-serv of pt_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0151","description":"Hhcp-serv of pt_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of foot infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28002","description":"Treatment of foot infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tte w or wo fol wcon_doppler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8929","description":"Tte w or wo fol wcon_doppler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of neck cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42815","description":"Excision of neck cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDA1","description":"ICD-IHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54240","description":"Penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQC1","description":"ICD-PEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIA0","description":"ICD-AFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor viii multimetric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85247","description":"Clot factor viii multimetric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLB0","description":"ICD-GHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC260","description":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHC1","description":"ICD-EGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAC0","description":"ICD-CDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42830","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45130","description":"Excision of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAC0","description":"ICD-EHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGC1","description":"ICD-KBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep renal graft/arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50328","description":"Prep renal graft/arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ respiratory tract infection_ 17 bacteria_ 8 fungus_ 13 virus_ and 16 antibiotic-resistance genes_ multiplex amplified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0373U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ respiratory tract infection_ 17 bacteria_ 8 fungus_ 13 virus_ and 16 antibiotic-resistance genes_ multiplex amplified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSE0","description":"ICD-LGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opiate(s)_ drug and metabolites_ each procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6056","description":"Opiate(s)_ drug and metabolites_ each procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTC0","description":"ICD-EGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDE1","description":"ICD-BBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sinus tarsi implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0510T","description":"Removal of sinus tarsi implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGB0","description":"ICD-GFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEF0","description":"ICD-CFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIB0","description":"ICD-KFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visualization of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31615","description":"Visualization of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ omadacycline_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0121","description":"Injection_ omadacycline_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inflammatory bowel dis mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8899","description":"Inflammatory bowel dis mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXB0","description":"ICD-OAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHB1","description":"ICD-JFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Security Deposit)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7334","description":"Community Transition Svcs (Security Deposit)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCC1","description":"ICD-CGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84590","description":"Assay of vitamin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKB0","description":"ICD-FIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACB1","description":"ICD-GACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRB1","description":"ICD-PGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXB0","description":"ICD-OHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pedicle soft tissue graft pr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4270","description":"Pedicle soft tissue graft pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTC0","description":"ICD-OHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7299","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","description":"HCPCS-J7299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAA0","description":"ICD-AHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKB1","description":"ICD-BAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLC0","description":"ICD-JGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGB0","description":"ICD-NKGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX10","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEA0","description":"ICD-BBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAA0","description":"ICD-CEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHD1","description":"ICD-GFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ plazomicin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0291","description":"Injection_ plazomicin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp subclav-subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35612","description":"Art byp subclav-subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86053","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home episodic case 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0272","description":"Home episodic case 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSC1","description":"ICD-CFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA31","description":"ICD-4KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0802T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWF1","description":"ICD-LAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHF0","description":"ICD-IIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCC1","description":"ICD-EHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self-adher band w <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6453","description":"Self-adher band w <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA224","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intens behave ther cardio dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0446","description":"Intens behave ther cardio dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted case mgmt per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2023","description":"Targeted case mgmt per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAE1","description":"ICD-OLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVE1","description":"ICD-OAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKA0","description":"ICD-FDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIE0","description":"ICD-MIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place needles h&n for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41019","description":"Place needles h&n for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epsd bk pain for 6 wks/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1134F","description":"Epsd bk pain for 6 wks/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGD0","description":"ICD-JHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 1 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34841","description":"Endovasc visc aorta 1 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93965","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harvest femoropopliteal vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35572","description":"Harvest femoropopliteal vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMA0","description":"ICD-IEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPC0","description":"ICD-CAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEF0","description":"ICD-IEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEA1","description":"ICD-MCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLD1","description":"ICD-BBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLB1","description":"ICD-FCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of spleen total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38102","description":"Removal of spleen total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl leath cuff kafo prox th","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4100","description":"Repl leath cuff kafo prox th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFC1","description":"ICD-BBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreserve testicular tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89335","description":"Cryopreserve testicular tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECA1","description":"ICD-OECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part removal of ankle/heel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28120","description":"Part removal of ankle/heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPA1","description":"ICD-GGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSA0","description":"ICD-KCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBB0","description":"ICD-GFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tendon shortening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26477","description":"Tendon shortening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penicillin g benzathine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0561","description":"Penicillin g benzathine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWE0","description":"ICD-LHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELC0","description":"ICD-FELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKA1","description":"ICD-GIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWE1","description":"ICD-GGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCE1","description":"ICD-CBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth kidney/ureter surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86251","description":"Anesth kidney/ureter surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADE0","description":"ICD-OADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1602","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1602","description":"CDT-D1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft een & lips","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15260","description":"Skin full graft een & lips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTF1","description":"ICD-CGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 21 valent (PCV21)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90684","description":"Pneumococcal conjugate vaccine_ 21 valent (PCV21)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE221","description":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMC1","description":"ICD-AFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6036","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","description":"HCPCS-L6036","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reusable underpad chair size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4540","description":"Reusable underpad chair size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJD1","description":"ICD-OKJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYA0","description":"ICD-ODYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXF1","description":"ICD-GDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal invas px w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59897","description":"Fetal invas px w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with transendoscopic endobronchial ultrasound (ebus)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7512","description":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with transendoscopic endobronchial ultrasound (ebus)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHA0","description":"ICD-ABHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQF0","description":"ICD-HBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJE0","description":"ICD-JBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXB0","description":"ICD-NDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of hymen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56700","description":"Partial removal of hymen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Probe_ Image-Guided_ Robotic_ Waterjet Ablation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2596","description":"Probe_ Image-Guided_ Robotic_ Waterjet Ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUE1","description":"ICD-BBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIC1","description":"ICD-GGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRB1","description":"ICD-GDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSE1","description":"ICD-KFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 20 targets (adenovirus_ coronavirus 229E_ coronaviru","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0099U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 20 targets (adenovirus_ coronavirus 229E_ coronaviru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50695","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23A","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBC1","description":"ICD-EDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXE0","description":"ICD-OKXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBA0","description":"ICD-IEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQC1","description":"ICD-CCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Mycoplasma Genitalium_ Amplified Probe Technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87563","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Mycoplasma Genitalium_ Amplified Probe Technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHF1","description":"ICD-MIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMC1","description":"ICD-GIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCF0","description":"ICD-MHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTA1","description":"ICD-FFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDA1","description":"ICD-BFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATD0","description":"ICD-FATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWD0","description":"ICD-CCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0A","description":"Low Rehab_ ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of haptoglobin quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83010","description":"Assay of haptoglobin quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lang comp goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9160","description":"Lang comp goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound prep f/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15004","description":"Wound prep f/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped crit care transport","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99466","description":"Ped crit care transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSC0","description":"ICD-GDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPB1","description":"ICD-FEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODND0","description":"ICD-ODND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIE0","description":"ICD-OIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUD0","description":"ICD-GHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPC1","description":"ICD-JCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD236","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNB1","description":"ICD-NGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66740","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVC0","description":"ICD-OAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEF0","description":"ICD-JDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBD0","description":"ICD-KBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLME1","description":"ICD-NLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECA1","description":"ICD-CECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct head/brain w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70460","description":"Ct head/brain w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyqvia 100mg immuneglobulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1575","description":"Hyqvia 100mg immuneglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPD1","description":"ICD-FIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart symp image plnr spect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0332T","description":"Heart symp image plnr spect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIC1","description":"ICD-JDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJE0","description":"ICD-GGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Management of a new patient with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0522","description":"Management of a new patient with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBE0","description":"ICD-OIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDE0","description":"ICD-KBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFE0","description":"ICD-GAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKC1","description":"ICD-OJKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adm Tocilizu COVID-19 2nd dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0250","description":"Adm Tocilizu COVID-19 2nd dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epoprostenol dilutant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0155","description":"Epoprostenol dilutant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neostigmine methylslfte inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2710","description":"Neostigmine methylslfte inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair ing hernia sliding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49525","description":"Repair ing hernia sliding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post op service lvrs min 6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0305","description":"Post op service lvrs min 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53000","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Activate matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4301","description":"Activate matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRF1","description":"ICD-HBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRF0","description":"ICD-LFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Histoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86698","description":"Histoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 1 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0815","description":"Pwc gp 1 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAA0","description":"ICD-NIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0774T","description":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFF0","description":"ICD-ODFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAB1","description":"ICD-OIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQC0","description":"ICD-GHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q3h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9497","description":"Hit antibiotic q3h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection_ with counseling by physician or other qualified health care profe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96380","description":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection_ with counseling by physician or other qualified health care profe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko dbl upright w/air pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1847","description":"Ko dbl upright w/air pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEA1","description":"ICD-NBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB110","description":"Special Care High _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB14","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Reliant medical group_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1015","description":"Clinical decision support mechanism Reliant medical group_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I131 iodide cap_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9517","description":"I131 iodide cap_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBA1","description":"ICD-NIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tilt table locking hip sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5270","description":"Tilt table locking hip sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24605","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pelvic abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45000","description":"Drainage of pelvic abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surface emg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3900","description":"Surface emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIB1","description":"ICD-OCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHC0","description":"ICD-BHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow harvest autolog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38232","description":"Bone marrow harvest autolog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9750","description":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft contral carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35509","description":"Art byp grft contral carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWE0","description":"ICD-DEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYC1","description":"ICD-LEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYA1","description":"ICD-DIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOB0","description":"ICD-GAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ls pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8661","description":"Fun stat score ls pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24C","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temproromandibular Joint Dysfunction - non-invasive physical therapies","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9130","description":"Temproromandibular Joint Dysfunction - non-invasive physical therapies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEA1","description":"ICD-KCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Topotecan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9351","description":"Topotecan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis test procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81099","description":"Urinalysis test procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj dihydroergotamine mesylt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1110","description":"Inj dihydroergotamine mesylt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1458","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","description":"HCPCS-M1458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUB1","description":"ICD-IGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOC1","description":"ICD-DGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp vhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0827","description":"Pwc gp vhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30300","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUE0","description":"ICD-MCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1475","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","description":"HCPCS-M1475","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cancelled appointment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9987","description":"Cancelled appointment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB104","description":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEF0","description":"ICD-JFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIF0","description":"ICD-FEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBA1","description":"ICD-BGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1972","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1972","description":"HCPCS-L1972","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 xhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0855","description":"Pwc gp 3 xhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD214","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRC1","description":"ICD-HCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPE0","description":"ICD-NKPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurofilament light chain_ digital immunoassay_ plasma_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0361U","description":"Neurofilament light chain_ digital immunoassay_ plasma_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDA0","description":"ICD-MDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation for wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9156","description":"Evaluation for wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exam of vagina w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57420","description":"Exam of vagina w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMD1","description":"ICD-NEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQC1","description":"ICD-HHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC52","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc fx & test/txmnt for op","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5015F","description":"Doc fx & test/txmnt for op","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0532","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","description":"HCPCS-G0532","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain w/ h noble m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2750","description":"Crown porcelain w/ h noble m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDE0","description":"ICD-GFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA231","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFC0","description":"ICD-OKFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPE1","description":"ICD-KIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGE1","description":"ICD-OHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23330","description":"Remove shoulder foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES334","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHF1","description":"ICD-CCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYC1","description":"ICD-CEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLED1","description":"ICD-MLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of fecal fat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82715","description":"Assay of fecal fat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWF0","description":"ICD-PEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAD0","description":"ICD-MCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBE1","description":"ICD-NGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision/removal of kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27424","description":"Revision/removal of kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILA1","description":"ICD-OILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCF0","description":"ICD-BBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHE1","description":"ICD-CGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26725","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80420","description":"Dexamethasone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYF1","description":"ICD-OIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXC0","description":"ICD-NKXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIA0","description":"ICD-MJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection alemtuzumab 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9979","description":"Injection alemtuzumab 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBB0","description":"ICD-GGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin mnl lck ultra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5811","description":"Endo knee-shin mnl lck ultra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXE1","description":"ICD-OKXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKC0","description":"ICD-OFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAB0","description":"ICD-CDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRC0","description":"ICD-DFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHA0","description":"ICD-CEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98007","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","description":"CPT-98007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAE1","description":"ICD-FBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGD0","description":"ICD-JIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mercaptopurine 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0108","description":"Mercaptopurine 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0646U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0646U","description":"CPT-0646U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gjb6 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81254","description":"Gjb6 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVD0","description":"ICD-OJVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61710","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0C","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJC1","description":"ICD-OIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFB1","description":"ICD-FAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Res_ nos waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2033","description":"Res_ nos waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Detect agent nos dna amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87798","description":"Detect agent nos dna amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0441T","description":"Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metaproterenol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7670","description":"Metaproterenol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolong e&m/psyctx serv o/p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99355","description":"Prolong e&m/psyctx serv o/p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTB1","description":"ICD-FFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intratubal occlusion device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4264","description":"Intratubal occlusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhv-6 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87531","description":"Hhv-6 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPC1","description":"ICD-KGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received at least one well-child visit with a PCP during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9964","description":"Patient received at least one well-child visit with a PCP during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGA1","description":"ICD-NCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision malig les complicat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7415","description":"Excision malig les complicat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ercp ea duct/ampulla dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43277","description":"Ercp ea duct/ampulla dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGF0","description":"ICD-NDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMB0","description":"ICD-NHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB05","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary pouch w/barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5071","description":"Urinary pouch w/barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJB1","description":"ICD-OEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10D","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of sternum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21620","description":"Partial removal of sternum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBF1","description":"ICD-NEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluorouracil injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9190","description":"Fluorouracil injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOD1","description":"ICD-KBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phenobarbital sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2560","description":"Phenobarbital sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj midazolam hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2250","description":"Inj midazolam hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture of specimen by kit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87084","description":"Culture of specimen by kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATC1","description":"ICD-BATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28E","description":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOD1","description":"ICD-KGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ prostate cancer_ mRNA expression assay of 12 genes (10 content and 2 housekeeping)_ RT-PCR test utilizing blood plasma and/or urine_ algorithms to predict high-grade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011M","description":"Oncology_ prostate cancer_ mRNA expression assay of 12 genes (10 content and 2 housekeeping)_ RT-PCR test utilizing blood plasma and/or urine_ algorithms to predict high-grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Weight record","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2001F","description":"Weight record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEC1","description":"ICD-NAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVF1","description":"ICD-JCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA150","description":"Clinically Complex _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25800","description":"Fusion of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXA1","description":"ICD-GHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55711","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","description":"CPT-55711","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXA1","description":"ICD-OFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58950","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital bed institutional t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0270","description":"Hospital bed institutional t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA24","description":"Very High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"APOL1 (apolipoprotein L1) (eg_ chronic kidney disease)_ risk variants (G1_ G2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0355U","description":"APOL1 (apolipoprotein L1) (eg_ chronic kidney disease)_ risk variants (G1_ G2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIE1","description":"ICD-BDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAC0","description":"ICD-MJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKE0","description":"ICD-FBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leveen/shunt patency exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78291","description":"Leveen/shunt patency exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB130","description":"Reduced Physical Function _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMD1","description":"ICD-BBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace/revise brain shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62230","description":"Replace/revise brain shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJD1","description":"ICD-FIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFA1","description":"ICD-JIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ SC_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5137","description":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ SC_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAA1","description":"ICD-IEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVB0","description":"ICD-BCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGD1","description":"ICD-JBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retrograde ejaculation anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89331","description":"Retrograde ejaculation anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Power operated vehicle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1230","description":"Power operated vehicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44403","description":"Colonoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDB1","description":"ICD-CEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCE0","description":"ICD-ICCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL42","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANF0","description":"ICD-KANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser inc for pkp/lkp recip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0290T","description":"Laser inc for pkp/lkp recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGC0","description":"ICD-JDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria and fungi)_ gram-positive organism identification and drug resistance element detection_ DNA (20 gram-positive bacterial targets_ 4 resistance gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0141U","description":"Infectious disease (bacteria and fungi)_ gram-positive organism identification and drug resistance element detection_ DNA (20 gram-positive bacterial targets_ 4 resistance gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIA0","description":"ICD-OLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45400","description":"Laparoscopic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFA1","description":"ICD-KBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXC0","description":"ICD-FGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impltj ntrstrml crnl rng seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65785","description":"Impltj ntrstrml crnl rng seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Loxapine_ inhalation powder_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9497","description":"Loxapine_ inhalation powder_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88302","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQA0","description":"ICD-HAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep b core antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86705","description":"Hep b core antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWC0","description":"ICD-OKWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC05","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No unplnd hosp readm in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9309","description":"No unplnd hosp readm in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj beta interferon sq 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3028","description":"Inj beta interferon sq 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA_ gene-expression profiling by real-time quantitative PCR of 5 genes (MDK_ HOXA13_ CDC2 [CDK1]_ IGFBP5_ and CXCR2)_ utilizing urine_ algorithm incor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0363U","description":"Oncology (urothelial)_ mRNA_ gene-expression profiling by real-time quantitative PCR of 5 genes (MDK_ HOXA13_ CDC2 [CDK1]_ IGFBP5_ and CXCR2)_ utilizing urine_ algorithm incor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRA1","description":"ICD-CCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement breastpump cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4283","description":"Replacement breastpump cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/clin ascvd dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9674","description":"Pt w/clin ascvd dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVE0","description":"ICD-OKVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22854","description":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/a/gen/trk12.6-20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12005","description":"Rpr s/n/a/gen/trk12.6-20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGD1","description":"ICD-JGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBC1","description":"ICD-KHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5157","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","description":"HCPCS-Q5157","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALC1","description":"ICD-AALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXA1","description":"ICD-JIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTA0","description":"ICD-NJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVC0","description":"ICD-FBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of System Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Other System Reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2095","description":"Documentation Of System Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Other System Reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29846","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKA0","description":"ICD-OIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25C","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOC0","description":"ICD-LDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYC0","description":"ICD-HCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQF1","description":"ICD-PFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29825","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE226","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTF1","description":"ICD-NKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDB0","description":"ICD-JCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNB0","description":"ICD-KHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE214","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD121","description":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHE1","description":"ICD-BIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESF1","description":"ICD-KESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temporal bone surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69979","description":"Temporal bone surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC11","description":"ICD-1KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTE1","description":"ICD-CFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare embryo for transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89255","description":"Prepare embryo for transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln part mand chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5741","description":"Denture reln part mand chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0561T","description":"Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27259","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNC0","description":"ICD-GDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXD1","description":"ICD-GGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0556U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","description":"CPT-0556U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92641","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","description":"CPT-92641","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CT/MRI brain done w/in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3111F","description":"CT/MRI brain done w/in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diaper serv reusable diaper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4538","description":"Diaper serv reusable diaper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYC1","description":"ICD-OIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLF0","description":"ICD-NKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intrmed rsk thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3551F","description":"Intrmed rsk thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-ionizing diagnostic procedure capable of quantifying_ monitoring_ and recording changes in structure of enamel_ dentin_ and cementum","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0600","description":"Non-ionizing diagnostic procedure capable of quantifying_ monitoring_ and recording changes in structure of enamel_ dentin_ and cementum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shortening of hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26479","description":"Shortening of hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETB0","description":"ICD-CETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFF1","description":"ICD-JDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPC1","description":"ICD-GIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUE0","description":"ICD-NBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHB1","description":"ICD-FCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL43","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00750","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","description":"CPT-00750","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30020","description":"Drainage of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUF0","description":"ICD-KHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCC0","description":"ICD-KFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22B","description":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/dxa results document","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8399","description":"Pt w/dxa results document","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICC0","description":"ICD-OICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWE1","description":"ICD-KEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of humeral externally controlled intramedullary device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0595T","description":"Removal of humeral externally controlled intramedullary device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMF1","description":"ICD-EAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD126","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cstm manual wheelchair/base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0008","description":"Cstm manual wheelchair/base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERF0","description":"ICD-CERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJD0","description":"ICD-GAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFF0","description":"ICD-CGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHA0","description":"ICD-BIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKF0","description":"ICD-NIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lactic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83605","description":"Assay of lactic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOE1","description":"ICD-KIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8C","description":"Low Rehab_ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUC0","description":"ICD-AGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB115","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Benzodiazepines1-12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80346","description":"Benzodiazepines1-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIA1","description":"ICD-IEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surrogate viral neutralization test (sVNT)_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ ELISA_ plasma_ serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0226U","description":"Surrogate viral neutralization test (sVNT)_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ ELISA_ plasma_ serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTC1","description":"ICD-FDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay for infectious agent antibody(ies)_ qualitative or semiquantitative_ single-step method (eg_ reagent strip);","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86318","description":"Immunoassay for infectious agent antibody(ies)_ qualitative or semiquantitative_ single-step method (eg_ reagent strip);","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNA1","description":"ICD-NJNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metoclopramide hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2765","description":"Metoclopramide hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEE0","description":"ICD-ECEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQD0","description":"ICD-DDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove part lumbar vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22102","description":"Remove part lumbar vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSE0","description":"ICD-GDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ prothrombin complex concentrate (human)_ balfaxar_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9159","description":"Injection_ prothrombin complex concentrate (human)_ balfaxar_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bl draw <3 yrs other vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36406","description":"Bl draw <3 yrs other vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0518U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","description":"CPT-0518U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUD1","description":"ICD-OIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1137","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echocardiography_ transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg_TAVR_ transcatheter pulmonary valve repl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93355","description":"Echocardiography_ transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg_TAVR_ transcatheter pulmonary valve repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNF0","description":"ICD-NCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYC0","description":"ICD-HIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJA1","description":"ICD-ODJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFA0","description":"ICD-BBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGE1","description":"ICD-OEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVA0","description":"ICD-CIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31750","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXC1","description":"ICD-CBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFD1","description":"ICD-KFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18F","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUE0","description":"ICD-OAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCD0","description":"ICD-NLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Init day hosp neonate care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99477","description":"Init day hosp neonate care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone harvest_auto graft proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7295","description":"Bone harvest_auto graft proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDA1","description":"ICD-OGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPC0","description":"ICD-OHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sub pt/ot current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8993","description":"Sub pt/ot current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDA0","description":"ICD-CIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Betadine/iodine swabs/wipes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4247","description":"Betadine/iodine swabs/wipes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid plastic custom fa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0480","description":"Tlso rigid plastic custom fa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indium in-111 pentetreotide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9572","description":"Indium in-111 pentetreotide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suprv interfac trnsport addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99486","description":"Suprv interfac trnsport addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJA1","description":"ICD-BGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ concentration technique_ smears_ and interpretation (eg_ Saccomanno technique) (List separately in addition to code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0829T","description":"Digitization of glass microscope slides for cytopathology_ concentration technique_ smears_ and interpretation (eg_ Saccomanno technique) (List separately in addition to code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMC0","description":"ICD-GEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHA0","description":"ICD-MLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALF1","description":"ICD-CALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMA1","description":"ICD-NLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mediastinoscpy w/medstnl bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39401","description":"Mediastinoscpy w/medstnl bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB217","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tee w or w/o fol w/cont_ mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8927","description":"Tee w or w/o fol w/cont_ mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAC1","description":"ICD-IBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ avacincaptad pegol_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9162","description":"Injection_ avacincaptad pegol_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33964","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ONC MTC MRNA XPRSN ALYS 108","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0208U","description":"ONC MTC MRNA XPRSN ALYS 108","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISF1","description":"ICD-GISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21461","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGA0","description":"ICD-NGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunodiffusion ouchterlony","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86331","description":"Immunodiffusion ouchterlony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of leg at hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27295","description":"Amputation of leg at hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFB1","description":"ICD-BAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDB0","description":"ICD-ODDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAB1","description":"ICD-BGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient receives hcv antibody test with nonreactive result","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1231","description":"Patient receives hcv antibody test with nonreactive result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDA0","description":"ICD-EDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWF1","description":"ICD-GBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHC0","description":"ICD-FHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9845","description":"Patient received anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31825","description":"Repair of windpipe defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFF1","description":"ICD-BIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (plasma cell disorders and myeloma)_ circulating plasma cell immunologic selection_ identification_ morphological characterization_ and enumeration of plasma cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0337U","description":"Oncology (plasma cell disorders and myeloma)_ circulating plasma cell immunologic selection_ identification_ morphological characterization_ and enumeration of plasma cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETC0","description":"ICD-OETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0029","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTF0","description":"ICD-BFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUD0","description":"ICD-GFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOA0","description":"ICD-HEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastroplasty duodenal switch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43845","description":"Gastroplasty duodenal switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures repair resin base","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5610","description":"Dentures repair resin base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Buttock fasciotomy w/dbrdmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27057","description":"Buttock fasciotomy w/dbrdmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEF0","description":"ICD-OIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDD1","description":"ICD-IIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25125","description":"Remove/graft forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITD0","description":"ICD-GITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOC0","description":"ICD-DDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam thoracolmb 2/> vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72080","description":"X-ray exam thoracolmb 2/> vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00872","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","description":"CPT-00872","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29895","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of finger splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29131","description":"Application of finger splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAA0","description":"ICD-ICAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01160","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","description":"CPT-01160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARB0","description":"ICD-HARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTB1","description":"ICD-KCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYA1","description":"ICD-PDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prefab stnlss steel crwn pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2930","description":"Prefab stnlss steel crwn pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUB0","description":"ICD-KDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTD0","description":"ICD-KGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTE1","description":"ICD-FCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Review/report bp recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93790","description":"Review/report bp recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSE0","description":"ICD-OHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aor ane >=6.0 cm max diam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9599","description":"Aor ane >=6.0 cm max diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA212","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9713","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWA0","description":"ICD-GIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLB0","description":"ICD-KDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tensix_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4146","description":"Tensix_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlorpromazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3230","description":"Chlorpromazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPE0","description":"ICD-JEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJE1","description":"ICD-NFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45393","description":"Colonoscopy w/decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILD0","description":"ICD-NILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pain assessment documented as positive_ follow-up plan not documented_ documentation the patient is not eligible at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8939","description":"Pain assessment documented as positive_ follow-up plan not documented_ documentation the patient is not eligible at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein l3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82107","description":"Alpha-fetoprotein l3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOE1","description":"ICD-HIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNA1","description":"ICD-BDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBD1","description":"ICD-AHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVE1","description":"ICD-OCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0501","description":"HCPCS-A0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJE1","description":"ICD-OCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 10 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0446U","description":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 10 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDD0","description":"ICD-GFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFF0","description":"ICD-CEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCC0","description":"ICD-MBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening tramadol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80373","description":"Drug screening tramadol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9942","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8D","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE116","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c vent tray gimbaled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1030","description":"W/c vent tray gimbaled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYF0","description":"ICD-PAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWD0","description":"ICD-OLWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFB0","description":"ICD-NGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9011","description":"Mccd_ risk adj_ level 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stenger test pure tone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92565","description":"Stenger test pure tone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1055T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1055T","description":"CPT-1055T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAC1","description":"ICD-EIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calibrated microcap tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4651","description":"Calibrated microcap tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKED0","description":"ICD-MKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUE0","description":"ICD-OFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYB1","description":"ICD-OKYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENB0","description":"ICD-BENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWD1","description":"ICD-CBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial valve remov init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31648","description":"Bronchial valve remov init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Op rad mg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9236","description":"Op rad mg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ image analysis of at least 128 histologic features and clinical factors_ prognostic algorithm determining the risk of distant metastases_ and prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0376U","description":"Oncology (prostate cancer)_ image analysis of at least 128 histologic features and clinical factors_ prognostic algorithm determining the risk of distant metastases_ and prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYD0","description":"ICD-OLYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYB1","description":"ICD-DHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METC1","description":"ICD-METC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12A","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ bilateral (List sep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93573","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ bilateral (List sep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNF1","description":"ICD-GHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69540","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATB0","description":"ICD-NATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUF1","description":"ICD-IHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00756","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","description":"CPT-00756","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise arm/leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64708","description":"Revise arm/leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy implant stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52282","description":"Cystoscopy implant stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red blood cells unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9021","description":"Red blood cells unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBD1","description":"ICD-OHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWA1","description":"ICD-KGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ chloroprocaine hydrochloride (clorotekal)_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2402","description":"Injection_ chloroprocaine hydrochloride (clorotekal)_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHD0","description":"ICD-EEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB12","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGE1","description":"ICD-CEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXA0","description":"ICD-GFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv rna plan care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0575F","description":"Hiv rna plan care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGE0","description":"ICD-JCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIE0","description":"ICD-GHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPF1","description":"ICD-NFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBF1","description":"ICD-BCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVF0","description":"ICD-FAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXA1","description":"ICD-BIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr fe/e/en/l/m 12.6-20.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12016","description":"Rpr fe/e/en/l/m 12.6-20.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us leiomyomata ablate <200","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071T","description":"Us leiomyomata ablate <200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUC1","description":"ICD-MGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0715","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0715","description":"HCPCS-E0715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQA1","description":"ICD-DFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Irrig drug delivery device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96523","description":"Irrig drug delivery device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 21 bacterial and fungal organisms and identification of 21 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0374U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 21 bacterial and fungal organisms and identification of 21 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytotoxic antibody screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86808","description":"Cytotoxic antibody screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQE1","description":"ICD-OIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBA0","description":"ICD-MIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMA1","description":"ICD-KHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCD0","description":"ICD-AHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc back les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21931","description":"Exc back les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKA0","description":"ICD-JCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion 32 or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2267","description":"Induced abortion 32 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEF1","description":"ICD-GAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLB0","description":"ICD-NGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYA0","description":"ICD-KEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDD1","description":"ICD-KEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADE1","description":"ICD-EADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDD0","description":"ICD-MIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28C","description":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBA0","description":"ICD-IBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUC1","description":"ICD-BBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAED1","description":"ICD-EAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCC0","description":"ICD-BBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo ak ultra-light material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5950","description":"Endo ak ultra-light material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSF0","description":"ICD-GCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENB1","description":"ICD-BENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQF0","description":"ICD-LCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXF1","description":"ICD-OJXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1071T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1071T","description":"CPT-1071T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBA1","description":"ICD-OJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who achieved a net increase in pam score of at least 3 points in a 6 to 12 month period (passing)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1347","description":"Patients who achieved a net increase in pam score of at least 3 points in a 6 to 12 month period (passing)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKA1","description":"ICD-NEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAC1","description":"ICD-FAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1490","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","description":"HCPCS-M1490","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOD0","description":"ICD-CAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVC0","description":"ICD-KIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clotting assay whole blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85396","description":"Clotting assay whole blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLD0","description":"ICD-GCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEF1","description":"ICD-OBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEA0","description":"ICD-ABEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTE0","description":"ICD-BFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDF0","description":"ICD-NCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonpneumatic compression controller without calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1031","description":"Nonpneumatic compression controller without calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOC1","description":"ICD-KFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pedcle fh/ch/ch/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15574","description":"Pedcle fh/ch/ch/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBD0","description":"ICD-EDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFC0","description":"ICD-NDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not rcvng epo thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4095F","description":"Pt not rcvng epo thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPF0","description":"ICD-OCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion 25-28 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2265","description":"Induced abortion 25-28 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHF0","description":"ICD-CIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBF1","description":"ICD-EIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1952","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","description":"HCPCS-L1952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fertility cycle (contraception & conception) tracking software application_ fda cleared_ per month_ includes accessories (e.g._ thermometer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9293","description":"Fertility cycle (contraception & conception) tracking software application_ fda cleared_ per month_ includes accessories (e.g._ thermometer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUC0","description":"ICD-EHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCA1","description":"ICD-NBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release encircling material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67115","description":"Release encircling material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO foot or ankle intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9731","description":"Patient unable to complete the FOTO foot or ankle intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSF0","description":"ICD-LGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0538","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","description":"HCPCS-G0538","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx isodose plan simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77316","description":"Brachytx isodose plan simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvis/hip joint surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27299","description":"Pelvis/hip joint surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tah rad debulk/lymph remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58954","description":"Tah rad debulk/lymph remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYC1","description":"ICD-KHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laetrile amygdalin vit b17","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3570","description":"Laetrile amygdalin vit b17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLB1","description":"ICD-MJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGB0","description":"ICD-NHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of arm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24201","description":"Removal of arm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGB0","description":"ICD-CFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLE1","description":"ICD-IFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKF0","description":"ICD-GFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMB1","description":"ICD-JIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fit contac lens for managmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92072","description":"Fit contac lens for managmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAE1","description":"ICD-IDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonemergency transport bus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0110","description":"Nonemergency transport bus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Who w/nontorsion jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3905","description":"Who w/nontorsion jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC31","description":"ICD-2GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNE1","description":"ICD-CDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-93898","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","description":"CPT-93898","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Atten current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9165","description":"Atten current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUD1","description":"ICD-CBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect forarm/wrist tum 3cm>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25078","description":"Resect forarm/wrist tum 3cm>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARE0","description":"ICD-DARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial visit for episode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0525F","description":"Initial visit for episode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFID0","description":"ICD-MFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microbe suscept mycobacteri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87190","description":"Microbe suscept mycobacteri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient not screened for tobacco use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1312","description":"Patient not screened for tobacco use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surg reduct osseoustuberosit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7485","description":"Surg reduct osseoustuberosit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBF1","description":"ICD-BFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB150","description":"Special Care Low _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUB1","description":"ICD-MDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVF0","description":"ICD-GIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQC0","description":"ICD-PDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sio flex pelvisacral custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0622","description":"Sio flex pelvisacral custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin w/base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6721","description":"Crown resin w/base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXE0","description":"ICD-KFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVE1","description":"ICD-JBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood platelet aggregation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85576","description":"Blood platelet aggregation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pul art balloon repr percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92998","description":"Pul art balloon repr percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYA1","description":"ICD-KGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMA1","description":"ICD-KIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28220","description":"Release of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0493","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIA0","description":"ICD-GGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAA0","description":"ICD-FBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAE0","description":"ICD-NCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8008","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8008","description":"HCPCS-C8008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDD1","description":"ICD-NCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nose allergy test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95065","description":"Nose allergy test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA_ gene expression profiling of 18 genes_ first-catch post-digital rectal examination urine (or processed first-catch urine)_ algorithm reported as per","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0403U","description":"Oncology (prostate)_ mRNA_ gene expression profiling of 18 genes_ first-catch post-digital rectal examination urine (or processed first-catch urine)_ algorithm reported as per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMA1","description":"ICD-NAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15952","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9190","description":"Medical reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg filler paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6240","description":"Hydrocolld drg filler paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB205","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1815","description":"Insulin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILC1","description":"ICD-KILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove rectum w/reservoir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45119","description":"Remove rectum w/reservoir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc order given vte prophylx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4044F","description":"Doc order given vte prophylx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene other bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81208","description":"Bcr/abl1 gene other bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0C","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYF1","description":"ICD-GIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit routine device maint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5035","description":"Hit routine device maint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44365","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronch ebus ivntj perph les","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31654","description":"Bronch ebus ivntj perph les","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWC1","description":"ICD-DCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHA1","description":"ICD-FAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIB0","description":"ICD-OLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0143U","description":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the pat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1174","description":"Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18B","description":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove elctrd transvenously","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33244","description":"Remove elctrd transvenously","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28110","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLE0","description":"ICD-BDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIE0","description":"ICD-BHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIF1","description":"ICD-OAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHF0","description":"ICD-AGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFME0","description":"ICD-OFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Expose behav assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0362T","description":"Expose behav assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap impl electrode antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43647","description":"Lap impl electrode antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVA1","description":"ICD-NKVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX46","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-125 sodium iodide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9527","description":"Iodine i-125 sodium iodide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEED1","description":"ICD-MEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBME0","description":"ICD-FBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0123U","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGE1","description":"ICD-OJGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB21","description":"ICD-2AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB136","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21436","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHME0","description":"ICD-JHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD254","description":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAB1","description":"ICD-CIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDC1","description":"ICD-JBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFB0","description":"ICD-FIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lateral trochanteric pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1290","description":"Lateral trochanteric pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMA0","description":"ICD-ABMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85999","description":"Hematology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXF0","description":"ICD-BGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25676","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMB0","description":"ICD-OEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supply allowance for non-adjunctive_ non-implanted continuous glucose monitor (cgm)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4239","description":"Supply allowance for non-adjunctive_ non-implanted continuous glucose monitor (cgm)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Giardia ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87269","description":"Giardia ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVC0","description":"ICD-NKVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVC1","description":"ICD-CDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIE1","description":"ICD-AHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of manganese","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83785","description":"Assay of manganese","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); set-up and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0811T","description":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); set-up and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVC1","description":"ICD-KCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L8720","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8720","description":"HCPCS-L8720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVF0","description":"ICD-NHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hocm 250-299mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9961","description":"Hocm 250-299mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; data upload_ analysis and initial report configura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0535T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; data upload_ analysis and initial report configura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Western blot test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84181","description":"Western blot test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEF0","description":"ICD-EFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19083","description":"Bx breast 1st lesion us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Permanent Fallopian Tube Occlusion With Degradable Biopolymer Implant_ Transcervical Approach_ Including Transvaginal Ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0567T","description":"Permanent Fallopian Tube Occlusion With Degradable Biopolymer Implant_ Transcervical Approach_ Including Transvaginal Ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA50","description":"High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parathyrd planar w/wo subtrj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78071","description":"Parathyrd planar w/wo subtrj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMA0","description":"ICD-MJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXA1","description":"ICD-FIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAND1","description":"ICD-NAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41008","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure for percutaneous transhepatic cholangiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47500","description":"Injection procedure for percutaneous transhepatic cholangiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gonadotropin chorionic (hCG) immunoassay with direct optical observation blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0167U","description":"Gonadotropin chorionic (hCG) immunoassay with direct optical observation blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIB1","description":"ICD-FHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHF0","description":"ICD-CDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2136","description":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDA0","description":"ICD-CGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTE1","description":"ICD-IFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic exercises","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97110","description":"Therapeutic exercises","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1/hiv-2 1 result antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86703","description":"Hiv-1/hiv-2 1 result antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSB1","description":"ICD-HFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMB1","description":"ICD-MDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEC1","description":"ICD-OKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBD1","description":"ICD-NCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPF1","description":"ICD-KIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDB1","description":"ICD-AHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOB0","description":"ICD-LHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGB1","description":"ICD-GBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC40","description":"Ultra High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHD1","description":"ICD-EAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11103","description":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIB0","description":"ICD-GHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKD0","description":"ICD-FCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients Age 66 And Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With A Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2081","description":"Patients Age 66 And Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With A Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRE0","description":"ICD-PIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32999","description":"Chest surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADF1","description":"ICD-CADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD121","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMF0","description":"ICD-ADMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUE1","description":"ICD-FGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLC1","description":"ICD-ODLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp ilioiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35663","description":"Art byp ilioiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUC0","description":"ICD-IDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDF1","description":"ICD-NFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES335","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDB1","description":"ICD-GGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0548","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","description":"HCPCS-G0548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKD0","description":"ICD-BIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGID0","description":"ICD-JGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPD0","description":"ICD-GDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESE0","description":"ICD-OESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traction stand free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0850","description":"Traction stand free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEA0","description":"ICD-GDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crutch and cane holder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2207","description":"Crutch and cane holder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSF0","description":"ICD-HBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBE0","description":"ICD-KIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Protozoa antibody nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86753","description":"Protozoa antibody nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9983","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Death did not occur after discharge from the hospital within 30 days post procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9817","description":"Death did not occur after discharge from the hospital within 30 days post procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx gastric unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9104","description":"Onc dx gastric unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0780T","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEME0","description":"ICD-BEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg congen hernia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2400","description":"Fetal surg congen hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0167","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","description":"HCPCS-J0167","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFD1","description":"ICD-NIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMC1","description":"ICD-JHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA06","description":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJC1","description":"ICD-NGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous rf 1st vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36475","description":"Endovenous rf 1st vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDD1","description":"ICD-OGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOB1","description":"ICD-DIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interro eval cardiac modulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0418T","description":"Interro eval cardiac modulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPD1","description":"ICD-CBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJF0","description":"ICD-NHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); blocking antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86042","description":"Acetylcholine receptor (AChR); blocking antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIB1","description":"ICD-IEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult day care per half day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5101","description":"Adult day care per half day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJA0","description":"ICD-CAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIME1","description":"ICD-MIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient achieved a PDC of at least 75% for their asthma controller medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9810","description":"Patient achieved a PDC of at least 75% for their asthma controller medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBC1","description":"ICD-FHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc face les sc <2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21011","description":"Exc face les sc <2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEB0","description":"ICD-ICEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPB1","description":"ICD-NGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc rf ablate renal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50592","description":"Perc rf ablate renal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTD1","description":"ICD-CDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cataract surgery complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66982","description":"Cataract surgery complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUB1","description":"ICD-NIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELA1","description":"ICD-NELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28B","description":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDB1","description":"ICD-OIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXA1","description":"ICD-JGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 1 Channel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77785","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 1 Channel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVF0","description":"ICD-FEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo cholecystectomy/graph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47563","description":"Laparo cholecystectomy/graph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKA1","description":"ICD-BGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYD1","description":"ICD-PEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release foot/toe nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64726","description":"Release foot/toe nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 1 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0816","description":"Pwc gp 1 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX22","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pacemaker_ leadless_ dual chamber (right atrial and right ventricular implantable components)_ rate-responsive_ including all necessary components for implantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1605","description":"Pacemaker_ leadless_ dual chamber (right atrial and right ventricular implantable components)_ rate-responsive_ including all necessary components for implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB44","description":"Low Rehab_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERA1","description":"ICD-CERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAC0","description":"ICD-IAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of leg at hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27290","description":"Amputation of leg at hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microsurg epi sperm asp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4028","description":"Microsurg epi sperm asp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetazolamid sodium injectio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1120","description":"Acetazolamid sodium injectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPD0","description":"ICD-OIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJA1","description":"ICD-NKJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services received by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9692","description":"Hospice services received by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); device supply with automated report generation_ up to 10 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0812T","description":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); device supply with automated report generation_ up to 10 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXE0","description":"ICD-GEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","description":"HCPCS-A9610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUC0","description":"ICD-OHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin (lyumjev)_ per 5 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1814","description":"Insulin (lyumjev)_ per 5 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl bifocal 4.00d/.1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2203","description":"Lens sphcyl bifocal 4.00d/.1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOF1","description":"ICD-DHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD151","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUF0","description":"ICD-AEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB16","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUD1","description":"ICD-NAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65265","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUF0","description":"ICD-OFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYE1","description":"ICD-CFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLB0","description":"ICD-AGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0401","description":"HCPCS-C0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATA1","description":"ICD-BATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD101","description":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1904","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1904","description":"CDT-D1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIF0","description":"ICD-IEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIF0","description":"ICD-CIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy care kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4629","description":"Tracheostomy care kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0531U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","description":"CPT-0531U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLE1","description":"ICD-MLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6199","description":"Implant procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTC0","description":"ICD-MDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKF0","description":"ICD-OAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFF0","description":"ICD-OAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIC0","description":"ICD-NJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert endovasc prosth taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33883","description":"Insert endovasc prosth taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPA1","description":"ICD-CCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNA1","description":"ICD-BGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEA0","description":"ICD-MBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPE1","description":"ICD-JHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD124","description":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0674","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0674","description":"HCPCS-G0674","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHD1","description":"ICD-ODHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOA0","description":"ICD-KCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYF1","description":"ICD-HBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Not disch home by day #2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8838","description":"Not disch home by day #2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCED0","description":"ICD-JCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXC1","description":"ICD-JCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27552","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of psa free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84154","description":"Assay of psa free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQA0","description":"ICD-HHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric analy w/ph ea spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82930","description":"Gastric analy w/ph ea spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99310","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBB1","description":"ICD-AFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt referral for ect docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4067F","description":"Pt referral for ect docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFID1","description":"ICD-NFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74000","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQE0","description":"ICD-LFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28160","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVE0","description":"ICD-JHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDB0","description":"ICD-CEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Robt lin-radsurg fractx 2-5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0340","description":"Robt lin-radsurg fractx 2-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRF1","description":"ICD-HCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy through stoma; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6019","description":"Colonoscopy through stoma; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp fem-ant-post tib/prl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35566","description":"Art byp fem-ant-post tib/prl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEC0","description":"ICD-NKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWC0","description":"ICD-GAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQC0","description":"ICD-OEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUA0","description":"ICD-JDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tb intradermal test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86580","description":"Tb intradermal test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEC1","description":"ICD-ABEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLF1","description":"ICD-AGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neutralization test viral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86382","description":"Neutralization test viral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFF1","description":"ICD-FIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supplies for external insulin infusion pump_ syringe type cartridge_ sterile_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4225","description":"Supplies for external insulin infusion pump_ syringe type cartridge_ sterile_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of neonatal thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84437","description":"Assay of neonatal thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 cast hi noble met","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2780","description":"Crown 3/4 cast hi noble met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPE0","description":"ICD-GAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOC0","description":"ICD-HFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12A","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYB0","description":"ICD-LGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD104","description":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE140","description":"Special Care Low _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45505","description":"Repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLB1","description":"ICD-FHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ cholangiocarcinoma and non-small cell lung neoplasia_ DNA and RNA analysis_ 1-23 genes_ interrogation for sequence variants and rearr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0022U","description":"Targeted genomic sequence analysis panel_ cholangiocarcinoma and non-small cell lung neoplasia_ DNA and RNA analysis_ 1-23 genes_ interrogation for sequence variants and rearr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX52","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Twelve volt battery utah/equ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7364","description":"Twelve volt battery utah/equ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISC1","description":"ICD-GISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX35","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBB0","description":"ICD-BDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDD0","description":"ICD-OIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMA0","description":"ICD-NEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBC1","description":"ICD-AHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phys blood bank serv authrj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86079","description":"Phys blood bank serv authrj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJD1","description":"ICD-KDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKA0","description":"ICD-GGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ruconest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0596","description":"Injection_ ruconest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63085","description":"Remove vert body dcmprn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENC0","description":"ICD-JENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA06","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27244","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACA0","description":"ICD-GACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-pbbk (fylnetra)_ biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5130","description":"Injection_ pegfilgrastim-pbbk (fylnetra)_ biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDA0","description":"ICD-JBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBA0","description":"ICD-OHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECF0","description":"ICD-BECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIF1","description":"ICD-GIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDF0","description":"ICD-EHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMC1","description":"ICD-CBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAC0","description":"ICD-OHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2C","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor viia (antihemophilic factor_ recombinant)-jncw (sevenfact)_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7212","description":"Factor viia (antihemophilic factor_ recombinant)-jncw (sevenfact)_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6533","description":"Gc stocking thighlngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL12","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXC1","description":"ICD-NIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients Receiving Palliative Care During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0034","description":"Patients Receiving Palliative Care During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUB1","description":"ICD-FEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJD1","description":"ICD-KIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGB1","description":"ICD-OAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSF0","description":"ICD-HHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFB1","description":"ICD-NFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRC1","description":"ICD-PJRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFE1","description":"ICD-CGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOD1","description":"ICD-LHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v interpret","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88141","description":"Cytopath c/v interpret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEB1","description":"ICD-FHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPA0","description":"ICD-FGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFA1","description":"ICD-BGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC155","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHB1","description":"ICD-GIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7563","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7563","description":"HCPCS-C7563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVD0","description":"ICD-OIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAA1","description":"ICD-JFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No scr utr malig/us/samp rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9620","description":"No scr utr malig/us/samp rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBB0","description":"ICD-MKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHC0","description":"ICD-IHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUD0","description":"ICD-BEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOB0","description":"ICD-KEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARC0","description":"ICD-PARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBA0","description":"ICD-GBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair major blood vessel(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33320","description":"Repair major blood vessel(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPF0","description":"ICD-KAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90964","description":"Esrd home pt serv p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA21","description":"ICD-2EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpt pt cat and pt1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9428","description":"Rpt pt cat and pt1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBA0","description":"ICD-KFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFED1","description":"ICD-BFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOD1","description":"ICD-GEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAC0","description":"ICD-KHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob prov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1255","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob prov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJD0","description":"ICD-NIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGE1","description":"ICD-CBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mecp2 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81302","description":"Mecp2 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJD1","description":"ICD-OHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00210","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","description":"CPT-00210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPF0","description":"ICD-FFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External cannula declotting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36860","description":"External cannula declotting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUA0","description":"ICD-IGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRE1","description":"ICD-PJRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct urethra stage 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53420","description":"Reconstruct urethra stage 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ labetalol hydrochloride (hikma) not therapeutically equivalent to j1820_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1921","description":"Injection_ labetalol hydrochloride (hikma) not therapeutically equivalent to j1820_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSB0","description":"ICD-HBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGA1","description":"ICD-JAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBC0","description":"ICD-FBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXF1","description":"ICD-NJXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDD1","description":"ICD-MDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGC0","description":"ICD-FDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microbe suscept macrobroth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87188","description":"Microbe suscept macrobroth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spine surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22899","description":"Spine surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISC0","description":"ICD-PISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVA0","description":"ICD-OFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42505","description":"Repair salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29876","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Csf ventriculography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78635","description":"Csf ventriculography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 15 valent (PCV15)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90671","description":"Pneumococcal conjugate vaccine_ 15 valent (PCV15)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHA0","description":"ICD-FIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35184","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachy_non-str_ytterbium-169","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2637","description":"Brachy_non-str_ytterbium-169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59136","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla i & ii typing hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81378","description":"Hla i & ii typing hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOD1","description":"ICD-GIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2173","description":"Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUD0","description":"ICD-KBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPE1","description":"ICD-OIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBA1","description":"ICD-JGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTF0","description":"ICD-BBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37788","description":"Revascularization penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJB0","description":"ICD-NGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHA1","description":"ICD-OBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast noble metal inlay 2 sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6606","description":"Cast noble metal inlay 2 sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0619U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","description":"CPT-0619U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1504","description":"HCPCS-B1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQF0","description":"ICD-PEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ moderate complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes an expanded review of","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97166","description":"Occupational therapy evaluation_ moderate complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes an expanded review of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC216","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTE0","description":"ICD-OBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Edetate disodium per 150 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3520","description":"Edetate disodium per 150 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24B","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDA1","description":"ICD-OCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSB0","description":"ICD-KFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXB1","description":"ICD-BFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8F","description":"Low Rehab_ ADL Index 0-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E2403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2403","description":"HCPCS-E2403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHF1","description":"ICD-OHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision_ unilateral (List separately in addition to cod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34715","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision_ unilateral (List separately in addition to cod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cltx med ankle fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27762","description":"Cltx med ankle fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5244","description":"Hearing aid_ prog_ mon_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPB0","description":"ICD-CCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytomegalovirus imm iv /vial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0850","description":"Cytomegalovirus imm iv /vial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon t1-3_n1-2_no pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9084","description":"Onc dx colon t1-3_n1-2_no pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rotary wing air mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0436","description":"Rotary wing air mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHME0","description":"ICD-OHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACA1","description":"ICD-BACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTA0","description":"ICD-KBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISD1","description":"ICD-KISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIB0","description":"ICD-GGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26770","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFC0","description":"ICD-GGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foll-up eval q3mo opiod tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9562","description":"Foll-up eval q3mo opiod tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPD0","description":"ICD-OBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suction pump portab hom modl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0600","description":"Suction pump portab hom modl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBC0","description":"ICD-AEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCME0","description":"ICD-FCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWA1","description":"ICD-DHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHC1","description":"ICD-OEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54250","description":"Penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLD1","description":"ICD-NHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDD1","description":"ICD-KGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHA1","description":"ICD-NLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below knee wood socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5639","description":"Below knee wood socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1321","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBF0","description":"ICD-EDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPC1","description":"ICD-CFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPF1","description":"ICD-CBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCD0","description":"ICD-MFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78122","description":"Blood volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coronectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7251","description":"Coronectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22B","description":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBB1","description":"ICD-KIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12057","description":"Intmd rpr face/mm >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOF1","description":"ICD-GAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tint_ any color/solid/grad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2745","description":"Tint_ any color/solid/grad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Posterior gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8000","description":"Posterior gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of spine 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72020","description":"X-ray exam of spine 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical dress holder reuse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4463","description":"Surgical dress holder reuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPD1","description":"ICD-NEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQF1","description":"ICD-PHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQF1","description":"ICD-DEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BellaCell HD or Surederm_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4220","description":"BellaCell HD or Surederm_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMF1","description":"ICD-BEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWE0","description":"ICD-HIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scr unheal etoh w/counsel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9621","description":"Scr unheal etoh w/counsel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB254","description":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBB1","description":"ICD-FEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of hand or finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29280","description":"Strapping of hand or finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBF1","description":"ICD-FCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA104","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYF0","description":"ICD-CIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLF0","description":"ICD-OLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leukocyte phagocytosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86344","description":"Leukocyte phagocytosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clear eyelid gland w/heat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0207T","description":"Clear eyelid gland w/heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXC0","description":"ICD-BAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Droperidol/fentanyl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1810","description":"Droperidol/fentanyl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPF0","description":"ICD-GEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray guide gi dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74360","description":"X-ray guide gi dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48155","description":"Removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVB0","description":"ICD-NJVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUE1","description":"ICD-MJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28297","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cavopulmonary shunting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33768","description":"Cavopulmonary shunting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE111","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISA1","description":"ICD-CISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuromend nerve wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9361","description":"Neuromend nerve wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB236","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWB1","description":"ICD-CEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of metatarsals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28309","description":"Incision of metatarsals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHB0","description":"ICD-IAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQE1","description":"ICD-LBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75731","description":"Artery x-rays adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDC0","description":"ICD-IIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Als 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0426","description":"Als 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ triluron_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7332","description":"Hyaluronan or derivative_ triluron_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intradermal Cancer Immunotherapy; Each Additional Injection (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0709T","description":"Intradermal Cancer Immunotherapy; Each Additional Injection (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ younger than 12 years of age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31551","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ younger than 12 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUC1","description":"ICD-KCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGD1","description":"ICD-FIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOB1","description":"ICD-DBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOA1","description":"ICD-PGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) (Nuwiq)_ 1 I.U.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9138","description":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) (Nuwiq)_ 1 I.U.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFC0","description":"ICD-OIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCF0","description":"ICD-NDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFD0","description":"ICD-GIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1958","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1958","description":"HCPCS-J1958","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC201","description":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0554","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","description":"HCPCS-G0554","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCF1","description":"ICD-CBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMB1","description":"ICD-EBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace lensshield cartridge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4257","description":"Replace lensshield cartridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhc lis nurse train ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0164","description":"Hhc lis nurse train ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEC0","description":"ICD-JEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXF1","description":"ICD-JGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMB1","description":"ICD-CHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of finger tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26474","description":"Fusion of finger tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIME1","description":"ICD-GIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLD1","description":"ICD-AGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXB1","description":"ICD-NJXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXD0","description":"ICD-CEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43117","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ DNA (80 genes) and RNA (36 genes)_ by next-generation sequencing from plasma_ including single nucleotide variants_ insertions/deletions_ copy number a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0409U","description":"Oncology (solid tumor)_ DNA (80 genes) and RNA (36 genes)_ by next-generation sequencing from plasma_ including single nucleotide variants_ insertions/deletions_ copy number a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27602","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTE1","description":"ICD-OFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCA0","description":"ICD-NKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99375","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc bla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51999","description":"Laparoscope proc bla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB53","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61682","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4C","description":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acquisition_ interpretation_ and report; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0470T","description":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acquisition_ interpretation_ and report; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGC0","description":"ICD-OCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)_ face-to-face w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97157","description":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)_ face-to-face w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGE1","description":"ICD-NDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ldr prostate brachy comp rat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0458","description":"Ldr prostate brachy comp rat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/mediast exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32662","description":"Thoracoscopy w/mediast exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQD1","description":"ICD-PFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lodging costs (e.g. hotel ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9994","description":"Lodging costs (e.g. hotel ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXD0","description":"ICD-NFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ isatuximab-irfc_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9227","description":"Injection_ isatuximab-irfc_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDME1","description":"ICD-CDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip adj flex ext abduct cont","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2624","description":"Hip adj flex ext abduct cont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise & repair chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32905","description":"Revise & repair chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resin one surface-anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2330","description":"Resin one surface-anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAA1","description":"ICD-JDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEB0","description":"ICD-GIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNC0","description":"ICD-OBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAA1","description":"ICD-BHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGD0","description":"ICD-BGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIE0","description":"ICD-KGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD155","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWA0","description":"ICD-HBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mdd severe w/o psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3090F","description":"Mdd severe w/o psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATC0","description":"ICD-FATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac cond noadd by guide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9061","description":"Onc prac cond noadd by guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQE0","description":"ICD-PGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARA1","description":"ICD-PARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC115","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEA0","description":"ICD-ECEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXD1","description":"ICD-NGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYD0","description":"ICD-HFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGE0","description":"ICD-CHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDC0","description":"ICD-KCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKC1","description":"ICD-GFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMB0","description":"ICD-EIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Poliovirus vaccine_ (any type(s)) (opv)_ live_ for oral use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90712","description":"Poliovirus vaccine_ (any type(s)) (opv)_ live_ for oral use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCC0","description":"ICD-GHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIED1","description":"ICD-CIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0671","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0671","description":"HCPCS-G0671","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDF0","description":"ICD-MJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98001","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","description":"CPT-98001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSC0","description":"ICD-PFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETA1","description":"ICD-CETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlorambucil 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0172","description":"Chlorambucil 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNA1","description":"ICD-JDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sperm cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55520","description":"Removal of sperm cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy fimbrioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58672","description":"Laparoscopy fimbrioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immed max part dent metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5223","description":"Immed max part dent metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacist at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9479","description":"Pharmacist at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44366","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Int mam art used for cabg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4110F","description":"Int mam art used for cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 21_ and 18) DNA sequence analysis of selected reg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0112U","description":"Fetal aneuploidy (trisomy 21_ and 18) DNA sequence analysis of selected reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADF0","description":"ICD-KADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ cell enumeration of circulating tumor cells_ utilizing whole blood_ algorithm_ for the presence of adenoma or cancer_ reported as a positive o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0091U","description":"Oncology (colorectal) screening_ cell enumeration of circulating tumor cells_ utilizing whole blood_ algorithm_ for the presence of adenoma or cancer_ reported as a positive o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVC1","description":"ICD-JCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGED1","description":"ICD-FGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIA1","description":"ICD-NDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTD0","description":"ICD-NJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pml/raralpha 1 breakpoint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81316","description":"Pml/raralpha 1 breakpoint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dvt prophylx recvd day 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4070F","description":"Dvt prophylx recvd day 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD220","description":"Clinically Complex _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAD0","description":"ICD-OBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHE0","description":"ICD-ADHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4343","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","description":"HCPCS-Q4343","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAC1","description":"ICD-FFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL30","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC101","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVE0","description":"ICD-FGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onlay porc/crmc >=3 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6609","description":"Onlay porc/crmc >=3 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLD1","description":"ICD-BFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPE1","description":"ICD-OJPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko dbl upright w/air pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1848","description":"Ko dbl upright w/air pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDE1","description":"ICD-GEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA12","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBE1","description":"ICD-BEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKE0","description":"ICD-NIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of parathormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83970","description":"Assay of parathormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHF1","description":"ICD-OCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Estradiol response panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80415","description":"Estradiol response panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29000","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB31","description":"ICD-3CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26450","description":"Incision of palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANA0","description":"ICD-GANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTC0","description":"ICD-MGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7529","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of beta-2 protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82232","description":"Assay of beta-2 protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ergonovine maleate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1330","description":"Ergonovine maleate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc stroke after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9257","description":"Doc stroke after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1450","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","description":"HCPCS-M1450","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj follitropin beta 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0128","description":"Inj follitropin beta 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI fetal sngl/1st gestation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74712","description":"MRI fetal sngl/1st gestation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAB0","description":"ICD-GFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscp harv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2112","description":"Knee arthroscp harv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTB0","description":"ICD-JFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Counseling_ individual_ by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9002","description":"Counseling_ individual_ by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAA0","description":"ICD-JFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIB0","description":"ICD-AEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHC0","description":"ICD-OAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Empiric antibiotic rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4045F","description":"Empiric antibiotic rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNC0","description":"ICD-CFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem odontogen cyst to 1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7450","description":"Rem odontogen cyst to 1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDD0","description":"ICD-EIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg3/4 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9115","description":"Onc dx ovarian stg3/4 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove nail plate add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11732","description":"Remove nail plate add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00860","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","description":"CPT-00860","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWE0","description":"ICD-KGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB121","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCND1","description":"ICD-GCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUB1","description":"ICD-ADUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA35","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMB1","description":"ICD-ADMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIB1","description":"ICD-KEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"4-bar link above knee w/swng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5614","description":"4-bar link above knee w/swng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBB1","description":"ICD-OFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryocautery of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57511","description":"Cryocautery of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL31","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid skin barrier 8x8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5122","description":"Solid skin barrier 8x8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage board postural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0606","description":"Drainage board postural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUA0","description":"ICD-JGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB213","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAC0","description":"ICD-EEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGF1","description":"ICD-KEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEME1","description":"ICD-MEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIF0","description":"ICD-EBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHA0","description":"ICD-CFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast cancer dx min invsive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8875","description":"Breast cancer dx min invsive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ using oral fluid_ reported as a comparison to an estimated steady-state range_ per date of service inclu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ using oral fluid_ reported as a comparison to an estimated steady-state range_ per date of service inclu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETF1","description":"ICD-CETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAE0","description":"ICD-CDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee disart_ sach ft_ endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5312","description":"Knee disart_ sach ft_ endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray upper gi delay w/kub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74241","description":"X-ray upper gi delay w/kub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVF1","description":"ICD-OCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHC0","description":"ICD-CHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coch implant trans coil repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8617","description":"Coch implant trans coil repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen system liquid portabl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0435","description":"Oxygen system liquid portabl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preorthodontic tx visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8660","description":"Preorthodontic tx visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd endoscopic stent place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43266","description":"Egd endoscopic stent place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","description":"HCPCS-M1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTB0","description":"ICD-BBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67938","description":"Remove eyelid foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXC0","description":"ICD-OLXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apc gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81201","description":"Apc gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco use txmnt counseling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4000F","description":"Tobacco use txmnt counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTB1","description":"ICD-BGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXA1","description":"ICD-NJXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIF1","description":"ICD-CDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAA1","description":"ICD-EAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22558","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat shoulder blade fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23575","description":"Treat shoulder blade fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJE1","description":"ICD-GHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove limb nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64782","description":"Remove limb nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64610","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBC1","description":"ICD-KBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Routine Home Care - A flat per diem before area wage adjustment for intermittent services furnished.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0602","description":"Routine Home Care - A flat per diem before area wage adjustment for intermittent services furnished.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove lower leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27635","description":"Remove lower leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0989T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","description":"CPT-0989T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whirlpool portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1300","description":"Whirlpool portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTF0","description":"ICD-BCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Erythro lactobionate /500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1364","description":"Erythro lactobionate /500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLC1","description":"ICD-KCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQD1","description":"ICD-LDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB06","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44345","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB106","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRD1","description":"ICD-KBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ melphalan flufenamide_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9247","description":"Injection_ melphalan flufenamide_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c shoulder harness/straps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0960","description":"W/c shoulder harness/straps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYD0","description":"ICD-HBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0654U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0654U","description":"CPT-0654U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITB0","description":"ICD-CITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spoke protectors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0065","description":"Spoke protectors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMC0","description":"ICD-OFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUD1","description":"ICD-NDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA11","description":"ICD-4GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWE0","description":"ICD-CDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collect/review data from pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99091","description":"Collect/review data from pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab_ excludes biosimilar_ 10mg (Herceptin)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9355","description":"Injection_ trastuzumab_ excludes biosimilar_ 10mg (Herceptin)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pmkr_ single_ non rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2620","description":"Pmkr_ single_ non rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit hydra over 3l diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9377","description":"Hit hydra over 3l diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA55","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMC0","description":"ICD-FEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXC0","description":"ICD-OIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEB0","description":"ICD-BBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEF1","description":"ICD-EHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETD0","description":"ICD-BETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQC0","description":"ICD-PEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETB0","description":"ICD-EETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD201","description":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0631U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0631U","description":"CPT-0631U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXA0","description":"ICD-CEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHA1","description":"ICD-MIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXD1","description":"ICD-NIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCF1","description":"ICD-BGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zrsr2 (Zinc Finger Ccch-Type_ Rna Binding Motif And Serine/Arginine-Rich 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variant(S) (Eg_ E65Fs_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81360","description":"Zrsr2 (Zinc Finger Ccch-Type_ Rna Binding Motif And Serine/Arginine-Rich 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variant(S) (Eg_ E65Fs_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHA0","description":"ICD-OHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXC0","description":"ICD-NLXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skn splt a-grft fac/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15120","description":"Skn splt a-grft fac/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIB0","description":"ICD-ACIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVF1","description":"ICD-BAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resin infiltration of lesion","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2990","description":"Resin infiltration of lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23B","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXA1","description":"ICD-OBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDC1","description":"ICD-NHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemi-wheelchair detachable a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1084","description":"Hemi-wheelchair detachable a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBE1","description":"ICD-EEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDD1","description":"ICD-BFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJA1","description":"ICD-JFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPD1","description":"ICD-GCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC140","description":"Special Care Low _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUD1","description":"ICD-MBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert idrl body crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63304","description":"Remove vert idrl body crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSB1","description":"ICD-GGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73503","description":"X-ray exam hip uni 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETB1","description":"ICD-KETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay)_ plasma_ algorithm reported as m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0395U","description":"Oncology (lung)_ multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay)_ plasma_ algorithm reported as m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0660U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0660U","description":"CPT-0660U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGF1","description":"ICD-NCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGE1","description":"ICD-NGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric partial denture fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6985","description":"Pediatric partial denture fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging without contrast_ breast; unilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8904","description":"Magnetic resonance imaging without contrast_ breast; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATE0","description":"ICD-AATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIC1","description":"ICD-CFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC33","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBA1","description":"ICD-FFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Follow up home visit/prental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1004","description":"Follow up home visit/prental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBD0","description":"ICD-IGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAF1","description":"ICD-NEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tongue base vol reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41530","description":"Tongue base vol reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTA1","description":"ICD-GGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct interprete max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0366","description":"Cone beam ct interprete max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASF0","description":"ICD-KASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMC0","description":"ICD-OIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRB0","description":"ICD-HGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMF1","description":"ICD-EEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7023","description":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPE0","description":"ICD-OIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNC1","description":"ICD-NLNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAID0","description":"ICD-BAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5D","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anabolic steroid 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80328","description":"Anabolic steroid 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTC1","description":"ICD-JGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ROTAVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87425","description":"IAAD IA ROTAVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCF0","description":"ICD-BGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDF1","description":"ICD-KDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB11","description":"ICD-4IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJC1","description":"ICD-BBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKA0","description":"ICD-BCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PTEN (phosphatase and tensin homolog) (eg_ Cowden syndrome_ PTEN hamartoma tumor syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0235U","description":"PTEN (phosphatase and tensin homolog) (eg_ Cowden syndrome_ PTEN hamartoma tumor syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIB1","description":"ICD-MJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90283","description":"Human ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self-adher band w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6454","description":"Self-adher band w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25628","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assessment of a patient","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0191","description":"Assessment of a patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAA0","description":"ICD-JCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUA1","description":"ICD-KBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBC1","description":"ICD-JCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replant forearm complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20805","description":"Replant forearm complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJC0","description":"ICD-GBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQF0","description":"ICD-OLQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDE0","description":"ICD-KIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD151","description":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFF1","description":"ICD-GGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCD1","description":"ICD-ECCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYE1","description":"ICD-DIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast prosthes w/o adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8030","description":"Breast prosthes w/o adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shdr fair lead cable molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6588","description":"Shdr fair lead cable molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXD0","description":"ICD-NDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIND0","description":"ICD-OIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esano aaa_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4273","description":"Esano aaa_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRC0","description":"ICD-OHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMB0","description":"ICD-EFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVB0","description":"ICD-OCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLE1","description":"ICD-KGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Door to punc time <2hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9580","description":"Door to punc time <2hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29871","description":"Knee arthroscopy/drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYF0","description":"ICD-KBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trach pros cleaning device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8513","description":"Trach pros cleaning device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat penis lesion graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54112","description":"Treat penis lesion graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22A","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELE0","description":"ICD-AELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73615","description":"Contrast x-ray of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKD1","description":"ICD-BHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIF0","description":"ICD-NJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGA1","description":"ICD-OJGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDC0","description":"ICD-BBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJA1","description":"ICD-JDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXB1","description":"ICD-OJXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each additional single probe stain procedure (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0849T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each additional single probe stain procedure (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFD0","description":"ICD-NAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj foramen epidural add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64480","description":"Inj foramen epidural add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHE0","description":"ICD-KIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA53","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Herpes simplex 1 ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87274","description":"Herpes simplex 1 ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLB1","description":"ICD-AHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOF0","description":"ICD-GBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCF1","description":"ICD-ADCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVD0","description":"ICD-FAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lefamulin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0691","description":"Injection_ lefamulin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB24","description":"Low Rehab_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo fem fx cast molded to p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2128","description":"Kafo fem fx cast molded to p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIF0","description":"ICD-OGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Charger and base station for intraurethral activation device_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1012","description":"Charger and base station for intraurethral activation device_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phys blood bank serv xmatch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86077","description":"Phys blood bank serv xmatch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on salivary glands_ including biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0113U","description":"Anesthesia for procedures on salivary glands_ including biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDC1","description":"ICD-ABDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/family 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90832","description":"Psytx pt&/family 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDF1","description":"ICD-BGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLF1","description":"ICD-ABLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX36","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC11","description":"ICD-2FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASE1","description":"ICD-CASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFB0","description":"ICD-BAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGA0","description":"ICD-OBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1473","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","description":"HCPCS-M1473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pan-cancer)_ analysis of minimal residual disease (MRD) from plasma_ with assays personalized to each patient based on prior next-generation sequencing of the patien","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0340U","description":"Oncology (pan-cancer)_ analysis of minimal residual disease (MRD) from plasma_ with assays personalized to each patient based on prior next-generation sequencing of the patien","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIME1","description":"ICD-OIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of c-peptide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84681","description":"Assay of c-peptide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy hand joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26100","description":"Biopsy hand joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJC0","description":"ICD-NBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 0.5/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11420","description":"Exc h-f-nk-sp b9+marg 0.5/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syringe w/needle insulin 3cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4232","description":"Syringe w/needle insulin 3cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHD0","description":"ICD-FGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXB0","description":"ICD-NAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLE0","description":"ICD-ADLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFE0","description":"ICD-CHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replcmnt breast pump shield","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4284","description":"Replcmnt breast pump shield","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESD0","description":"ICD-DESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assess hlth/behave init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96150","description":"Assess hlth/behave init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYF1","description":"ICD-OHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNA1","description":"ICD-OKNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision addl breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19126","description":"Excision addl breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDD0","description":"ICD-MHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound cleanser any type/size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6260","description":"Wound cleanser any type/size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOB1","description":"ICD-OCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQD1","description":"ICD-GCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58900","description":"Biopsy of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUA0","description":"ICD-MLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERE0","description":"ICD-PERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply intrcav radiat interm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77762","description":"Apply intrcav radiat interm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13B","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0704","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0704","description":"CDT-D0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAF0","description":"ICD-NAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJF0","description":"ICD-GEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAC0","description":"ICD-GCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAF1","description":"ICD-ECAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUF1","description":"ICD-BIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADD0","description":"ICD-AADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cartilage for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20912","description":"Remove cartilage for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC121","description":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMA0","description":"ICD-JEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSF0","description":"ICD-OLSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHE0","description":"ICD-BBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33420","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICC0","description":"ICD-MICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQC1","description":"ICD-OAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMF1","description":"ICD-KFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open tx septal fx w/wo stabj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21336","description":"Open tx septal fx w/wo stabj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVB1","description":"ICD-OKVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Double transfer toe-hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26554","description":"Double transfer toe-hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFD0","description":"ICD-NHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMA1","description":"ICD-MCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0734","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICB0","description":"ICD-FICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAC0","description":"ICD-JDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGED0","description":"ICD-CGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Instillation_ taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0911","description":"Instillation_ taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of ureter & kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50750","description":"Fusion of ureter & kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBA1","description":"ICD-OBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIF1","description":"ICD-CFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve palsy microsurg graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15842","description":"Nerve palsy microsurg graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBE1","description":"ICD-GFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0942T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","description":"CPT-0942T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1904","description":"HCPCS-A1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWF1","description":"ICD-OEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKC0","description":"ICD-CEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22612","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVE0","description":"ICD-OLVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plerixafor injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2562","description":"Plerixafor injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRE1","description":"ICD-DIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iliac revasc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37222","description":"Iliac revasc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAF1","description":"ICD-BDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophgl motil w/stim/perfus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91013","description":"Esophgl motil w/stim/perfus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2146","description":"Leg Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMB0","description":"ICD-BFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whlchr att- conv 1 arm drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0958","description":"Whlchr att- conv 1 arm drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81403","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMA1","description":"ICD-FIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Frozen Entree","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1760","description":"Home Delivered Meals-Frozen Entree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEF0","description":"ICD-OFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRA1","description":"ICD-LDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB231","description":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESD1","description":"ICD-PESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smear fluorescent/acid stai","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87206","description":"Smear fluorescent/acid stai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWB0","description":"ICD-KGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deb subq tissue 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11042","description":"Deb subq tissue 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hmes/trachvalve adhesivedisk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7506","description":"Hmes/trachvalve adhesivedisk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ag detect nos ia single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87450","description":"Ag detect nos ia single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEA0","description":"ICD-NHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUF0","description":"ICD-OLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trluml perip athrc brchiocph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0237T","description":"Trluml perip athrc brchiocph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGME1","description":"ICD-NGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI lower extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73719","description":"MRI lower extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIB0","description":"ICD-KCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATF0","description":"ICD-OATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2090","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIE0","description":"ICD-FBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDC1","description":"ICD-NLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVA1","description":"ICD-OIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doppler echo exam heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93321","description":"Doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAB0","description":"ICD-KEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLC1","description":"ICD-CCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEB0","description":"ICD-EGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB03","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pmkr_ single_ rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1786","description":"Pmkr_ single_ rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit2.6-7.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12042","description":"Intmd rpr n-hf/genit2.6-7.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHF0","description":"ICD-KEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture type pulse field gel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87152","description":"Culture type pulse field gel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gene test myo musclr dyst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3853","description":"Gene test myo musclr dyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAF1","description":"ICD-EGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGC0","description":"ICD-JAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVC0","description":"ICD-NFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc hip/pelv tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27045","description":"Exc hip/pelv tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0528","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0528","description":"HCPCS-J0528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0702","description":"HCPCS-B0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVC1","description":"ICD-JBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUD1","description":"ICD-AAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILC0","description":"ICD-GILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMB0","description":"ICD-AEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA224","description":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXA0","description":"ICD-NIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDB1","description":"ICD-OKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECA0","description":"ICD-GECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYF0","description":"ICD-LBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1121","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMF0","description":"ICD-NJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9818","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9818","description":"HCPCS-C9818","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy orchiopexy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54692","description":"Laparoscopy orchiopexy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPC1","description":"ICD-CIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMB0","description":"ICD-GIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIC1","description":"ICD-ECIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ankle joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27626","description":"Remove ankle joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDF0","description":"ICD-NDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8G","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision benign lesion>1.25c","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7411","description":"Excision benign lesion>1.25c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart failure assessed (includes assessment of all the following components) (CAD): Blood pressure measured (2000F) Level of activity assessed (1003F) Clinical symptoms of vol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0105U","description":"Heart failure assessed (includes assessment of all the following components) (CAD): Blood pressure measured (2000F) Level of activity assessed (1003F) Clinical symptoms of vol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMF1","description":"ICD-OGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Succinycholine chloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0330","description":"Succinycholine chloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab-abbs_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5115","description":"Injection_ rituximab-abbs_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial hosp prog service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0129","description":"Partial hosp prog service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCF0","description":"ICD-CGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKF1","description":"ICD-CFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24685","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXA1","description":"ICD-BEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49606","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjunctive continuous glucose monitor or receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2102","description":"Adjunctive continuous glucose monitor or receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWC1","description":"ICD-DAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNE0","description":"ICD-JBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64859","description":"Nerve surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1005T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","description":"CPT-1005T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism National Imaging Associates_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1005","description":"Clinical Decision Support Mechanism National Imaging Associates_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFB0","description":"ICD-OHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Individual_ Follow-Up Session_ At Least 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0592T","description":"Health And Well-Being Coaching Face-To-Face; Individual_ Follow-Up Session_ At Least 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen dsg wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6024","description":"Collagen dsg wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Md certification hha patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0180","description":"Md certification hha patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHA0","description":"ICD-JGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUD1","description":"ICD-JCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMD1","description":"ICD-MCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKF1","description":"ICD-FCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom shape cover bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5704","description":"Custom shape cover bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cephapirin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0710","description":"Cephapirin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTA1","description":"ICD-FBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILD1","description":"ICD-IILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52007","description":"Cystoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDC0","description":"ICD-OFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Most recent tobacco status is tobacco free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9791","description":"Most recent tobacco status is tobacco free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36245","description":"Ins cath abd/l-ext art 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYF1","description":"ICD-PKYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEED0","description":"ICD-FEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic/Device/Drug Matrix For Opposing Bone-To-Bone Or Soft Tissue-To Bone (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1734","description":"Orthopedic/Device/Drug Matrix For Opposing Bone-To-Bone Or Soft Tissue-To Bone (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMA0","description":"ICD-AEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMF0","description":"ICD-KBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKB1","description":"ICD-JIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ targeted hybrid-capture genomic sequence analysis panel_ circulating tumor DNA (ctDNA) analysis of 56 or more genes_ interrogation for sequence variants_ ge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0428U","description":"Oncology (breast)_ targeted hybrid-capture genomic sequence analysis panel_ circulating tumor DNA (ctDNA) analysis of 56 or more genes_ interrogation for sequence variants_ ge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGF1","description":"ICD-KBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19369","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYA1","description":"ICD-OBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1803","description":"HCPCS-A1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWF0","description":"ICD-PFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPD1","description":"ICD-FEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic elbow sequential","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7180","description":"Electronic elbow sequential","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4C","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect hip/pelv tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27059","description":"Resect hip/pelv tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECB1","description":"ICD-CECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Facial augmentation implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5925","description":"Facial augmentation implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRF1","description":"ICD-DCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of shoulder ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23415","description":"Release of shoulder ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anti-phospholipid antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86148","description":"Anti-phospholipid antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Range of motion measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95852","description":"Range of motion measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1099","description":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXA1","description":"ICD-OGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWF0","description":"ICD-OFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDF0","description":"ICD-KFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2C","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA31","description":"ICD-4AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYA1","description":"ICD-CEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGA1","description":"ICD-KFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXE0","description":"ICD-OIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTF0","description":"ICD-IBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit tocolysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9349","description":"Hit tocolysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0800T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFC0","description":"ICD-BHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-maly_ biosimilar_ (Alymsys)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9142","description":"Injection_ bevacizumab-maly_ biosimilar_ (Alymsys)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAE1","description":"ICD-AEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1060","description":"Thoracic pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHE1","description":"ICD-BAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coronary artery bypass/reop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33530","description":"Coronary artery bypass/reop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBC1","description":"ICD-OIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFB1","description":"ICD-KAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87469","description":"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJC0","description":"ICD-GEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJD1","description":"ICD-ODJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMB0","description":"ICD-OAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVB1","description":"ICD-KBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-sterile eye pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6411","description":"Non-sterile eye pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0602","description":"Manual breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9855","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metaproterenol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7668","description":"Metaproterenol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73660","description":"X-ray exam of toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRC1","description":"ICD-OBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALD1","description":"ICD-FALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESB0","description":"ICD-LESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQE1","description":"ICD-LFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ cervical or vaginal (any reporting system)_ requiring interpretation by physician (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0831T","description":"Digitization of glass microscope slides for cytopathology_ cervical or vaginal (any reporting system)_ requiring interpretation by physician (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNA0","description":"ICD-JDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADA1","description":"ICD-NADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFE0","description":"ICD-FDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46924","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDF1","description":"ICD-OEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUB0","description":"ICD-GBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maxillofacial fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21100","description":"Maxillofacial fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd control bleeding any","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43255","description":"Egd control bleeding any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTE1","description":"ICD-GFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWB0","description":"ICD-PIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB246","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22A","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-33882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","description":"CPT-33882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD112","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plague vaccine_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90727","description":"Plague vaccine_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDC1","description":"ICD-OBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES256","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATC0","description":"ICD-MATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMF1","description":"ICD-BAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerv sr wire occ/man pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0160","description":"Cerv sr wire occ/man pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOE0","description":"ICD-PFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 20.1-30.0","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12056","description":"Intmd rpr face/mm 20.1-30.0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC11","description":"ICD-2EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQA0","description":"ICD-OAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTA0","description":"ICD-ADTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDD1","description":"ICD-JIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of phosphorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84100","description":"Assay of phosphorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo tibial fracture soft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2112","description":"Afo tibial fracture soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Current cig smoker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9642","description":"Current cig smoker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYA1","description":"ICD-LEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEE1","description":"ICD-GCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx laryngoscopy excl nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31525","description":"Dx laryngoscopy excl nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95706","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVA1","description":"ICD-JDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEC0","description":"ICD-AAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLE1","description":"ICD-KHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso rem fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43194","description":"Esophagoscp rig trnso rem fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXB0","description":"ICD-BBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDED1","description":"ICD-CDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peri-px pacemaker device evl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93286","description":"Peri-px pacemaker device evl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALA1","description":"ICD-FALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13121","description":"Cmplx rpr s/a/l 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHE1","description":"ICD-AEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA260","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTB0","description":"ICD-ACTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRC0","description":"ICD-PCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSF1","description":"ICD-PKSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPC1","description":"ICD-OEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC31","description":"ICD-4BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRD1","description":"ICD-LFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBB1","description":"ICD-KDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOC1","description":"ICD-OBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal allograft pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48556","description":"Removal allograft pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTA0","description":"ICD-EBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No trnsfr from anesth to cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0582F","description":"No trnsfr from anesth to cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE231","description":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRE1","description":"ICD-HBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAC1","description":"ICD-AHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC136","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIC0","description":"ICD-EGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELF1","description":"ICD-FELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJA1","description":"ICD-OJJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis g dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87527","description":"Hepatitis g dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD136","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQF0","description":"ICD-CFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33368","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0605U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","description":"CPT-0605U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE256","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIC0","description":"ICD-NEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens spher single plano 4.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2100","description":"Lens spher single plano 4.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQF1","description":"ICD-LFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSC0","description":"ICD-LGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurawrap nerve protector_cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9353","description":"Neurawrap nerve protector_cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41005","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD206","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVA1","description":"ICD-KAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHF1","description":"ICD-OLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB113","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFA0","description":"ICD-BEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL43","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECA0","description":"ICD-NECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHE1","description":"ICD-OJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0017","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUD0","description":"ICD-OBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECB1","description":"ICD-EECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjst forearm pro/sup device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1802","description":"Adjst forearm pro/sup device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cbt each addl hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94645","description":"Cbt each addl hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj trigeminal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64400","description":"N block inj trigeminal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLE1","description":"ICD-GCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMC0","description":"ICD-BDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRD0","description":"ICD-KCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD225","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERD0","description":"ICD-CERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXA0","description":"ICD-FHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYC1","description":"ICD-HIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWC1","description":"ICD-HDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64809","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQA1","description":"ICD-PCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQA0","description":"ICD-LHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0513U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","description":"CPT-0513U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle/tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24301","description":"Muscle/tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNF0","description":"ICD-OFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0938T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","description":"CPT-0938T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSB1","description":"ICD-PKSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOA1","description":"ICD-HIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC112","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIE1","description":"ICD-OIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of wrist prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25250","description":"Removal of wrist prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of wrist prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25251","description":"Removal of wrist prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOC0","description":"ICD-CGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDB1","description":"ICD-IBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDE0","description":"ICD-JDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rad resect abd tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22905","description":"Rad resect abd tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1246","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHA1","description":"ICD-NFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Desipramine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6032","description":"Desipramine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOB0","description":"ICD-DIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTE0","description":"ICD-FCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSF1","description":"ICD-PJSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX55","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No assess bone loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8863","description":"No assess bone loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNF1","description":"ICD-CGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec sz spec ht a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1227","description":"Wheelchair spec sz spec ht a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTD0","description":"ICD-NGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIA1","description":"ICD-MLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDB1","description":"ICD-BGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTE1","description":"ICD-NKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXF1","description":"ICD-JBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTA0","description":"ICD-AFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUE0","description":"ICD-CGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC31","description":"ICD-1HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-2 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87537","description":"Hiv-2 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVF0","description":"ICD-CBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXE1","description":"ICD-JFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No reason for no hep c rna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9204","description":"No reason for no hep c rna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIA1","description":"ICD-IDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravasc us heart add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92979","description":"Intravasc us heart add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINE0","description":"ICD-GINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo-asst vag hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58550","description":"Laparo-asst vag hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXA0","description":"ICD-OJXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect hip tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27075","description":"Resect hip tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4B","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bp sys>=140 and/or dias >=90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8477","description":"Bp sys>=140 and/or dias >=90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documented reason for not assessing hepatitis B virus (HBV) status (e.g._ patient not initiating anti-TNF therapy_ patient declined) prior to initiating anti-TNF therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9504","description":"Documented reason for not assessing hepatitis B virus (HBV) status (e.g._ patient not initiating anti-TNF therapy_ patient declined) prior to initiating anti-TNF therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alert device_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9280","description":"Alert device_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18E","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compression stocking bk40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6532","description":"Compression stocking bk40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0496T","description":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of jaw nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64738","description":"Incision of jaw nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14D","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Face tent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4619","description":"Face tent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGB0","description":"ICD-KEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTC1","description":"ICD-OKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc rehab svcs considered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4079F","description":"Doc rehab svcs considered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSA0","description":"ICD-HFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLC1","description":"ICD-KGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01622","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","description":"CPT-01622","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWF1","description":"ICD-PAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31231","description":"Nasal endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adj cmo not pres rsn not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8929","description":"Adj cmo not pres rsn not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWB1","description":"ICD-PCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCD0","description":"ICD-IGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28D","description":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11C","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD154","description":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHD0","description":"ICD-GHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMA0","description":"ICD-BHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGME1","description":"ICD-OGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE113","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDB1","description":"ICD-OFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHF0","description":"ICD-JIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1004","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1004","description":"CDT-D1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test sock elbw disart/above","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6682","description":"Test sock elbw disart/above","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair spinal fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63709","description":"Repair spinal fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTB0","description":"ICD-ADTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYC0","description":"ICD-PJYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYE0","description":"ICD-KHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPA0","description":"ICD-GCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJE1","description":"ICD-KIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93314","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHB1","description":"ICD-FDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1359","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/endoscopic fnb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45392","description":"Colonoscopy w/endoscopic fnb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDF1","description":"ICD-BEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDC0","description":"ICD-NJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Facial nerve function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92516","description":"Facial nerve function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRE1","description":"ICD-OLRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Charger elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0495","description":"Charger elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBA1","description":"ICD-AEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rasburicase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2783","description":"Rasburicase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA24","description":"Medium Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal extent unknwn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9095","description":"Onc dx rectal extent unknwn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIE0","description":"ICD-GEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUA1","description":"ICD-FGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECF1","description":"ICD-EECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthroflex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4125","description":"Arthroflex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft ilioiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35563","description":"Art byp grft ilioiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCF0","description":"ICD-CDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNF1","description":"ICD-NLNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOC0","description":"ICD-KGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJF1","description":"ICD-OBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray special views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71035","description":"Chest x-ray special views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXC1","description":"ICD-KIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of eye thickness","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76514","description":"Echo exam of eye thickness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA50","description":"Default_ /90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDA0","description":"ICD-GBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCF0","description":"ICD-GFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl nasal pillow comb mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7029","description":"Repl nasal pillow comb mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAD1","description":"ICD-JFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBME0","description":"ICD-MBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTC0","description":"ICD-JHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L4-L5 inters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0196T","description":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L4-L5 inters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLE0","description":"ICD-AHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTE0","description":"ICD-GCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUD1","description":"ICD-ECUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIC0","description":"ICD-CIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMB0","description":"ICD-GFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWC1","description":"ICD-KGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt ed re comp thxpy rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4268F","description":"Pt ed re comp thxpy rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35271","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood pressure reading not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1281","description":"Blood pressure reading not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47361","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert non-tunnel cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36556","description":"Insert non-tunnel cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPA0","description":"ICD-JDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVD1","description":"ICD-GEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA21","description":"ICD-1LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analgesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9230","description":"Analgesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA155","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; each additional device (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0450T","description":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; each additional device (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18H","description":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAB0","description":"ICD-FHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ flow cytometry_ sputum_ 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP]_ CD206_ CD66b_ CD3_ CD19)_ algorithm reported as likelihood of lung cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0406U","description":"Oncology (lung)_ flow cytometry_ sputum_ 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP]_ CD206_ CD66b_ CD3_ CD19)_ algorithm reported as likelihood of lung cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUE0","description":"ICD-OLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCA0","description":"ICD-CBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genotype cytomegalovirus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87910","description":"Genotype cytomegalovirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC21","description":"ICD-1JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCA0","description":"ICD-MGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATA0","description":"ICD-FATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC11","description":"ICD-3EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of digit nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64831","description":"Repair of digit nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12D","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow mold doub splt soc ste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6120","description":"Elbow mold doub splt soc ste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHD0","description":"ICD-GDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tun ip cath perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49418","description":"Insert tun ip cath perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric bypass for obesity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43846","description":"Gastric bypass for obesity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXE1","description":"ICD-NHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUD1","description":"ICD-NLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHC1","description":"ICD-MKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENF1","description":"ICD-CENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTF0","description":"ICD-CDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB11","description":"ICD-3FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray strenoclavic jt 3/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71130","description":"X-ray strenoclavic jt 3/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNF1","description":"ICD-GCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81462","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKB0","description":"ICD-CFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Episiotomy or vaginal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59300","description":"Episiotomy or vaginal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Static or dynami afo pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4396","description":"Static or dynami afo pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDE0","description":"ICD-EGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIF0","description":"ICD-FBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add tooth to partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5650","description":"Add tooth to partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGD0","description":"ICD-NJGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMB0","description":"ICD-MIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHF1","description":"ICD-NEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRA0","description":"ICD-HDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQD1","description":"ICD-HDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ipratropium bromide comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7645","description":"Ipratropium bromide comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUC0","description":"ICD-NEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAID0","description":"ICD-OAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0803","description":"HCPCS-C0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPC1","description":"ICD-JEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4207","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4207","description":"HCPCS-Q4207","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac MRI for morph w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75561","description":"Cardiac MRI for morph w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTE0","description":"ICD-IDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tcran magn stim redetemine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90869","description":"Tcran magn stim redetemine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27830","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPC0","description":"ICD-JIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKD0","description":"ICD-CFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27041","description":"Biopsy of soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMF1","description":"ICD-BGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25A","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCME0","description":"ICD-NCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCF0","description":"ICD-ADCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQB1","description":"ICD-GIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Annual gynecological examina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0612","description":"Annual gynecological examina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTF0","description":"ICD-NCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJF1","description":"ICD-FDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIID0","description":"ICD-KIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIB0","description":"ICD-BBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fit spectacles bifocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92341","description":"Fit spectacles bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical splint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5988","description":"Surgical splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automated rbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85041","description":"Automated rbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAA0","description":"ICD-MKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rerevise eye muscles add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67332","description":"Rerevise eye muscles add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOA0","description":"ICD-PKOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ace inhibitor or arb therapy not prescribed during the measurement period_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1203","description":"Ace inhibitor or arb therapy not prescribed during the measurement period_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHF0","description":"ICD-FEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFA0","description":"ICD-BGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp genet test hyp cardiomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3865","description":"Comp genet test hyp cardiomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27000","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment planning for magnetic field induction ablation of malignant prostate tissue_ using data from previously performed magnetic resonance imaging (MRI) examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0738T","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue_ using data from previously performed magnetic resonance imaging (MRI) examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Clostridium difficile toxin A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87803","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Clostridium difficile toxin A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cefepime hcl for injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0692","description":"Cefepime hcl for injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0A","description":"Medium Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTD0","description":"ICD-NKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCF0","description":"ICD-NLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATA0","description":"ICD-IATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRB0","description":"ICD-GFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOF1","description":"ICD-OEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12A","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES344","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1248","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYC0","description":"ICD-HFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg <4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64892","description":"Nerve graft arm/leg <4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13B","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC217","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27306","description":"Incision of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove skin nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64788","description":"Remove skin nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUB1","description":"ICD-OLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGB1","description":"ICD-CGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWE0","description":"ICD-PEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPA0","description":"ICD-CIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin dispos pen 1.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5570","description":"Insulin dispos pen 1.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27445","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD245","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBD0","description":"ICD-CHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Giardia lamblia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86674","description":"Giardia lamblia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUD0","description":"ICD-GIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unskilled respitecare /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5151","description":"Unskilled respitecare /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9277","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","description":"HCPCS-J9277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4A","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPF1","description":"ICD-KAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bcg vaccine intravesical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90586","description":"Bcg vaccine intravesical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0901T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","description":"CPT-0901T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILD0","description":"ICD-FILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMD0","description":"ICD-OAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKC0","description":"ICD-JGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALA1","description":"ICD-BALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYB1","description":"ICD-OIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68325","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWB0","description":"ICD-GIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDF1","description":"ICD-IFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHME0","description":"ICD-NHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIE0","description":"ICD-GCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 52mg 3 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7297","description":"Levonorgestrel iu 52mg 3 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast prosthesis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8039","description":"Breast prosthesis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRA0","description":"ICD-LFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEID1","description":"ICD-MEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1343","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ each additional vessel or separate lesion_ normal or abnormal connections (List separately in addition to c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33904","description":"Percutaneous pulmonary artery revascularization by stent placement_ each additional vessel or separate lesion_ normal or abnormal connections (List separately in addition to c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCC1","description":"ICD-EGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTE1","description":"ICD-NDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBA0","description":"ICD-IIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcysteine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7604","description":"Acetylcysteine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANF1","description":"ICD-BANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDA0","description":"ICD-CEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5944","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5944","description":"CDT-D5944","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIA1","description":"ICD-JEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Right heart cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93451","description":"Right heart cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31780","description":"Reconstruct windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0804","description":"HCPCS-B0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef spec metabolic noninherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4154","description":"Ef spec metabolic noninherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA230","description":"Clinically Complex _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Systemic corticosteroids rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4135F","description":"Systemic corticosteroids rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRC0","description":"ICD-CFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0406","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0406","description":"CDT-D0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx esophageal unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9099","description":"Onc dx esophageal unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHE1","description":"ICD-FGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFID1","description":"ICD-CFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOC0","description":"ICD-DCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2186","description":"Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQB0","description":"ICD-DCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAD1","description":"ICD-CIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGE0","description":"ICD-JIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ romosozumab-aqqg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3111","description":"Injection_ romosozumab-aqqg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67145","description":"Treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24341","description":"Repair arm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYE0","description":"ICD-LHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Belt/harness extremity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0945","description":"Belt/harness extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYA0","description":"ICD-PGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBE0","description":"ICD-GCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC221","description":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIC0","description":"ICD-ACIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop follow-up visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99024","description":"Postop follow-up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76506","description":"Echo exam of head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWE0","description":"ICD-DHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise bile duct sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47460","description":"Incise bile duct sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurofilament light chain (NfL)_ ultra-sensitive immunoassay_ serum or cerebrospinal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0443U","description":"Neurofilament light chain (NfL)_ ultra-sensitive immunoassay_ serum or cerebrospinal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysterectomy/revise vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58280","description":"Hysterectomy/revise vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGB1","description":"ICD-FGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0B","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0903","description":"HCPCS-C0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBF1","description":"ICD-AHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft wrist bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25440","description":"Repair/graft wrist bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18G","description":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHF0","description":"ICD-FHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ disp_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5262","description":"Hearing aid_ disp_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWB0","description":"ICD-PLWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSD0","description":"ICD-LBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALE1","description":"ICD-KALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDD1","description":"ICD-EHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDA1","description":"ICD-KCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5946","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5946","description":"CDT-D5946","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSD0","description":"ICD-OGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAA0","description":"ICD-BGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELE0","description":"ICD-NELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11C","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gngvl flap w rootplan 1-3 th","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4241","description":"Gngvl flap w rootplan 1-3 th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEA1","description":"ICD-BCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFF0","description":"ICD-JEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQC1","description":"ICD-PKQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCE1","description":"ICD-KHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKA1","description":"ICD-OHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18A","description":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWB1","description":"ICD-LDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr any 30.1-60 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14301","description":"Tis trnfr any 30.1-60 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUA1","description":"ICD-CCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF)_ derived from augmentative algorithmic analysis of the dataset acquired via contrast cardia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0899T","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF)_ derived from augmentative algorithmic analysis of the dataset acquired via contrast cardia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6008","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33476","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4185","description":"Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTF1","description":"ICD-GFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Technetium tc99m arcitumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9568","description":"Technetium tc99m arcitumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSE0","description":"ICD-DFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRF1","description":"ICD-PLRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Slp stdy unatnd w/anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95801","description":"Slp stdy unatnd w/anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methylphenidate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80360","description":"Methylphenidate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28C","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16251","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPE1","description":"ICD-BFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound exam follow-up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76970","description":"Ultrasound exam follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOC0","description":"ICD-LHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Above knee hydracadence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5610","description":"Above knee hydracadence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC36","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCE1","description":"ICD-GBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Development Of The Treatment Plan_ Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2086","description":"Office-Based Treatment For Opioid Use Disorder_ Including Development Of The Treatment Plan_ Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGE1","description":"ICD-GFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKB0","description":"ICD-BHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPA1","description":"ICD-JGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fx distal radial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25606","description":"Treat fx distal radial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anaphylaxis due to the vaccine on or before the date of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1219","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab 10 mg and hyaluronidase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9311","description":"Injection_ rituximab 10 mg and hyaluronidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEE0","description":"ICD-NIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACE1","description":"ICD-AACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAC1","description":"ICD-NLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology Cardiac Specialist Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4002","description":"Electrophysiology Cardiac Specialist Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of a chlamydia screening test with proper follow-up","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9820","description":"Documentation of a chlamydia screening test with proper follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYC1","description":"ICD-GGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stress tte complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93351","description":"Stress tte complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISA1","description":"ICD-HISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCF0","description":"ICD-EDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dstrj extensive retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67227","description":"Dstrj extensive retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGD0","description":"ICD-CGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAA0","description":"ICD-OAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDD1","description":"ICD-MIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Donor lobectomy (lung)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2061","description":"Donor lobectomy (lung)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAC0","description":"ICD-CCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALC1","description":"ICD-JALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBA0","description":"ICD-FEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hard protect helmet custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8003","description":"Hard protect helmet custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0516T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transparent film <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6257","description":"Transparent film <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENF0","description":"ICD-FENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAE1","description":"ICD-MHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYD0","description":"ICD-HIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXF1","description":"ICD-FGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDME1","description":"ICD-NDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuragen nerve guide_ per cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9352","description":"Neuragen nerve guide_ per cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull for treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61770","description":"Incise skull for treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0302","description":"HCPCS-C0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin protect wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2604","description":"Skin protect wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCF1","description":"ICD-MGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPD0","description":"ICD-FFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cane adjust/fixed quad/3 pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0105","description":"Cane adjust/fixed quad/3 pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50974","description":"Ureter endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA60","description":"Low Rehab_ ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0515U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","description":"CPT-0515U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antithromb no presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8697","description":"Antithromb no presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC31","description":"ICD-1GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYF0","description":"ICD-DGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01234","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","description":"CPT-01234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAB0","description":"ICD-CFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVE1","description":"ICD-GHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHF0","description":"ICD-JFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUB0","description":"ICD-GHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compre dental tx adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8090","description":"Compre dental tx adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0998T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","description":"CPT-0998T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB135","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise & treat bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51020","description":"Incise & treat bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNB0","description":"ICD-KCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0642T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pancreatic cancer)_ multiplex immunoassay of C5_ C4_ cystatin C_ factor B_ osteoprotegerin (OPG)_ gelsolin_ IGFBP3_ CA125 and multiplex electrochemiluminescent imm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0342U","description":"Oncology (pancreatic cancer)_ multiplex immunoassay of C5_ C4_ cystatin C_ factor B_ osteoprotegerin (OPG)_ gelsolin_ IGFBP3_ CA125 and multiplex electrochemiluminescent imm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1A","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFB1","description":"ICD-BBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJF0","description":"ICD-GDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHE0","description":"ICD-EDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWA0","description":"ICD-HAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLE1","description":"ICD-JCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1087","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1295","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOB1","description":"ICD-PGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screen cerv/vag thin layer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0123","description":"Screen cerv/vag thin layer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDF1","description":"ICD-ECDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCF0","description":"ICD-NCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRC1","description":"ICD-OKRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve pedicle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64905","description":"Nerve pedicle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand restoration multiple fi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6905","description":"Hand restoration multiple fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot lamin/prepreg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3031","description":"Foot lamin/prepreg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0886T","description":"Sigmoidoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast prosthesis w adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8031","description":"Breast prosthesis w adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Power operated vehicle noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0812","description":"Power operated vehicle noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEE1","description":"ICD-GDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXC1","description":"ICD-GHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33365","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIF1","description":"ICD-KGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPB0","description":"ICD-JDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKE1","description":"ICD-BEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mitomycin pyelocalyceal instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9064","description":"Mitomycin pyelocalyceal instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARA0","description":"ICD-GARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of zinc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84630","description":"Assay of zinc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0701","description":"HCPCS-A0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA226","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release finger contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26525","description":"Release finger contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXC0","description":"ICD-KCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKF1","description":"ICD-KAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYC0","description":"ICD-CAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90476","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NFCT DS BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0202U","description":"NFCT DS BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEA1","description":"ICD-FHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18C","description":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Motion analysis video/3d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96000","description":"Motion analysis video/3d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid uptake measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78012","description":"Thyroid uptake measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXE1","description":"ICD-KBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc nhlstg 1-2 no relap no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9134","description":"Onc nhlstg 1-2 no relap no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIE0","description":"ICD-CFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telecare equipment installation and removal with training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W2025","description":"Telecare equipment installation and removal with training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx orbit w/manipulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21401","description":"Closed tx orbit w/manipulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWF1","description":"ICD-GGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEF0","description":"ICD-OGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00813","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","description":"CPT-00813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54060","description":"Excision of penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRB1","description":"ICD-LBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1313","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBC0","description":"ICD-ECBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUD0","description":"ICD-CGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pericard exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32661","description":"Thoracoscopy w/pericard exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMC1","description":"ICD-EAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-99470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","description":"CPT-99470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKD0","description":"ICD-CCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of skin abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10061","description":"Drainage of skin abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB224","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj tendon sheath/ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20550","description":"Inj tendon sheath/ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)_ including placement of a new ele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0520T","description":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)_ including placement of a new ele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit periorbt w/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21395","description":"Opn tx orbit periorbt w/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJA0","description":"ICD-BCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient  compression arm sleeve and glove combination_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6575","description":"Gradient  compression arm sleeve and glove combination_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALD0","description":"ICD-KALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTB1","description":"ICD-OGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1165","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPB0","description":"ICD-KAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization counseling by a physician or other qualified health care professional for COVID-19_ ages under 21_ 5-15 minutes time (This code is used for the Medicaid EPSDT)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0315","description":"Immunization counseling by a physician or other qualified health care professional for COVID-19_ ages under 21_ 5-15 minutes time (This code is used for the Medicaid EPSDT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFME0","description":"ICD-KFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHD0","description":"ICD-BAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc active inj drug use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9518","description":"Doc active inj drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEF1","description":"ICD-ECEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGC0","description":"ICD-OAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPF0","description":"ICD-NKPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine proces distract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171T","description":"Lumbar spine proces distract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L5827","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","description":"HCPCS-L5827","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22C","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXE0","description":"ICD-CAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLE0","description":"ICD-IGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKC0","description":"ICD-NLKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGD1","description":"ICD-NJGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIB0","description":"ICD-MDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPA0","description":"ICD-BDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWB1","description":"ICD-DBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pet image w/ct skull-thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78815","description":"Pet image w/ct skull-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Polysom 6/> yrs 4/> param","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95810","description":"Polysom 6/> yrs 4/> param","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQF1","description":"ICD-DBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKC1","description":"ICD-BGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOA1","description":"ICD-PFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCB0","description":"ICD-GDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1C","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBE1","description":"ICD-JHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treprostinil injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3285","description":"Treprostinil injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHB0","description":"ICD-FFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFF0","description":"ICD-JHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56151","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53620","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace pretibial shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4130","description":"Replace pretibial shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYD1","description":"ICD-CIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had a suicide safety plan initiated_ reviewed_ or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1351","description":"Patients who had a suicide safety plan initiated_ reviewed_ or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25645","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBF0","description":"ICD-EBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor ix ptc/chrstmas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85250","description":"Clot factor ix ptc/chrstmas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA217","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEE0","description":"ICD-OJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2930","description":"Methylprednisolone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDE0","description":"ICD-ODDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWB0","description":"ICD-CGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress forearm 1 space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25023","description":"Decompress forearm 1 space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVF1","description":"ICD-BBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATE1","description":"ICD-OATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-medical Transportation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6110","description":"Non-medical Transportation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRE1","description":"ICD-KDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15B","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBA1","description":"ICD-ABBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHA1","description":"ICD-MDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML50","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 30-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0516","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 30-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVF1","description":"ICD-CHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Combo ankle/foot prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5975","description":"Combo ankle/foot prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHA0","description":"ICD-NDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABA1","description":"ICD-KABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFD1","description":"ICD-CDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artacent wound_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4169","description":"Artacent wound_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orphenadrine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2360","description":"Orphenadrine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant semi-imp hear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2230","description":"Implant semi-imp hear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMB1","description":"ICD-AEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUB1","description":"ICD-ECUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTF1","description":"ICD-EDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAD1","description":"ICD-EBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHF0","description":"ICD-MJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0103","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0103","description":"CDT-D0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTD0","description":"ICD-OCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/ove","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2206","description":"Lens sphcy bifocal 4.00d/ove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore parathyroid glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60500","description":"Explore parathyroid glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACME0","description":"ICD-ACME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroejaculation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55870","description":"Electroejaculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES220","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0267T","description":"Implt/rpl crtd sns dev lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65875","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLA1","description":"ICD-MBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescrl fuse w/ instr l4/l5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0309T","description":"Prescrl fuse w/ instr l4/l5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht pharm per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9810","description":"Ht pharm per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNC1","description":"ICD-NHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Above knee surgical stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4490","description":"Above knee surgical stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHC0","description":"ICD-AFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWF0","description":"ICD-DEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTB0","description":"ICD-MJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQC1","description":"ICD-OBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cogenex Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4229","description":"Cogenex Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQA1","description":"ICD-HHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJF1","description":"ICD-NGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPA1","description":"ICD-KDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60100","description":"Biopsy of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWD1","description":"ICD-GFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56640","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brief (20 minutes) in-home visit for a new patient post-discharge.  For use only in a Medicare-appro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2001","description":"Brief (20 minutes) in-home visit for a new patient post-discharge.  For use only in a Medicare-appro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fosaprepitant (focinvez)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1434","description":"Injection_ fosaprepitant (focinvez)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBF1","description":"ICD-OGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRD0","description":"ICD-DGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23C","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENF0","description":"ICD-GENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart infarct image (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78469","description":"Heart infarct image (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD106","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko w/0 joint rigid molded to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1834","description":"Ko w/0 joint rigid molded to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEB0","description":"ICD-NDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who have a diagnosis of pregnancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9778","description":"Patients who have a diagnosis of pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUD0","description":"ICD-MGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHC1","description":"ICD-GGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Advanced life support mileag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0390","description":"Advanced life support mileag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visual audiometry (vra)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92579","description":"Visual audiometry (vra)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Larynscop remve cart + scop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31561","description":"Larynscop remve cart + scop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54500","description":"Biopsy of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPF1","description":"ICD-NKPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE204","description":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFF1","description":"ICD-NEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental bitewing single film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0270","description":"Dental bitewing single film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUD1","description":"ICD-BCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA144","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tail bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27080","description":"Removal of tail bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65400","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","description":"CPT-98014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99336","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44346","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart image (pet) single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78491","description":"Heart image (pet) single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin (lyumjev) for administration through dme (i.e._ insulin pump) per 50 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1813","description":"Insulin (lyumjev) for administration through dme (i.e._ insulin pump) per 50 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gauze > 48 in no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6224","description":"Gauze > 48 in no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post fusion 13/> vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22804","description":"Post fusion 13/> vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCE1","description":"ICD-IFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tcranial magn stim tx deli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90868","description":"Tcranial magn stim tx deli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhcp-serv of ot_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0152","description":"Hhcp-serv of ot_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic control band & belt u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2630","description":"Pelvic control band & belt u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20604","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILD1","description":"ICD-JILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNF0","description":"ICD-JDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIME1","description":"ICD-AIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNA1","description":"ICD-BHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8H","description":"High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKA1","description":"ICD-GCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAD1","description":"ICD-KDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA11","description":"ICD-1BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYA1","description":"ICD-LBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJA0","description":"ICD-GIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX01","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBE1","description":"ICD-OJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1089","description":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEC1","description":"ICD-KGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWC0","description":"ICD-GIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPA1","description":"ICD-FEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Integrated keratoprosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1818","description":"Integrated keratoprosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVD0","description":"ICD-JDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWF1","description":"ICD-PGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ famotidine_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0028","description":"Injection_ famotidine_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit 2.5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12041","description":"Intmd rpr n-hf/genit 2.5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMC0","description":"ICD-FBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESA0","description":"ICD-CESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental recement crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2920","description":"Dental recement crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unipuncture control system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1580","description":"Unipuncture control system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVB0","description":"ICD-CGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace socket below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5700","description":"Replace socket below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81405","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWA1","description":"ICD-CCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2001","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2001","description":"CDT-D2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement blood pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1620","description":"Replacement blood pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHME1","description":"ICD-EHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOE0","description":"ICD-OGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGA0","description":"ICD-GGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMA1","description":"ICD-JDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAE1","description":"ICD-CGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso flex custom fab thoraci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0452","description":"Tlso flex custom fab thoraci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc type nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9289","description":"Doc type nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDA0","description":"ICD-FFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHC1","description":"ICD-CGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAB1","description":"ICD-NJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"XK GNOTYP XK EXONS 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0200U","description":"XK GNOTYP XK EXONS 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINF0","description":"ICD-CINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36583","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer ultrasonic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0575","description":"Nebulizer ultrasonic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61330","description":"Decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFC0","description":"ICD-FEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB11","description":"ICD-3IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLA1","description":"ICD-MCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUE1","description":"ICD-NKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable endoscope sheath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4270","description":"Disposable endoscope sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDE0","description":"ICD-AHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35881","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOF1","description":"ICD-HGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEC0","description":"ICD-BAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOF1","description":"ICD-PFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFC1","description":"ICD-JBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMA0","description":"ICD-GGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAF1","description":"ICD-AEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITF1","description":"ICD-GITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc chro sin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9607","description":"Perc d-e cor revasc chro sin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDE1","description":"ICD-OCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECD1","description":"ICD-KECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood thymol turbidity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2033","description":"Blood thymol turbidity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQC1","description":"ICD-CDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB31","description":"ICD-4CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fem focal defic constant fri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5230","description":"Fem focal defic constant fri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Participant-Directed Goods and Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1901","description":"Participant-Directed Goods and Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66850","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leuprolide acetate implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9219","description":"Leuprolide acetate implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEED0","description":"ICD-CEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPB0","description":"ICD-KGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELB0","description":"ICD-OELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay serum cholinesterase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82480","description":"Assay serum cholinesterase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; first 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96136","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reoperation carotid add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35390","description":"Reoperation carotid add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ nerve(s) and accompanying structures throughout their entire anatomic course in one extremity_ comprehensive_ including real-time cine imaging with image documenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76883","description":"Ultrasound_ nerve(s) and accompanying structures throughout their entire anatomic course in one extremity_ comprehensive_ including real-time cine imaging with image documenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPF1","description":"ICD-JEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antithromb no presc no reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8698","description":"Antithromb no presc no reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICB1","description":"ICD-EICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQE0","description":"ICD-OCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJF0","description":"ICD-BEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEA0","description":"ICD-MKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDF0","description":"ICD-MFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXA0","description":"ICD-NLXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25685","description":"Treat wrist fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ viltolarsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9071","description":"Injection_ viltolarsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJC0","description":"ICD-BFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smoking cessation class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9453","description":"Smoking cessation class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKB1","description":"ICD-FCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score hip < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8652","description":"Fun stat score hip < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace ureter by bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50840","description":"Replace ureter by bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFB0","description":"ICD-OEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone 40 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1030","description":"Methylprednisolone 40 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISF1","description":"ICD-PISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd optical endomicroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43252","description":"Egd optical endomicroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 50 mcg/0.5 mL dosage_ for int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91309","description":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 50 mcg/0.5 mL dosage_ for int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFF1","description":"ICD-CAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscop w/arytenoidectom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31560","description":"Laryngoscop w/arytenoidectom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMA0","description":"ICD-BEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Card MRI veloc flow mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75565","description":"Card MRI veloc flow mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk waist belt padded and lin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5690","description":"Bk waist belt padded and lin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXD1","description":"ICD-JHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXD0","description":"ICD-OLXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation Medicine (Allograft Rejection_ Pediatric Liver And Small Bowel)_ Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells_ Utilizing Whole P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81560","description":"Transplantation Medicine (Allograft Rejection_ Pediatric Liver And Small Bowel)_ Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells_ Utilizing Whole P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGE1","description":"ICD-NJGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dna antibody native","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86225","description":"Dna antibody native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIED1","description":"ICD-KIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repriza_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4143","description":"Repriza_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMD0","description":"ICD-EEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXC0","description":"ICD-BEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOA0","description":"ICD-GBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients on active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1268","description":"Patients on active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert heart pm ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33207","description":"Insert heart pm ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQB0","description":"ICD-OHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test thor paraspinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95869","description":"Muscle test thor paraspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC44","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy gastrostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43653","description":"Laparoscopy gastrostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bone lower jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21025","description":"Excision of bone lower jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 4.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2300","description":"Lens sphere trifocal 4.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRF0","description":"ICD-OKRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTB0","description":"ICD-CFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXB1","description":"ICD-FDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOE0","description":"ICD-PHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJD1","description":"ICD-NHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRE1","description":"ICD-OCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epsd bk pain for >6 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1135F","description":"Epsd bk pain for >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (genetic platelet disorders)_ genomic sequence analysis of 43 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Comprehensive Platelet Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0274U","description":"Hematology (genetic platelet disorders)_ genomic sequence analysis of 43 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Comprehensive Platelet Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0405","description":"HCPCS-A0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDD0","description":"ICD-ECDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFC1","description":"ICD-NJFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKF1","description":"ICD-CBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpretation required","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36907","description":"Transluminal balloon angioplasty_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpretation required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0514","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Minocycline hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2265","description":"Minocycline hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERF1","description":"ICD-GERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETA1","description":"ICD-GETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCD1","description":"ICD-MKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRB1","description":"ICD-GIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPA1","description":"ICD-OGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVF0","description":"ICD-FCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVF1","description":"ICD-KAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD256","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0557U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","description":"CPT-0557U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPD0","description":"ICD-NEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVE1","description":"ICD-ODVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5167","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5167","description":"HCPCS-Q5167","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYC0","description":"ICD-OJYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1103T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1103T","description":"CPT-1103T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYB1","description":"ICD-PGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostectomy_ partial_ exostectomy or condylectomy_ metatarsal head_ each meta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3052F","description":"Ostectomy_ partial_ exostectomy or condylectomy_ metatarsal head_ each meta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Positron emission tomography radiopharmaceutical_ diagnostic_ for non-tumor identification_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9598","description":"Positron emission tomography radiopharmaceutical_ diagnostic_ for non-tumor identification_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Transcriptome Sequencing Of Paired Malignant And Normal Rna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0298U","description":"Oncology (Pan Tumor)_ Whole Transcriptome Sequencing Of Paired Malignant And Normal Rna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap inc hern repair comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49655","description":"Lap inc hern repair comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA131","description":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87626","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","description":"CPT-87626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home std case rate 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0270","description":"Home std case rate 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6751","description":"Crown porcelain base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood/lymph nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78199","description":"Blood/lymph nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC246","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQD1","description":"ICD-HIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair hand joint with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26542","description":"Repair hand joint with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dalbavancin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0875","description":"Injection_ dalbavancin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDD0","description":"ICD-FFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQA0","description":"ICD-HFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMA0","description":"ICD-CBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFC0","description":"ICD-BGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63271","description":"Excise intrspinl lesion thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zoster (shingles) vaccine (HZV)_ recombinant_ sub-unit_ adjuvanted_ for intramuscular injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90750","description":"Zoster (shingles) vaccine (HZV)_ recombinant_ sub-unit_ adjuvanted_ for intramuscular injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSB1","description":"ICD-LHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCA0","description":"ICD-EHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair nonunion carpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25431","description":"Repair nonunion carpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ amivantamab-vmjw_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9061","description":"Injection_ amivantamab-vmjw_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMF1","description":"ICD-IEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor IX_ albumin fusion protein (recombinant)_ Idelvion_ 1 i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9139","description":"Injection_ Factor IX_ albumin fusion protein (recombinant)_ Idelvion_ 1 i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSC0","description":"ICD-HHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doxorubicin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9000","description":"Doxorubicin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRE0","description":"ICD-CCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSE1","description":"ICD-KDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25526","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIE0","description":"ICD-ABIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTF1","description":"ICD-AGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat elevation sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2300","description":"Pwr seat elevation sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2040","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","description":"HCPCS-A2040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91111","description":"Esophageal capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINC1","description":"ICD-JINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hypnotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90880","description":"Hypnotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUD0","description":"ICD-FEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENE0","description":"ICD-CENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HPYLORI STOOL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87338","description":"IAAD IA HPYLORI STOOL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLE1","description":"ICD-OGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPF0","description":"ICD-NFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion/graft of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24802","description":"Fusion/graft of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93151","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resp virus 6-11 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87632","description":"Resp virus 6-11 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEA0","description":"ICD-FBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIND1","description":"ICD-OIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bendamustine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9033","description":"Bendamustine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA31","description":"ICD-2JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBED1","description":"ICD-JBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBC1","description":"ICD-NEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVE0","description":"ICD-JEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28546","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8H","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMC1","description":"ICD-BHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAME0","description":"ICD-KAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFME1","description":"ICD-FFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOD1","description":"ICD-CFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQF0","description":"ICD-PIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAF0","description":"ICD-ACAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy/lung bx each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31628","description":"Bronchoscopy/lung bx each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJF1","description":"ICD-OLJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOE0","description":"ICD-OLOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWC1","description":"ICD-PFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve annulus reconstruction_ with implantation of adjustable annulus reconstruction device_ percutaneous approach including transseptal puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0544T","description":"Transcatheter mitral valve annulus reconstruction_ with implantation of adjustable annulus reconstruction device_ percutaneous approach including transseptal puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEA0","description":"ICD-AEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oocyte identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89254","description":"Oocyte identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDE1","description":"ICD-BIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7564","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7564","description":"HCPCS-C7564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9822","description":"Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB104","description":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLD0","description":"ICD-IBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87182","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","description":"CPT-87182","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRA0","description":"ICD-LCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4431","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","description":"HCPCS-Q4431","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMC1","description":"ICD-NLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUB1","description":"ICD-KDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSD0","description":"ICD-PCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pantoprazole (Hikma)_ not therapeutically equivalent to J2470_ 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2471","description":"Injection_ pantoprazole (Hikma)_ not therapeutically equivalent to J2470_ 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACB0","description":"ICD-BACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumb artif diskectomy addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0163T","description":"Lumb artif diskectomy addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1813","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","description":"HCPCS-E1813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Symes type poster opening so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5634","description":"Symes type poster opening so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92235","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of skull & brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62145","description":"Repair of skull & brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES356","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0106U","description":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect back tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21936","description":"Resect back tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug hotline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0030","description":"Alcohol and/or drug hotline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRF0","description":"ICD-KGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aor-celiac-msn-renal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35631","description":"Art byp aor-celiac-msn-renal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHD1","description":"ICD-CGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDE1","description":"ICD-IIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOE0","description":"ICD-LIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo w/ankle joint_ prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1971","description":"Afo w/ankle joint_ prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhc lpn/rn obs/asses ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0163","description":"Hhc lpn/rn obs/asses ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser tx skin 250-500 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96921","description":"Laser tx skin 250-500 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dolasetron mesylate oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0180","description":"Dolasetron mesylate oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOC1","description":"ICD-OCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Creatine isoforms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82554","description":"Creatine isoforms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient receiving hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9690","description":"Patient receiving hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enterostomal therapy by a re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9474","description":"Enterostomal therapy by a re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLD1","description":"ICD-JHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Battery cables","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4612","description":"Battery cables","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Language screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5363","description":"Language screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXE1","description":"ICD-NIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"U2Af1 (U2 Small Nuclear Rna Auxiliary Factor 1) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ S34F_ S34Y_ Q157R_ Q157P)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81357","description":"U2Af1 (U2 Small Nuclear Rna Auxiliary Factor 1) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ S34F_ S34Y_ Q157R_ Q157P)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFC0","description":"ICD-BFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBD0","description":"ICD-OCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYA1","description":"ICD-ODYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQD1","description":"ICD-OKQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUB1","description":"ICD-BGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28B","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAE1","description":"ICD-EDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR MoAb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9840","description":"RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR MoAb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRD0","description":"ICD-HCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHD0","description":"ICD-IFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0477","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEC0","description":"ICD-NBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRB0","description":"ICD-LBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOC1","description":"ICD-OHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL22","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLA1","description":"ICD-IBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pet image skull-thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78812","description":"Pet image skull-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHC0","description":"ICD-JGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE126","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Norsn no dicom format doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9329","description":"Norsn no dicom format doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prehensile actuator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7040","description":"Prehensile actuator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJA0","description":"ICD-JEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSB0","description":"ICD-GFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15C","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBA0","description":"ICD-IHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWA1","description":"ICD-PIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTF1","description":"ICD-CFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES160","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUD0","description":"ICD-IDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (asceniv)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9072","description":"Injection_ immune globulin (asceniv)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE141","description":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antiviral not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9244","description":"Antiviral not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt brain chemotx add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61517","description":"Implt brain chemotx add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK_ BRAF_ EGFR_ ERBB2_ MET_ NTRK1-3_ RET_ ROS1)_ and KRAS G12C and PD-L1_ if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0414U","description":"Oncology (lung)_ augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK_ BRAF_ EGFR_ ERBB2_ MET_ NTRK1-3_ RET_ ROS1)_ and KRAS G12C and PD-L1_ if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERD1","description":"ICD-HERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECF0","description":"ICD-EECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small disposable underpad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4542","description":"Small disposable underpad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXB0","description":"ICD-GIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYF0","description":"ICD-PDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGC0","description":"ICD-GFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHF1","description":"ICD-BFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKE1","description":"ICD-FFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA201","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crisis intervention mental h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9485","description":"Crisis intervention mental h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory bp recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93786","description":"Ambulatory bp recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLC0","description":"ICD-EFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kyphosis pad floating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1025","description":"Kyphosis pad floating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subfas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0819T","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subfas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML13","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLA1","description":"ICD-BDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLB0","description":"ICD-KFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECD1","description":"ICD-JECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA52","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEA1","description":"ICD-OIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27703","description":"Reconstruction ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADF1","description":"ICD-AADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47780","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMD0","description":"ICD-JHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICB0","description":"ICD-AICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27501","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSE1","description":"ICD-CGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEE0","description":"ICD-JFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1102","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1102","description":"CDT-D1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spontaneous nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92541","description":"Spontaneous nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJD1","description":"ICD-FFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15D","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB140","description":"Special Care Low _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHD0","description":"ICD-OGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGC1","description":"ICD-BGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9392","description":"Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFA1","description":"ICD-JHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0350U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDB0","description":"ICD-NEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ esophageal sphincter augmentation procedure_ placement of sphincter augmentation device (ie_ magnetic band)_ including cruroplasty when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43284","description":"Laparoscopy_ surgical_ esophageal sphincter augmentation procedure_ placement of sphincter augmentation device (ie_ magnetic band)_ including cruroplasty when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Above knee wood socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5644","description":"Above knee wood socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25D","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTF1","description":"ICD-NLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antiepileptics nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80339","description":"Antiepileptics nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBF0","description":"ICD-IHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDC1","description":"ICD-OCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dextranomer/hyaluronic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8604","description":"Dextranomer/hyaluronic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35321","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGA1","description":"ICD-BIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCA0","description":"ICD-OHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWE0","description":"ICD-GCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKC0","description":"ICD-KBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABC0","description":"ICD-GABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42320","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKC1","description":"ICD-FDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKE0","description":"ICD-KHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENF0","description":"ICD-KENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cabg w/o pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56651","description":"Anesth cabg w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABC1","description":"ICD-CABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot plate molded stirrup at","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2250","description":"Foot plate molded stirrup at","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ dual focus_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2525","description":"Contact lens_ hydrophilic_ dual focus_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0503","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0503","description":"CDT-D0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQB1","description":"ICD-DBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMA1","description":"ICD-IDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cptr-asst dir ms px","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20985","description":"Cptr-asst dir ms px","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS)_ bone-density study and fracture-risk assessment_ 1 or more sites_ hips_ pelvis_ or spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0815T","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS)_ bone-density study and fracture-risk assessment_ 1 or more sites_ hips_ pelvis_ or spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc to have fall in asc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8910","description":"Pt doc to have fall in asc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec hand ind art digits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6880","description":"Elec hand ind art digits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXB1","description":"ICD-GDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47555","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRC1","description":"ICD-GHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2098","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLA1","description":"ICD-JBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove renal tube w/fluoro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50389","description":"Remove renal tube w/fluoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQE0","description":"ICD-PAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAC1","description":"ICD-GFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB46","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUE0","description":"ICD-BGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUB0","description":"ICD-NEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA07","description":"Very High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64680","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVB0","description":"ICD-JAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACD0","description":"ICD-OACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLB0","description":"ICD-OFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25375","description":"Revise radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBA1","description":"ICD-AGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPD1","description":"ICD-KEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tot contact ak/knee disart s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5650","description":"Tot contact ak/knee disart s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYF1","description":"ICD-PAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fremanezumab-vfrm_ 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician_ not for use when drug is self-administere","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3031","description":"Injection_ fremanezumab-vfrm_ 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician_ not for use when drug is self-administere","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADE1","description":"ICD-OADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSD1","description":"ICD-KGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITF0","description":"ICD-IITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA17","description":"Default_ /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYD1","description":"ICD-PBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUD0","description":"ICD-JDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEE0","description":"ICD-EAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX17","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20C","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1421","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","description":"HCPCS-M1421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGME1","description":"ICD-JGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPD0","description":"ICD-BIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEC0","description":"ICD-NCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQF0","description":"ICD-PKQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Jaw arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29804","description":"Jaw arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hd trapeze bar attach to bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0911","description":"Hd trapeze bar attach to bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBF0","description":"ICD-ECBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Com wrap-around sv_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2021","description":"Com wrap-around sv_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGE0","description":"ICD-BHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAC1","description":"ICD-IFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKA0","description":"ICD-CDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUC1","description":"ICD-ODUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA26","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYA0","description":"ICD-KIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITC0","description":"ICD-NITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCB0","description":"ICD-MHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLF1","description":"ICD-JDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHD0","description":"ICD-IDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-invasive vagus nerve stimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0735","description":"Non-invasive vagus nerve stimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFA1","description":"ICD-JAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEF1","description":"ICD-IAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens_ 1.54-1.65 p/1.60-1.79g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2782","description":"Lens_ 1.54-1.65 p/1.60-1.79g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNC1","description":"ICD-BHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01320","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","description":"CPT-01320","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIA1","description":"ICD-JIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNF0","description":"ICD-FBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18E","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of amputation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24935","description":"Revision of amputation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neurostim arrays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61886","description":"Implant neurostim arrays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct lower extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73700","description":"Ct lower extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIA0","description":"ICD-EEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen concentrator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1390","description":"Oxygen concentrator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8497","description":"Cabg meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEA1","description":"ICD-ICEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEE0","description":"ICD-CIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICA0","description":"ICD-MICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJF0","description":"ICD-KHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0929T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","description":"CPT-0929T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assessment for hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5010","description":"Assessment for hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKD1","description":"ICD-KEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asser com tx face-face/15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0039","description":"Asser com tx face-face/15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11B","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOD1","description":"ICD-HIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHE1","description":"ICD-EHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus (SARS-CoV-2) (coronavirus disease [COVID-19]) mutation identification in targeted region(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87913","description":"Severe acute respiratory syndrome coronavirus (SARS-CoV-2) (coronavirus disease [COVID-19]) mutation identification in targeted region(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA151","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48145","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPD1","description":"ICD-NHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMD0","description":"ICD-KIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOD1","description":"ICD-OBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9819","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTA1","description":"ICD-NKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amobarbital 125 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0300","description":"Amobarbital 125 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVC0","description":"ICD-CGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76017","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","description":"CPT-76017","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHA1","description":"ICD-IBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSC0","description":"ICD-GHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQE0","description":"ICD-CIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA32","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Norsn no ct rpt to reg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9326","description":"Norsn no ct rpt to reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methylenedioxyamphetamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80359","description":"Methylenedioxyamphetamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0682U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682U","description":"CPT-0682U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00865","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","description":"CPT-00865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anidulafungin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0348","description":"Anidulafungin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKC0","description":"ICD-KGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAB1","description":"ICD-KBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRD0","description":"ICD-LBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVD0","description":"ICD-NLVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFD0","description":"ICD-CEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin chromotography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83021","description":"Hemoglobin chromotography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy forearm soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25065","description":"Biopsy forearm soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOA0","description":"ICD-GHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transection or ligation_ carotid artery in cavernous sinus_ with repair by anastomosis or graft (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61610","description":"Transection or ligation_ carotid artery in cavernous sinus_ with repair by anastomosis or graft (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD244","description":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manipulation of spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22505","description":"Manipulation of spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPE1","description":"ICD-GHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Paramed intrcept nonvol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0208","description":"Paramed intrcept nonvol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; HIV-1 antigen(s)_ with HIV-1 and HIV-2 antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87806","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; HIV-1 antigen(s)_ with HIV-1 and HIV-2 antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repr elbw med ligmnt w/tissu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24345","description":"Repr elbw med ligmnt w/tissu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDC1","description":"ICD-ADDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVD1","description":"ICD-JBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPA0","description":"ICD-OKPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOB1","description":"ICD-OIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDD0","description":"ICD-JCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath impl vasc access portal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4300","description":"Cath impl vasc access portal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vasopressin_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2598","description":"Injection_ vasopressin_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAC0","description":"ICD-GAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMF1","description":"ICD-GFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQB1","description":"ICD-GFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGME0","description":"ICD-AGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCB1","description":"ICD-BHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Axolotl ambient or axolotl cryo_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4215","description":"Axolotl ambient or axolotl cryo_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0850","description":"Pwc gp 3 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWE1","description":"ICD-PCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cessj therapy cath removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37214","description":"Cessj therapy cath removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2A","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Yersinia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86793","description":"Yersinia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect face/scalp tum 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21016","description":"Resect face/scalp tum 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAA1","description":"ICD-ABAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9810","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9810","description":"HCPCS-C9810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ docetaxel (ingenus) not therapeutically equivalent to j9171_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9172","description":"Injection_ docetaxel (ingenus) not therapeutically equivalent to j9171_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen probe used w oximeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4606","description":"Oxygen probe used w oximeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of pyloric muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43520","description":"Incision of pyloric muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46751","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMB1","description":"ICD-JFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26060","description":"Incision of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1299","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","description":"HCPCS-J1299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALF1","description":"ICD-KALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJD0","description":"ICD-CGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRD1","description":"ICD-OHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB43","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHB1","description":"ICD-JIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cocaine hydrochloride nasal solution (numbrino)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9143","description":"Cocaine hydrochloride nasal solution (numbrino)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPA1","description":"ICD-KBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cultured chondrocytes implnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7330","description":"Cultured chondrocytes implnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUD1","description":"ICD-JAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermavest_ plurivest sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4153","description":"Dermavest_ plurivest sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93970","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFB0","description":"ICD-JCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYE0","description":"ICD-DGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYD1","description":"ICD-ODYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIC0","description":"ICD-NIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGF0","description":"ICD-KBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Safety concerns screen provided and negative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9923","description":"Safety concerns screen provided and negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening oxycodone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80365","description":"Drug screening oxycodone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grade 2 or above diarrhea and/or grade 2 or above colitis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1181","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC236","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLF1","description":"ICD-IFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01714","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","description":"CPT-01714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELF1","description":"ICD-AELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADB0","description":"ICD-FADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impact tooth remov part bony","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7230","description":"Impact tooth remov part bony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYF0","description":"ICD-HFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEC0","description":"ICD-ACEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUE1","description":"ICD-GFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSE1","description":"ICD-LCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVD1","description":"ICD-OHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQC0","description":"ICD-HGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0503","description":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0618","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","description":"HCPCS-J0618","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87811","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC20","description":"Very High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27097","description":"Revision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid met imaging body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78018","description":"Thyroid met imaging body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLC1","description":"ICD-GCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIA0","description":"ICD-MHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQA0","description":"ICD-PGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJB1","description":"ICD-CAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVE0","description":"ICD-CDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cannabinoid synthetic 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80352","description":"Cannabinoid synthetic 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFC1","description":"ICD-NAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23545","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumizyme injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0221","description":"Lumizyme injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGF0","description":"ICD-KDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oversize lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2780","description":"Oversize lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Power module combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0479","description":"Power module combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis Of Schizophrenia_ Schizoaffective Disorder_ Or Bipolar Disorder On Or Between January 1 Of The","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0032","description":"Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis Of Schizophrenia_ Schizoaffective Disorder_ Or Bipolar Disorder On Or Between January 1 Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEC1","description":"ICD-EIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"XCellerate_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4234","description":"XCellerate_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQF1","description":"ICD-GHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGF1","description":"ICD-KFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove in/ex hem grp & fiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46257","description":"Remove in/ex hem grp & fiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0930T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","description":"CPT-0930T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFA1","description":"ICD-CDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnio-Maxx or Amnio Maxx Lite_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4239","description":"Amnio-Maxx or Amnio Maxx Lite_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGB0","description":"ICD-BCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFD1","description":"ICD-OEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cool quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0108T","description":"Cool quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUB1","description":"ICD-MFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJF0","description":"ICD-OFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC136","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epieffect_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4278","description":"Epieffect_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCC0","description":"ICD-ACCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46700","description":"Repair of anal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No vis inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9630","description":"No vis inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFD0","description":"ICD-KIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE136","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTA1","description":"ICD-AGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPE1","description":"ICD-NIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAA0","description":"ICD-IGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJB1","description":"ICD-KAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Streptozocin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9320","description":"Streptozocin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC23","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4368","description":"Ostomy filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVC0","description":"ICD-CFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit for hemodialysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99512","description":"Home visit for hemodialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPD1","description":"ICD-KDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLA0","description":"ICD-GGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUD0","description":"ICD-IHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTF0","description":"ICD-NJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFD1","description":"ICD-CBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE244","description":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle w/suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67334","description":"Revise eye muscle w/suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33369","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA113","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVA0","description":"ICD-JDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA106","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERE0","description":"ICD-LERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTC1","description":"ICD-EGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYF0","description":"ICD-KGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide (ingenus)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9073","description":"Injection_ cyclophosphamide (ingenus)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx contour defects 1 cc/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11950","description":"Tx contour defects 1 cc/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trimethobenzamide hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3250","description":"Trimethobenzamide hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOD0","description":"ICD-DEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBF1","description":"ICD-ODBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18B","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABF1","description":"ICD-FABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ctlso milwauke initial model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1000","description":"Ctlso milwauke initial model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient  compression arm sleeve_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6578","description":"Gradient  compression arm sleeve_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us transrectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76872","description":"Us transrectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert pulse gen dual leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33213","description":"Insert pulse gen dual leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/3+ post-op nausea&vom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4556F","description":"Pt w/3+ post-op nausea&vom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove elbow bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24138","description":"Remove elbow bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung transplant single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32851","description":"Lung transplant single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDA0","description":"ICD-AEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optx thigh fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27269","description":"Optx thigh fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct chest spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72128","description":"Ct chest spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct lwr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73702","description":"Ct lwr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise abdomen-venous shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49426","description":"Revise abdomen-venous shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBF0","description":"ICD-BDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHC1","description":"ICD-NJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCC1","description":"ICD-IBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00604","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","description":"CPT-00604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD246","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRD0","description":"ICD-PCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8H","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of intranasal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30118","description":"Removal of intranasal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPB0","description":"ICD-FGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICB1","description":"ICD-GICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"C-1 esterase_ cinryze","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0598","description":"C-1 esterase_ cinryze","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGE0","description":"ICD-FFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plasma 1 donor frz w/in 8 hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9017","description":"Plasma 1 donor frz w/in 8 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFC1","description":"ICD-JEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Augmentation lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21127","description":"Augmentation lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interprof phone/online 11-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99447","description":"Interprof phone/online 11-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUB1","description":"ICD-GFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFF1","description":"ICD-GCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cognit impairment assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3720F","description":"Cognit impairment assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERE1","description":"ICD-PERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOF1","description":"ICD-OBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVC0","description":"ICD-GHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUF0","description":"ICD-OHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPF0","description":"ICD-GIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKB1","description":"ICD-JCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQA1","description":"ICD-CBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIA1","description":"ICD-EAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5211","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEND1","description":"ICD-JEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYC0","description":"ICD-OLYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC51","description":"Medium Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFA1","description":"ICD-NHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sitz bath chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0162","description":"Sitz bath chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt not on statin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9508","description":"Doc pt not on statin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIF1","description":"ICD-ODIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0104","description":"HCPCS-B0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct head/brain w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70450","description":"Ct head/brain w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NeoPatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4176","description":"NeoPatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63047","description":"Remove spine lamina 1 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHC0","description":"ICD-MDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUB1","description":"ICD-GGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement facemask interfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7031","description":"Replacement facemask interfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"T cell absolute count/ratio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86360","description":"T cell absolute count/ratio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEE0","description":"ICD-FFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traction frame attach pelvic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0890","description":"Traction frame attach pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice in snf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5004","description":"Hospice in snf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANC0","description":"ICD-OANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHF1","description":"ICD-MCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMD1","description":"ICD-ACMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE246","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18D","description":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFC0","description":"ICD-NAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUE0","description":"ICD-JFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins lt atrl mont pres lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0294T","description":"Ins lt atrl mont pres lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQB0","description":"ICD-GEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATF1","description":"ICD-IATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8B","description":"Medium Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External bleaching home app","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9975","description":"External bleaching home app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALA0","description":"ICD-FALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis_ each comparator genome (eg_ parents_ siblings)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0425U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis_ each comparator genome (eg_ parents_ siblings)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTA0","description":"ICD-OKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFB1","description":"ICD-CCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin intermed 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5552","description":"Insulin intermed 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cataract mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8765","description":"Cataract mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABED1","description":"ICD-ABED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEA1","description":"ICD-NEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPD0","description":"ICD-JAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavior identification assessment_ administered by a physician or other qualified health care professional_ each 15 minutes of the physician_s or other qualified health care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97151","description":"Behavior identification assessment_ administered by a physician or other qualified health care professional_ each 15 minutes of the physician_s or other qualified health care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21A","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare donor heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33944","description":"Prepare donor heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAE0","description":"ICD-AAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGE0","description":"ICD-BBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUD0","description":"ICD-NFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOC0","description":"ICD-OCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82672","description":"Assay of estrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHB0","description":"ICD-MCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHD1","description":"ICD-NIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28296","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACC0","description":"ICD-OACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20A","description":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Saliva test_ hormone level;","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3650","description":"Saliva test_ hormone level;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMA0","description":"ICD-NAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision or replacement of chest wall respiratory sensor electrode or electrode array_ including connection to existing pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0467T","description":"Revision or replacement of chest wall respiratory sensor electrode or electrode array_ including connection to existing pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seat lift mechanism toilet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0172","description":"Seat lift mechanism toilet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Veneer repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2983","description":"Veneer repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTC0","description":"ICD-OKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMB0","description":"ICD-IDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0921T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","description":"CPT-0921T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00216","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","description":"CPT-00216","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB31","description":"ICD-3IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUB0","description":"ICD-MKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem exostosis any site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7471","description":"Rem exostosis any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/repl vagus n eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64569","description":"Revise/repl vagus n eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWF1","description":"ICD-GDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNF0","description":"ICD-OGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANB1","description":"ICD-KANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGB1","description":"ICD-GCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFA0","description":"ICD-GCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurological procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95999","description":"Neurological procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-qyyp_ biosimilar_ (trazimera)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5116","description":"Injection_ trastuzumab-qyyp_ biosimilar_ (trazimera)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC124","description":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of fb reaction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7540","description":"Removal of fb reaction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCF0","description":"ICD-MFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"History of mole changes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1050F","description":"History of mole changes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHC1","description":"ICD-GEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30435","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKE0","description":"ICD-OEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplj hematopoietic boost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38243","description":"Transplj hematopoietic boost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYC0","description":"ICD-DIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRD0","description":"ICD-GIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of externally accessible nephroureteral catheter (eg_ external/internal stent) requiring fluoroscopic guidance_ with ureteral stricture balloon dilatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7546","description":"Removal and replacement of externally accessible nephroureteral catheter (eg_ external/internal stent) requiring fluoroscopic guidance_ with ureteral stricture balloon dilatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0517U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","description":"CPT-0517U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ irinotecan liposome_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9205","description":"Injection_ irinotecan liposome_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIB1","description":"ICD-CCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preventive behavior change_ online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum_ provided to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0488T","description":"Preventive behavior change_ online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum_ provided to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse/graft added joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26863","description":"Fuse/graft added joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINE1","description":"ICD-CINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolysins screen i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85390","description":"Fibrinolysins screen i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHB0","description":"ICD-OCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIA1","description":"ICD-GHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68360","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLB0","description":"ICD-MCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLC0","description":"ICD-OBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECC0","description":"ICD-EECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28H","description":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKE0","description":"ICD-BAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQD1","description":"ICD-KCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2B","description":"Very High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHE0","description":"ICD-KAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGB1","description":"ICD-CFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX05","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUE1","description":"ICD-GCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant_ inclusive of all radiological supervision and interpretation_ intraprocedural roadmapping_ and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0553T","description":"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant_ inclusive of all radiological supervision and interpretation_ intraprocedural roadmapping_ and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Topical ox deliver sys_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0446","description":"Topical ox deliver sys_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBF1","description":"ICD-OIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval appros surg thxpy epi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5200F","description":"Eval appros surg thxpy epi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy abdominal mass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49180","description":"Biopsy abdominal mass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOB1","description":"ICD-CBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE226","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGA0","description":"ICD-CGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1494","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","description":"HCPCS-M1494","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg_ Neisseria meningitidis_ Streptococcus pneumoniae_ Listeria_ Haemophilus influenza","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87483","description":"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg_ Neisseria meningitidis_ Streptococcus pneumoniae_ Listeria_ Haemophilus influenza","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ implantable aortic counte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0463T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ implantable aortic counte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68510","description":"Biopsy of tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWE0","description":"ICD-KAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICD0","description":"ICD-NICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6070","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99426","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27246","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXB0","description":"ICD-CHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA31","description":"High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLC0","description":"ICD-AHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33840","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDF0","description":"ICD-NGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETE0","description":"ICD-BETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARA0","description":"ICD-CARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peginesatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0890","description":"Peginesatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKD0","description":"ICD-KBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGC1","description":"ICD-FAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below knee total contact","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5637","description":"Below knee total contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFC1","description":"ICD-NGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKF0","description":"ICD-OIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70220","description":"X-ray exam of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46060","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERA1","description":"ICD-DERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUE0","description":"ICD-EHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCC0","description":"ICD-MFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fosphenytoin inj pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2009","description":"Fosphenytoin inj pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser inc for pkp/lkp donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0289T","description":"Laser inc for pkp/lkp donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mild osa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8848","description":"Mild osa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical home_ maintenance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0281","description":"Medical home_ maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBE1","description":"ICD-AFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWB0","description":"ICD-OCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQC1","description":"ICD-GBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33010","description":"Drainage of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARF0","description":"ICD-KARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Facial replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5929","description":"Facial replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPF1","description":"ICD-FFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA45","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genitourinary nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78799","description":"Genitourinary nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITA0","description":"ICD-FITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMD0","description":"ICD-FFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGF1","description":"ICD-OKGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2127","description":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8B","description":"High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVE0","description":"ICD-FIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEF1","description":"ICD-AFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX23","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIF1","description":"ICD-IAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glucarpidase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9293","description":"Injection_ glucarpidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVA1","description":"ICD-FGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S)_ (Remote) Up To 30 Days; Implantable Cardiovascular Physiologic Monitor System_ Implantable Loop Recorder System_ Or Subcutaneous Cardiac Rh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2066","description":"Interrogation Device Evaluation(S)_ (Remote) Up To 30 Days; Implantable Cardiovascular Physiologic Monitor System_ Implantable Loop Recorder System_ Or Subcutaneous Cardiac Rh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0B","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conform band n/s w<3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6442","description":"Conform band n/s w<3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28G","description":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARA1","description":"ICD-HARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOA0","description":"ICD-OLOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIE1","description":"ICD-OLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD230","description":"Clinically Complex _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVB0","description":"ICD-JCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEE1","description":"ICD-KCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcv >=10mg daily predniso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4194F","description":"Pt rcv >=10mg daily predniso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAE1","description":"ICD-KDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Follow up pulm nod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9345","description":"Follow up pulm nod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDB0","description":"ICD-FFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert levonorgestrel ius","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4981","description":"Insert levonorgestrel ius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom fabricate w/c cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2609","description":"Custom fabricate w/c cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD112","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Detect agent nos dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87799","description":"Detect agent nos dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRC1","description":"ICD-PCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of finger/thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26951","description":"Amputation of finger/thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLC0","description":"ICD-JHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUD1","description":"ICD-JFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDC1","description":"ICD-OGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLD0","description":"ICD-GFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA25","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPE0","description":"ICD-OEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUA0","description":"ICD-FEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLC1","description":"ICD-OHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAE0","description":"ICD-AHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWB1","description":"ICD-PEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES260","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWE1","description":"ICD-HFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53415","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress spinal cord lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63056","description":"Decompress spinal cord lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDE0","description":"ICD-IEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACD0","description":"ICD-NACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak flex inner socket ext fra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5651","description":"Ak flex inner socket ext fra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25D","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Administration of patient-focused health risk assessment instrument (eg_ health hazard appraisal) with scoring and documentation_ per standardized instrument","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96160","description":"Administration of patient-focused health risk assessment instrument (eg_ health hazard appraisal) with scoring and documentation_ per standardized instrument","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCE0","description":"ICD-KCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9342","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","description":"HCPCS-J9342","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00851","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","description":"CPT-00851","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUA0","description":"ICD-CDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIA1","description":"ICD-CGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonpower mattress overlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0371","description":"Nonpower mattress overlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKB1","description":"ICD-GAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQA0","description":"ICD-CIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammo probably bengn docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3343F","description":"Mammo probably bengn docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ moxifloxacin 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2280","description":"Inj_ moxifloxacin 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor liver/arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47147","description":"Prep donor liver/arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHB0","description":"ICD-MHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8H","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYE1","description":"ICD-CAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull & explore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61250","description":"Pierce skull & explore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDF0","description":"ICD-FEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJC0","description":"ICD-OAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJE0","description":"ICD-GIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No early ind/delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9355","description":"No early ind/delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Umbilical cord occlud w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59072","description":"Umbilical cord occlud w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34151","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFD1","description":"ICD-KIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGC0","description":"ICD-OHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHA0","description":"ICD-NLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00192","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","description":"CPT-00192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDB0","description":"ICD-IEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whlchr ampu fxd arm leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1170","description":"Whlchr ampu fxd arm leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colon motility 6 hr study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91117","description":"Colon motility 6 hr study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIF0","description":"ICD-CHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert ureteral support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50605","description":"Insert ureteral support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemophilus influenza b vaccine (hib)_ prp-d conjugate_ for booster use only_ intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90646","description":"Hemophilus influenza b vaccine (hib)_ prp-d conjugate_ for booster use only_ intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEA1","description":"ICD-MLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of larynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31578","description":"Removal of larynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDD0","description":"ICD-MCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hsv dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87530","description":"Hsv dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat recline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1003","description":"Pwr seat recline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOE1","description":"ICD-OKOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWE1","description":"ICD-DGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMF0","description":"ICD-OBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc funct no deficiencies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8542","description":"Doc funct no deficiencies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerebrospinal fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78630","description":"Cerebrospinal fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1903","description":"HCPCS-B1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41825","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral con def mod palat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5959","description":"Intraoral con def mod palat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNF0","description":"ICD-BBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extra-oral posterior dental radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0705","description":"Extra-oral posterior dental radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLA0","description":"ICD-CDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with iliac and/or femoral artery angiograph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7517","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with iliac and/or femoral artery angiograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFE1","description":"ICD-KCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACC0","description":"ICD-JACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0407","description":"HCPCS-B0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAA0","description":"ICD-OEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ant fusion 4-7 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22810","description":"Ant fusion 4-7 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lat retinacular release open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27425","description":"Lat retinacular release open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUA1","description":"ICD-MAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55450","description":"Ligation of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAA1","description":"ICD-JAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5247","description":"Hearing aid_ prog_ mon_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQF0","description":"ICD-PBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKF0","description":"ICD-JBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esw wound healing addl wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0300T","description":"Esw wound healing addl wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert self-contd prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54401","description":"Insert self-contd prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prednisolone acetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2650","description":"Prednisolone acetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADC1","description":"ICD-IADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97035","description":"Ultrasound therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHF0","description":"ICD-JHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKE1","description":"ICD-NHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain thigh/knee lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27301","description":"Drain thigh/knee lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit complex cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5501","description":"Hit complex cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIA0","description":"ICD-IFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFB1","description":"ICD-CAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECE1","description":"ICD-JECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery for liver lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47300","description":"Surgery for liver lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFF1","description":"ICD-OKFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICE0","description":"ICD-NICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Known Familial Variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81308","description":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Known Familial Variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22A","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC21","description":"High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKA1","description":"ICD-NCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percut thrombect av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36870","description":"Percut thrombect av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDA0","description":"ICD-NHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHE0","description":"ICD-GEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHID1","description":"ICD-OHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRC0","description":"ICD-KHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Management of established patient with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0527","description":"Management of established patient with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXE1","description":"ICD-NBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal cord puncture prenatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59012","description":"Fetal cord puncture prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lsh uterus 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58541","description":"Lsh uterus 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRC0","description":"ICD-OGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINC0","description":"ICD-BINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXF0","description":"ICD-BAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTB0","description":"ICD-MBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMA1","description":"ICD-BFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBC1","description":"ICD-ADBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEC0","description":"ICD-BIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther behav svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2020","description":"Ther behav svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt lithium 3.6 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0604","description":"Repl batt lithium 3.6 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSB0","description":"ICD-DGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKB1","description":"ICD-OAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ethchlorvynol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6050","description":"Ethchlorvynol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKA0","description":"ICD-OBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYB0","description":"ICD-HHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide (Xipere)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3299","description":"Injection_ triamcinolone acetonide (Xipere)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEA0","description":"ICD-GEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of renin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84244","description":"Assay of renin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ decitabine (sun pharma) not therapeutically equivalent to j0894_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0893","description":"Injection_ decitabine (sun pharma) not therapeutically equivalent to j0894_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESA1","description":"ICD-OESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEE1","description":"ICD-BBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extraosseous joint stblztion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0335T","description":"Extraosseous joint stblztion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYD0","description":"ICD-LBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVA0","description":"ICD-BIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQE0","description":"ICD-DFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No antibio w in 10d of sympt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9287","description":"No antibio w in 10d of sympt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESD0","description":"ICD-KESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9485","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATF0","description":"ICD-IATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","description":"HCPCS-M1387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSC1","description":"ICD-LDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit >30.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12047","description":"Intmd rpr n-hf/genit >30.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWF1","description":"ICD-LGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetics dna probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88271","description":"Cytogenetics dna probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0081","description":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBC1","description":"ICD-BEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0A","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vad different session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33992","description":"Remove vad different session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUB0","description":"ICD-AGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUE0","description":"ICD-BEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYD1","description":"ICD-OIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEE1","description":"ICD-FGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSD0","description":"ICD-DGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBB0","description":"ICD-BBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21510","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment social skills group_ administered by physician or other qualified health care professional face-to-face with multiple patients","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0372T","description":"Adaptive behavior treatment social skills group_ administered by physician or other qualified health care professional face-to-face with multiple patients","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj w/fluor eval cv device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36598","description":"Inj w/fluor eval cv device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace part denture teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5640","description":"Replace part denture teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNF0","description":"ICD-CCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of neck muscle/rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21705","description":"Revision of neck muscle/rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","description":"HCPCS-Q4407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ercp stent exchange w/dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43276","description":"Ercp stent exchange w/dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Term device_ multi art digit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6715","description":"Term device_ multi art digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPE0","description":"ICD-NBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rehabilitative support for musculoskeletal care mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1370","description":"Rehabilitative support for musculoskeletal care mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQE0","description":"ICD-OAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8625","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICB1","description":"ICD-IICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEB1","description":"ICD-OLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYE0","description":"ICD-PCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0822","description":"Pwc gp 2 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Balloon dilate urtrl strix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50706","description":"Balloon dilate urtrl strix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1C","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAA1","description":"ICD-OGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ neurostimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1778","description":"Lead_ neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJC0","description":"ICD-BAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped fluid and electrolyte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4103","description":"Ef ped fluid and electrolyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ etranacogene dezaparvovec-drlb_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1411","description":"Injection_ etranacogene dezaparvovec-drlb_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93244","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBE1","description":"ICD-ABBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crutch underarm pair wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0112","description":"Crutch underarm pair wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc post surg anatomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9613","description":"Doc post surg anatomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXD1","description":"ICD-FIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dolasetron mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1260","description":"Dolasetron mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQF1","description":"ICD-LEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUC0","description":"ICD-KHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISC1","description":"ICD-HISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSA1","description":"ICD-GCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQB1","description":"ICD-PJQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA31","description":"ICD-4BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBID0","description":"ICD-MBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSA0","description":"ICD-DFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMF1","description":"ICD-IAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Percutaneous Right Heart Ventricular Assist Device_ Venous Cannula_ At Separate And Distinct Session From Insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33997","description":"Removal Of Percutaneous Right Heart Ventricular Assist Device_ Venous Cannula_ At Separate And Distinct Session From Insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA131","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24587","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis_ 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0380U","description":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis_ 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEME1","description":"ICD-AEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAE0","description":"ICD-OHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth neck organ 1yr/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32051","description":"Anesth neck organ 1yr/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSC1","description":"ICD-KDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHB0","description":"ICD-NJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDID0","description":"ICD-GDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECE1","description":"ICD-AECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWA1","description":"ICD-CGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0662U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0662U","description":"CPT-0662U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMF0","description":"ICD-IGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHD1","description":"ICD-EFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-jmdb_ biosimilar_ (Fulphila)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5108","description":"Injection_ pegfilgrastim-jmdb_ biosimilar_ (Fulphila)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA21","description":"ICD-4HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome banding study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88283","description":"Chromosome banding study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXA1","description":"ICD-CEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIF0","description":"ICD-NFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBF0","description":"ICD-BCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUF0","description":"ICD-BDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compre audiometry evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0212T","description":"Compre audiometry evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFA0","description":"ICD-NKFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45309","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYF0","description":"ICD-KAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSA1","description":"ICD-KHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot inhibit prot c antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85302","description":"Clot inhibit prot c antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr umbil hern reduc > 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49585","description":"Rpr umbil hern reduc > 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove & graft wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25135","description":"Remove & graft wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0805","description":"HCPCS-C0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alpha-1-antitrypsin pheno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82104","description":"Alpha-1-antitrypsin pheno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0638U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0638U","description":"CPT-0638U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHA1","description":"ICD-MEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD210","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOA0","description":"ICD-OGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSC1","description":"ICD-PJSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trapeze bar free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0940","description":"Trapeze bar free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0560T","description":"Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen imp urinary 2.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8603","description":"Collagen imp urinary 2.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test urine for porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84119","description":"Test urine for porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g._ virtual check-in_ by a physician or other qualified health care professiona","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2012","description":"Brief communication technology-based service_ e.g._ virtual check-in_ by a physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA02","description":"Default_ /Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIF1","description":"ICD-JAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOE1","description":"ICD-HFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diphtheria_ tetanus toxoids_ and whole cell pertussis vaccine and hemophilus influenza b vaccine (dtp-hib)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90720","description":"Diphtheria_ tetanus toxoids_ and whole cell pertussis vaccine and hemophilus influenza b vaccine (dtp-hib)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screen c/v thin layer by md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0124","description":"Screen c/v thin layer by md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXD0","description":"ICD-CCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual cell count each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85032","description":"Manual cell count each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVD1","description":"ICD-KDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44140","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYC1","description":"ICD-DHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJF1","description":"ICD-FBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38530","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 1 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64493","description":"Inj paravert f jnt l/s 1 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIE0","description":"ICD-CCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOF0","description":"ICD-DCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0904","description":"HCPCS-A0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJB1","description":"ICD-NGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBD0","description":"ICD-ACBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTB1","description":"ICD-ODTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-adcd (vegzelma)_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5129","description":"Injection_ bevacizumab-adcd (vegzelma)_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECC1","description":"ICD-MECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Use of speech device service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92609","description":"Use of speech device service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILA0","description":"ICD-JILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJD0","description":"ICD-KIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIF0","description":"ICD-JCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0144A","description":"IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair spinal fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63707","description":"Repair spinal fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEF1","description":"ICD-EGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bupren/nal 6.1 to 10mg bupre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0574","description":"Bupren/nal 6.1 to 10mg bupre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28G","description":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBE1","description":"ICD-MBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25C","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD140","description":"Special Care High _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICC1","description":"ICD-KICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPA1","description":"ICD-OKPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44650","description":"Repair bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of umbilicus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49250","description":"Excision of umbilicus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML05","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heavy duty wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0006","description":"Heavy duty wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFB0","description":"ICD-OCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate w/rise psa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9080","description":"Onc dx prostate w/rise psa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laminotomy addl cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63043","description":"Laminotomy addl cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17260","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLF1","description":"ICD-OLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor inhibitor test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85335","description":"Factor inhibitor test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWC1","description":"ICD-CFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient reason for not screening for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety (e.g._ patient declined or othe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1237","description":"Patient reason for not screening for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety (e.g._ patient declined or othe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHF1","description":"ICD-MGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI compatible system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0859","description":"MRI compatible system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIA0","description":"ICD-JEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAF1","description":"ICD-OHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Organic acid single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83921","description":"Organic acid single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHF1","description":"ICD-AIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTE1","description":"ICD-ADTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4347","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","description":"HCPCS-Q4347","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17276","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Port_ indwelling_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1788","description":"Port_ indwelling_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gr34 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2359","description":"Gr34 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES231","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant nerve end","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64787","description":"Implant nerve end","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Disease Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4010","description":"Infectious Disease Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEF1","description":"ICD-KEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj naloxone hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2310","description":"Inj naloxone hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSD0","description":"ICD-HHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPB0","description":"ICD-GDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11450","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBB1","description":"ICD-AGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCA1","description":"ICD-ICCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQE1","description":"ICD-OAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAC0","description":"ICD-MEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUF1","description":"ICD-KCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27448","description":"Incision of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rhophylac injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2791","description":"Rhophylac injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEC0","description":"ICD-GGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDE0","description":"ICD-NIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0087","description":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEC1","description":"ICD-NHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIC0","description":"ICD-GAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLF0","description":"ICD-GFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDC0","description":"ICD-JCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ brexanolone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1632","description":"Injection_ brexanolone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAD0","description":"ICD-CHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1084","description":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Axolotl DualGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4332","description":"Axolotl DualGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX52","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMD1","description":"ICD-NHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; common deletions or variant (eg_ Southeast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81257","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; common deletions or variant (eg_ Southeast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDE1","description":"ICD-IDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXC0","description":"ICD-BIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVD0","description":"ICD-OHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enrollment**","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0009","description":"Enrollment**","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Aim Specialty Health_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1007","description":"Clinical Decision Support Mechanism Aim Specialty Health_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESC1","description":"ICD-CESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGD1","description":"ICD-BBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPC1","description":"ICD-OAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJA1","description":"ICD-NDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FLT3 (fms-related tyrosine kinase 3) (eg_ acute myeloid leukemia) internal tandem duplication (ITD) variants_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0046U","description":"FLT3 (fms-related tyrosine kinase 3) (eg_ acute myeloid leukemia) internal tandem duplication (ITD) variants_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBC0","description":"ICD-OGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXD0","description":"ICD-NJXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert intracorporeal device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33979","description":"Insert intracorporeal device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLA1","description":"ICD-KCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Clinical Problem_ With Limited Review Of Patient_S History And Medical Records And Straightforward Medical Decision Making When Using Ti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80503","description":"Pathology Clinical Consultation; For A Clinical Problem_ With Limited Review Of Patient_S History And Medical Records And Straightforward Medical Decision Making When Using Ti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEE1","description":"ICD-FHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sterile eye pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6410","description":"Sterile eye pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rsa upper extr exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0349T","description":"Rsa upper extr exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rimantadine hcl_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9036","description":"Rimantadine hcl_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Paramedicintercep nonhospals","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0207","description":"Paramedicintercep nonhospals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0101","description":"HCPCS-C0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery expos/graft artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33987","description":"Artery expos/graft artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERF0","description":"ICD-PERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA134","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27177","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no pneumococcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8865","description":"Doc med reas no pneumococcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote 30 day ecg rev/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93228","description":"Remote 30 day ecg rev/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNA1","description":"ICD-FHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-routine bl draw 3/> yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36410","description":"Non-routine bl draw 3/> yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33241","description":"Remove pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI neck spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72156","description":"MRI neck spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Histrelin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1675","description":"Histrelin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFB1","description":"ICD-OGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQA0","description":"ICD-DGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUC0","description":"ICD-OBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHD0","description":"ICD-EDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLA0","description":"ICD-CHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGE1","description":"ICD-GIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86701","description":"Hiv-1antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDME1","description":"ICD-MDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUA1","description":"ICD-GAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQF0","description":"ICD-DHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUE0","description":"ICD-OIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0901","description":"HCPCS-C0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMA1","description":"ICD-MGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPC1","description":"ICD-BHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Single Trajectory For 1 Si","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61736","description":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Single Trajectory For 1 Si","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Soft interface below knee se","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2820","description":"Soft interface below knee se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAB0","description":"ICD-JDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"4vhpv vaccine 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90649","description":"4vhpv vaccine 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHED0","description":"ICD-IHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55708","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","description":"CPT-55708","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEE1","description":"ICD-FEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGE0","description":"ICD-GDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUF1","description":"ICD-FGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse pancreas cyst and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48520","description":"Fuse pancreas cyst and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHD1","description":"ICD-ECHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corf skilled nursing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0128","description":"Corf skilled nursing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alprostadil urethral suppos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0275","description":"Alprostadil urethral suppos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63744","description":"Revision of spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASC1","description":"ICD-PASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay carboxyhb quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82375","description":"Assay carboxyhb quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFE1","description":"ICD-JAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCC0","description":"ICD-CHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62258","description":"Replace brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt silver oxide 3 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0602","description":"Repl batt silver oxide 3 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15999","description":"Removal of pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of arm nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64861","description":"Repair of arm nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_yttrium-90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2616","description":"Brachytx_ non-str_yttrium-90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99234","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUE0","description":"ICD-JDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC211","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0447T","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prednisolone oral per 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7510","description":"Prednisolone oral per 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVF0","description":"ICD-GEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICID1","description":"ICD-ICID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetics 25-99","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88274","description":"Cytogenetics 25-99","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nervous system nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78699","description":"Nervous system nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQD1","description":"ICD-CBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXF0","description":"ICD-CBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6245","description":"Bridge porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB36","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGB1","description":"ICD-OGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYB0","description":"ICD-KEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC50","description":"Very High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral/facial photo images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0350","description":"Oral/facial photo images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9128","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9128","description":"CDT-D9128","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0B","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prior dx/active clin ascvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9662","description":"Prior dx/active clin ascvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Create eardrum opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69433","description":"Create eardrum opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABF1","description":"ICD-JABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLA0","description":"ICD-BFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0141A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNE1","description":"ICD-NBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd cautery tumor polyp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43250","description":"Egd cautery tumor polyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22869","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJC1","description":"ICD-OFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1378","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","description":"HCPCS-M1378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24579","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert w/o lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5679","description":"Socket insert w/o lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIC1","description":"ICD-NHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of kidney/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50405","description":"Revision of kidney/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB01","description":"Very High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIB1","description":"ICD-GGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHF1","description":"ICD-EIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDE1","description":"ICD-JIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJE1","description":"ICD-KHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXD0","description":"ICD-BFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wedging of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29740","description":"Wedging of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA135","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBB1","description":"ICD-NLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITB0","description":"ICD-FITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRA1","description":"ICD-HCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLE0","description":"ICD-KCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJE0","description":"ICD-KEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMC1","description":"ICD-MLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDD1","description":"ICD-CBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ each additional site (Lis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0844T","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ each additional site (Lis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound filler dry form / gram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6262","description":"Wound filler dry form / gram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA15","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCC1","description":"ICD-BFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIC0","description":"ICD-EBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iv oct for proc init vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0291T","description":"Iv oct for proc init vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCD1","description":"ICD-FDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina tissue compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57111","description":"Remove vagina tissue compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTA0","description":"ICD-KFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29835","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUD0","description":"ICD-BDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial strain imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0399T","description":"Myocardial strain imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor vii proconvertin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85230","description":"Clot factor vii proconvertin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9771","description":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49613","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATF1","description":"ICD-FATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0102","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0102","description":"CDT-D0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANE0","description":"ICD-KANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune (psoriasis)_ mRNA_ next-generation sequencing_ gene expression profiling of 50-100 genes_ skin-surface collection using adhesive patch_ algorithm reported as likeli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0258U","description":"Autoimmune (psoriasis)_ mRNA_ next-generation sequencing_ gene expression profiling of 50-100 genes_ skin-surface collection using adhesive patch_ algorithm reported as likeli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEC0","description":"ICD-IHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPA0","description":"ICD-KCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ pegylated-aucl (Jivi)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9141","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ pegylated-aucl (Jivi)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGC0","description":"ICD-CIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBB1","description":"ICD-FHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKE0","description":"ICD-GCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQC1","description":"ICD-DEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDB1","description":"ICD-BDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage lymph node lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38300","description":"Drainage lymph node lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE216","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMC1","description":"ICD-BAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUA1","description":"ICD-MDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8909","description":"Mra w/cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQF1","description":"ICD-LAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAA1","description":"ICD-CAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCA0","description":"ICD-BBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transabdom amnioinfus w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59070","description":"Transabdom amnioinfus w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGF0","description":"ICD-NGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA14","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXC1","description":"ICD-JHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB105","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFE1","description":"ICD-JBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB251","description":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDD0","description":"ICD-JHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1085","description":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Uppr gi scope w/submuc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43236","description":"Uppr gi scope w/submuc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDA1","description":"ICD-GHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky =50)_ cardiac c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2207","description":"Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky =50)_ cardiac c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEID1","description":"ICD-IEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam pad_ any size or shape_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6601","description":"Gradient compression bandaging supply_ high density foam pad_ any size or shape_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hgh risk for thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3552F","description":"Hgh risk for thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIC0","description":"ICD-AAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow imaging body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78104","description":"Bone marrow imaging body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFED0","description":"ICD-CFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ravulizumab-cwvz_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1303","description":"Injection_ ravulizumab-cwvz_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCE0","description":"ICD-BGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBE0","description":"ICD-BEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBD1","description":"ICD-GGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24470","description":"Revision of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINC0","description":"ICD-CINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASA1","description":"ICD-DASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLND0","description":"ICD-OLND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHD1","description":"ICD-CHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLF0","description":"ICD-KFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEF1","description":"ICD-OHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-htn or htn doc_ f/u indc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8950","description":"Pre-htn or htn doc_ f/u indc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGD0","description":"ICD-NIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50650","description":"Removal of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITC1","description":"ICD-IITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75822","description":"Vein x-ray arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELE0","description":"ICD-KELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9459","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUE1","description":"ICD-KAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE211","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pasrr level i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2010","description":"Pasrr level i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla class ii phenotype qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86831","description":"Hla class ii phenotype qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0650U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0650U","description":"CPT-0650U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBB0","description":"ICD-OEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJC1","description":"ICD-FHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPE1","description":"ICD-KFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy w/us needle bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43232","description":"Esophagoscopy w/us needle bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEA0","description":"ICD-MDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDE1","description":"ICD-MBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0491","description":"Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAF0","description":"ICD-FGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ includes closed feedback loop leads and all implantable components_ with rechargeable battery and charging system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1826","description":"Generator_ neurostimulator (implantable)_ includes closed feedback loop leads and all implantable components_ with rechargeable battery and charging system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1023","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39540","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain aneurysm repr complx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61698","description":"Brain aneurysm repr complx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anterior swing band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2335","description":"Anterior swing band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDC0","description":"ICD-NCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIC1","description":"ICD-GDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lithium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80178","description":"Assay of lithium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVE1","description":"ICD-BFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Init pm e/m new pat 65+ yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99387","description":"Init pm e/m new pat 65+ yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External receiver_ cgm sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9278","description":"External receiver_ cgm sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ravulizumab-cwvz_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9052","description":"Injection_ ravulizumab-cwvz_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWC1","description":"ICD-GGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp tibial-tib/peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35570","description":"Art byp tibial-tib/peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUE1","description":"ICD-CFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complex drainage wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10180","description":"Complex drainage wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAD0","description":"ICD-ICAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTC1","description":"ICD-KHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dengue vaccine_ quadrivalent_ live_ 2 dose schedule_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90584","description":"Dengue vaccine_ quadrivalent_ live_ 2 dose schedule_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEB1","description":"ICD-NFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB21","description":"ICD-3GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIB1","description":"ICD-BHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHED0","description":"ICD-AHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcath stent cca w/o eps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37216","description":"Transcath stent cca w/o eps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHD0","description":"ICD-GIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0459","description":"Chest wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWD1","description":"ICD-OCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENC1","description":"ICD-JENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTF0","description":"ICD-FGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB50","description":"High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pild/placebo control clin tr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0276","description":"Pild/placebo control clin tr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPB0","description":"ICD-BDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ADENOVIRUS ENTERIC TYP 40/41","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87301","description":"IAAD IA ADENOVIRUS ENTERIC TYP 40/41","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGA1","description":"ICD-GAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo iv infusion addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96415","description":"Chemo iv infusion addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUF1","description":"ICD-IDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHE1","description":"ICD-NCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC44","description":"Very High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31360","description":"Removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMD1","description":"ICD-KEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYF1","description":"ICD-CAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRA1","description":"ICD-CDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEE1","description":"ICD-IDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enamel microabrasion","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9970","description":"Enamel microabrasion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHE0","description":"ICD-BEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRF1","description":"ICD-HIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLD1","description":"ICD-NCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50340","description":"Removal of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18X","description":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special base curve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2730","description":"Special base curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1C","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGA1","description":"ICD-CHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27198","description":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBED0","description":"ICD-CBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOF0","description":"ICD-OAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJE0","description":"ICD-FBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47451","description":"Anesth surgery of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXC1","description":"ICD-BHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLC1","description":"ICD-MBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Camp day waiver/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2037","description":"Camp day waiver/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWE0","description":"ICD-CCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pericardiocentesis_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33016","description":"Pericardiocentesis_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLB1","description":"ICD-KCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 cast based metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6781","description":"Crown 3/4 cast based metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressant tricyclic 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80336","description":"Antidepressant tricyclic 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHF1","description":"ICD-BGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPD0","description":"ICD-CHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSB1","description":"ICD-LCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYE0","description":"ICD-PFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr pul art unifocal w/o cpb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33925","description":"Rpr pul art unifocal w/o cpb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLB0","description":"ICD-JCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUE0","description":"ICD-MHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heavy duty wheeled walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0149","description":"Heavy duty wheeled walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEB1","description":"ICD-NBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTB1","description":"ICD-MGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prefab stainless steel crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2933","description":"Prefab stainless steel crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFC1","description":"ICD-FHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDA0","description":"ICD-OFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNA0","description":"ICD-OHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACF1","description":"ICD-NACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRB0","description":"ICD-HCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extraoral posterior image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0251","description":"Extraoral posterior image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glassia injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0257","description":"Glassia injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEE1","description":"ICD-ABEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAF0","description":"ICD-MBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3B","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMB0","description":"ICD-ICMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAE1","description":"ICD-NKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUC0","description":"ICD-OJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCA1","description":"ICD-BDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTB0","description":"ICD-BHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse esophagus & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43341","description":"Fuse esophagus & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of foot tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28226","description":"Release of foot tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVF0","description":"ICD-GFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAE1","description":"ICD-MEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8618","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVE0","description":"ICD-BAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLB0","description":"ICD-CFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","description":"HCPCS-Q4403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOD1","description":"ICD-PAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI neck spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72141","description":"MRI neck spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove pharynx foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42809","description":"Remove pharynx foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2640","description":"Brachytx_ stranded_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Consult inc prep of slides","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0485","description":"Consult inc prep of slides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAE0","description":"ICD-MKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43634","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTB1","description":"ICD-MCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1805","description":"HCPCS-B1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLB1","description":"ICD-MKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise flexor carpi radialis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25001","description":"Incise flexor carpi radialis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIA1","description":"ICD-BHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0902","description":"HCPCS-C0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debride infected skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11000","description":"Debride infected skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc brst cncr stage 0 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3370F","description":"Ajcc brst cncr stage 0 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBE1","description":"ICD-OIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct upper extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73201","description":"Ct upper extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8I","description":"Low Rehab_ ADL Index 0-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFB1","description":"ICD-KIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYC1","description":"ICD-HFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXD1","description":"ICD-CBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDE1","description":"ICD-OIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPD1","description":"ICD-NCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBE0","description":"ICD-NFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYE0","description":"ICD-GEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPF1","description":"ICD-GHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal vaccine inhalation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3530","description":"Nasal vaccine inhalation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise knuckle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26530","description":"Revise knuckle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES360","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20B","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interim labor facility globa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4005","description":"Interim labor facility globa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78265","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBB0","description":"ICD-ADBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ropivacaine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2795","description":"Ropivacaine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4355","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","description":"HCPCS-Q4355","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWA1","description":"ICD-CFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retinal tamp_ silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1814","description":"Retinal tamp_ silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0767T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99425","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHC1","description":"ICD-FGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","description":"HCPCS-J1737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99221","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHA0","description":"ICD-NHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQB1","description":"ICD-OFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPD1","description":"ICD-OIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27003","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC141","description":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Toxoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86777","description":"Toxoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71550","description":"MRI chest w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFB1","description":"ICD-OLFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98972","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGA0","description":"ICD-NLGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBND1","description":"ICD-OBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise spinal cord ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63182","description":"Revise spinal cord ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUE1","description":"ICD-KIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23500","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX34","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43193","description":"Esophagoscp rig trnso biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOD0","description":"ICD-OKOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls initiation artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33947","description":"Ecmo/ecls initiation artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAE1","description":"ICD-BCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQF0","description":"ICD-GHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLA1","description":"ICD-FDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEA1","description":"ICD-IHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQC1","description":"ICD-OEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIB1","description":"ICD-EGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of cannula(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36823","description":"Insertion of cannula(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9145","description":"Injection_ daratumumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8011","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8011","description":"HCPCS-C8011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMF1","description":"ICD-KGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJA1","description":"ICD-GEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOA0","description":"ICD-CBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9999","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9999","description":"HCPCS-A9999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGD1","description":"ICD-FAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ non-small cell lung neoplasia_ DN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0136U","description":"Targeted genomic sequence analysis panel_ non-small cell lung neoplasia_ DN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trans elec jt stim dev sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0762","description":"Trans elec jt stim dev sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGC1","description":"ICD-KGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPA1","description":"ICD-JHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11C","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEF0","description":"ICD-AAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Battery for hearing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5266","description":"Battery for hearing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOF0","description":"ICD-CCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIE0","description":"ICD-FCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50555","description":"Kidney endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mtms by pharm np 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99605","description":"Mtms by pharm np 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQE1","description":"ICD-OLQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fo nontorsion joint cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3935","description":"Fo nontorsion joint cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; paper_ 2-dimensional_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82488","description":"Chromatography_ qualitative; paper_ 2-dimensional_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bpci home visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9187","description":"Bpci home visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIE1","description":"ICD-FCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CT/MRI chest/neck follup rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9554","description":"CT/MRI chest/neck follup rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKD0","description":"ICD-NHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEB0","description":"ICD-BCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDD1","description":"ICD-MJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGB0","description":"ICD-NBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQB0","description":"ICD-GFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYE1","description":"ICD-HDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28436","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNC1","description":"ICD-NBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRF1","description":"ICD-PFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCE0","description":"ICD-ECCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bowel lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44111","description":"Excision of bowel lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARD0","description":"ICD-LARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sternal pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1050","description":"Sternal pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trans bench w/wo comm open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0247","description":"Trans bench w/wo comm open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermacell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4122","description":"Dermacell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX45","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray frnt lat lordotc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71021","description":"Chest x-ray frnt lat lordotc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHC0","description":"ICD-IIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corneal smear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65430","description":"Corneal smear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQA1","description":"ICD-KIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 1 vhd 451-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0802","description":"Pov group 1 vhd 451-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway press chinstrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7036","description":"Pos airway press chinstrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWC1","description":"ICD-OKWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECC0","description":"ICD-JECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHA0","description":"ICD-NEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pet image full body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78813","description":"Pet image full body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVA0","description":"ICD-KFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAF0","description":"ICD-GIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC31","description":"ICD-4JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvef <40% or dep lv sys fcn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8934","description":"Lvef <40% or dep lv sys fcn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB245","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRF1","description":"ICD-KIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMB0","description":"ICD-FGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture aerobic quant other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87071","description":"Culture aerobic quant other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAA1","description":"ICD-OAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRC0","description":"ICD-HBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"App topical fluoride varnish","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99188","description":"App topical fluoride varnish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21280","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDND0","description":"ICD-FDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc forearm tum deep 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25073","description":"Exc forearm tum deep 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23532","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No admit w/in 180d req remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9411","description":"No admit w/in 180d req remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUA0","description":"ICD-GBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0623T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical psychologist or clinical social worker time_ per calendar month. (these services inc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0323","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical psychologist or clinical social worker time_ per calendar month. (these services inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dxa ordered for osteo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8861","description":"Dxa ordered for osteo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUB0","description":"ICD-MJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNC1","description":"ICD-OBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAF1","description":"ICD-KAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMA1","description":"ICD-CDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEB1","description":"ICD-BDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXA0","description":"ICD-CFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCND0","description":"ICD-JCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/.25-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2311","description":"Lens sphc trifo 7.25-12/.25-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJE0","description":"ICD-BAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion/graft of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25805","description":"Fusion/graft of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMD0","description":"ICD-CDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mirikizumab-mrkz_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2267","description":"Injection_ mirikizumab-mrkz_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDD0","description":"ICD-AIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Implantation Or Replacement Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0587T","description":"Percutaneous Implantation Or Replacement Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFD0","description":"ICD-GDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXC0","description":"ICD-CDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDC1","description":"ICD-CHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (MAIA)_ not therapeutically equivalent to J9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9051","description":"Injection_ bortezomib (MAIA)_ not therapeutically equivalent to J9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB45","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28102","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUB0","description":"ICD-KAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWB1","description":"ICD-LGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation cone locator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5985","description":"Radiation cone locator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGE0","description":"ICD-OFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIF1","description":"ICD-NGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of femur 2/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73552","description":"X-ray exam of femur 2/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVB0","description":"ICD-BHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of upper nose/throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42806","description":"Biopsy of upper nose/throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1034T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1034T","description":"CPT-1034T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0892","description":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/drain eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67440","description":"Explore/drain eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40842","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEE0","description":"ICD-ADEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAE1","description":"ICD-CDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLB1","description":"ICD-IHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Image test ref carot diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3100F","description":"Image test ref carot diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC254","description":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCA1","description":"ICD-MCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alveolus open reduction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7671","description":"Alveolus open reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28H","description":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYD1","description":"ICD-OLYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAA0","description":"ICD-NAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA31","description":"ICD-2IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9306","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9306","description":"HCPCS-C9306","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESE1","description":"ICD-GESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/o 3+ post-opnausea&vom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4557F","description":"Pt w/o 3+ post-opnausea&vom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASD1","description":"ICD-LASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUB1","description":"ICD-BAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXB0","description":"ICD-GFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Topographic brain mapping","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8040","description":"Topographic brain mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28750","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXF1","description":"ICD-CFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/2.12-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2108","description":"Spherocylinder 4.25d/2.12-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/control bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45382","description":"Colonoscopy w/control bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise spermatic cord veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55530","description":"Revise spermatic cord veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37270","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","description":"CPT-37270","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA02","description":"Medium Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA201","description":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAB1","description":"ICD-EGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCA1","description":"ICD-GGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEID1","description":"ICD-JEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAD1","description":"ICD-IHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opps service_sched team conf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0175","description":"Opps service_sched team conf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diphenhydramine hcl injectio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1200","description":"Diphenhydramine hcl injectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Specimen site not prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8798","description":"Specimen site not prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compres burn garment leotard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6510","description":"Compres burn garment leotard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQF0","description":"ICD-GEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFND0","description":"ICD-CFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast add strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19284","description":"Perq dev breast add strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWD1","description":"ICD-OBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX26","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWC1","description":"ICD-KIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRE1","description":"ICD-OBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWF1","description":"ICD-HDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Power wheelchair noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0898","description":"Power wheelchair noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGF1","description":"ICD-OHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFD1","description":"ICD-KEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBE0","description":"ICD-KEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval on foot documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8410","description":"Eval on foot documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implnt/abut fixed dent mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6115","description":"Implnt/abut fixed dent mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with atherectomy_ includes angioplasty within the same vessel_ when performe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7534","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with atherectomy_ includes angioplasty within the same vessel_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUE0","description":"ICD-CCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Residential Habilitation 1-3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0100","description":"Residential Habilitation 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0568U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","description":"CPT-0568U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBID1","description":"ICD-KBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGA1","description":"ICD-NGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKC0","description":"ICD-NBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMA0","description":"ICD-CHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enteral ng tubing w/ stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4081","description":"Enteral ng tubing w/ stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow child myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7191","description":"Elbow child myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1303","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCD0","description":"ICD-ABCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay carbamazepine free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80157","description":"Assay carbamazepine free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","description":"HCPCS-A2033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal endoscop po debrid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2342","description":"Nasal endoscop po debrid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rib(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32900","description":"Removal of rib(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Division of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58600","description":"Division of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLF0","description":"ICD-OBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng anti-rheum thxpy ra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4195F","description":"Pt rcvng anti-rheum thxpy ra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast exam abdominl aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75625","description":"Contrast exam abdominl aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIB0","description":"ICD-CEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 1 std up to 300lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0800","description":"Pov group 1 std up to 300lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICD0","description":"ICD-MICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert prost urethral stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53855","description":"Insert prost urethral stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body adbomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49402","description":"Remove foreign body adbomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCB0","description":"ICD-KFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANC1","description":"ICD-JANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00732","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","description":"CPT-00732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PABPN1 (poly[A] binding protein nuclear 1) (eg_ oculopharyngeal muscular dystrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81312","description":"PABPN1 (poly[A] binding protein nuclear 1) (eg_ oculopharyngeal muscular dystrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBA1","description":"ICD-OGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Oritavancin_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9444","description":"Injection_ Oritavancin_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9943","description":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEB0","description":"ICD-MFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Copd symptoms assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1015F","description":"Copd symptoms assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMC1","description":"ICD-CFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98977","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQE1","description":"ICD-DBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alloderm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4116","description":"Alloderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJE0","description":"ICD-KBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA05","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automatic ext defibrillator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0617","description":"Automatic ext defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSC1","description":"ICD-HGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOE0","description":"ICD-CEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38381","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC204","description":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKA0","description":"ICD-OFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24D","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath w/drainage 2-way silcne","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4315","description":"Cath w/drainage 2-way silcne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8901","description":"Mra w/o cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18X","description":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVA0","description":"ICD-FCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0701","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0701","description":"CDT-D0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient transferred directly from anesthetizing location to PACE or other non-ICU location","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9656","description":"Patient transferred directly from anesthetizing location to PACE or other non-ICU location","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXC1","description":"ICD-NAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBF1","description":"ICD-CIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEE0","description":"ICD-AEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0686U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686U","description":"CPT-0686U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKB0","description":"ICD-FFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNC1","description":"ICD-KGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known S","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0224","description":"Intravenous infusion_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no min inv dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8876","description":"Doc reas no min inv dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUC0","description":"ICD-JCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M.avium-intra dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87560","description":"M.avium-intra dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev soft tiss 1st imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10035","description":"Perq dev soft tiss 1st imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot insert remov molded spe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3001","description":"Foot insert remov molded spe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUC0","description":"ICD-GFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHF0","description":"ICD-GCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain open abdom abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49040","description":"Drain open abdom abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16051","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDD1","description":"ICD-IGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUF0","description":"ICD-OEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBD0","description":"ICD-AHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","description":"HCPCS-M1428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTF0","description":"ICD-BHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0486T","description":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PuraPly_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4195","description":"PuraPly_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0643U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0643U","description":"CPT-0643U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"DPYD (dihydropyrimidine dehydrogenase) (eg_ 5-fluorouracil/5-FU and capecitabine drug metabolism)_ gene analysis_ common variant(s) (eg_ *2A_ *4_ *5_ *6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81232","description":"DPYD (dihydropyrimidine dehydrogenase) (eg_ 5-fluorouracil/5-FU and capecitabine drug metabolism)_ gene analysis_ common variant(s) (eg_ *2A_ *4_ *5_ *6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13A","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETE1","description":"ICD-JETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB260","description":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWA0","description":"ICD-CGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLF1","description":"ICD-ODLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASB1","description":"ICD-PASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj tst 5-6 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95909","description":"Nrv cndj tst 5-6 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; adenovirus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87809","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; adenovirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDB0","description":"ICD-JDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dopamine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1265","description":"Dopamine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIA1","description":"ICD-AAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bis xtracell fluid analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93702","description":"Bis xtracell fluid analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00904","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","description":"CPT-00904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHC1","description":"ICD-OLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLB0","description":"ICD-NHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWA0","description":"ICD-OEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIE1","description":"ICD-GAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42405","description":"Biopsy of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDC1","description":"ICD-IBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAA1","description":"ICD-IHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occlusion analysis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9950","description":"Occlusion analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUC0","description":"ICD-EEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21209","description":"Reduction of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No 30 day f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9404","description":"No 30 day f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TYMS (thymidylate synthetase) (eg_ 5-fluorouracil/5-FU drug metabolism)_ gene analysis_ common variant(s) (eg_ tandem repeat variant)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81346","description":"TYMS (thymidylate synthetase) (eg_ 5-fluorouracil/5-FU drug metabolism)_ gene analysis_ common variant(s) (eg_ tandem repeat variant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst w/t/o & vag repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58263","description":"Vag hyst w/t/o & vag repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTB0","description":"ICD-JHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIE0","description":"ICD-KEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFA1","description":"ICD-JBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRE0","description":"ICD-CBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHB0","description":"ICD-FAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prenatal at risk education","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1003","description":"Prenatal at risk education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep c therapy started","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9206","description":"Hep c therapy started","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neostim dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4267","description":"Neostim dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech therapy_ in the home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9128","description":"Speech therapy_ in the home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid monaural in ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5050","description":"Hearing aid monaural in ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLB1","description":"ICD-MFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group health education","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99078","description":"Group health education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEED1","description":"ICD-GEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIE1","description":"ICD-IEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous methb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88741","description":"Transcutaneous methb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00830","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","description":"CPT-00830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABF0","description":"ICD-GABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autonomic nrv syst funj test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95923","description":"Autonomic nrv syst funj test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJA0","description":"ICD-JCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icut allergy titrate-airborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95027","description":"Icut allergy titrate-airborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac rehab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93797","description":"Cardiac rehab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLD1","description":"ICD-JCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBC1","description":"ICD-FDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67911","description":"Revise eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYD1","description":"ICD-LFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCA1","description":"ICD-MLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELF0","description":"ICD-EELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTA0","description":"ICD-FGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj arthroscopy synovectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7875","description":"Tmj arthroscopy synovectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECC1","description":"ICD-AECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supply_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T5999","description":"Supply_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVD1","description":"ICD-FGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBB1","description":"ICD-AIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKF1","description":"ICD-JGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMC0","description":"ICD-NFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29884","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72149","description":"MRI lumbar spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIF0","description":"ICD-NIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXC1","description":"ICD-OAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22554","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0618U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","description":"CPT-0618U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped size brief/diaper lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4530","description":"Ped size brief/diaper lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIA0","description":"ICD-MLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKD1","description":"ICD-NIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSA1","description":"ICD-DBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE134","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording and storage_ data scanning with signal extraction_ technical analysis and result","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0475T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording and storage_ data scanning with signal extraction_ technical analysis and result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLA0","description":"ICD-CGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14B","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALD0","description":"ICD-GALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary rehabilitation pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9473","description":"Pulmonary rehabilitation pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pozelimab-bbfg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9376","description":"Injection_ pozelimab-bbfg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Motor speech current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8999","description":"Motor speech current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Odontics repr abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6095","description":"Odontics repr abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIF1","description":"ICD-OLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal neck/armpit lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38555","description":"Removal neck/armpit lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shldr disartic switch contro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6960","description":"Shldr disartic switch contro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBF0","description":"ICD-CHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; Each Additional Le","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0630T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; Each Additional Le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneum compressor segmental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0651","description":"Pneum compressor segmental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNC0","description":"ICD-OGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Delayed breast prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19342","description":"Delayed breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"JK GNOTYP SLC14A1 EXON 9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0192U","description":"JK GNOTYP SLC14A1 EXON 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBD1","description":"ICD-MEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0561U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","description":"CPT-0561U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis b dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87515","description":"Hepatitis b dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace molded thigh lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4040","description":"Replace molded thigh lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWF1","description":"ICD-HHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUF1","description":"ICD-FCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHE0","description":"ICD-IDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8A","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteoarthritis composite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0005F","description":"Osteoarthritis composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGID0","description":"ICD-OGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBF1","description":"ICD-IGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJF0","description":"ICD-OLJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx complx malar w/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21366","description":"Opn tx complx malar w/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYC0","description":"ICD-OGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGD0","description":"ICD-GDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATD1","description":"ICD-AATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61640","description":"Dilate ic vasospasm init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove tonsils and adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42821","description":"Remove tonsils and adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJB1","description":"ICD-BFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMF1","description":"ICD-MAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTD1","description":"ICD-OJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gel pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0196","description":"Gel pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84703","description":"Chorionic gonadotropin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thera par drugs 2 or > admin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9612","description":"Thera par drugs 2 or > admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amikacin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0278","description":"Amikacin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55705","description":"Biopsy of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD212","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOF1","description":"ICD-KDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64656","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","description":"CPT-64656","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical site infection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9312","description":"Surgical site infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93622","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIA1","description":"ICD-MBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0547","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","description":"HCPCS-G0547","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis B Vaccine (Hepb)_ 3-Antigen (S_ Pre-S1_ Pre-S2)_ 10 Mcg Dosage_ 3 Dose Schedule_ For Intramuscular Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90759","description":"Hepatitis B Vaccine (Hepb)_ 3-Antigen (S_ Pre-S1_ Pre-S2)_ 10 Mcg Dosage_ 3 Dose Schedule_ For Intramuscular Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunfix e-phorsis/urine/csf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86335","description":"Immunfix e-phorsis/urine/csf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1821","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","description":"HCPCS-L1821","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQE0","description":"ICD-HDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28E","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKA0","description":"ICD-KDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not screening for tobacco use (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9904","description":"Documentation of medical reason(s) for not screening for tobacco use (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC205","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical home level iii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9150","description":"Medical home level iii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calcium glycer & lact/10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0620","description":"Calcium glycer & lact/10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phenothiazine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6057","description":"Phenothiazine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below elbow prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6400","description":"Below elbow prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins mark thor for rt perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32553","description":"Ins mark thor for rt perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25A","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11772","description":"Remove pilonidal cyst compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEB0","description":"ICD-EBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1057T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1057T","description":"CPT-1057T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEE0","description":"ICD-MFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vc lesion scope/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31546","description":"Remove vc lesion scope/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIE0","description":"ICD-FDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBA1","description":"ICD-MKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGA0","description":"ICD-CIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of toe joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28054","description":"Biopsy of toe joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJE1","description":"ICD-CFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNB1","description":"ICD-JGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor xii hageman","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85280","description":"Clot factor xii hageman","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collect & prep genetic samp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0422","description":"Collect & prep genetic samp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSE0","description":"ICD-DDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA21","description":"ICD-2GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWD0","description":"ICD-OGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB60","description":"High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRC0","description":"ICD-OJRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8429","description":"Gradient pressure wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49594","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJB0","description":"ICD-JDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXC1","description":"ICD-CEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACED1","description":"ICD-ACED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERD0","description":"ICD-HERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECF0","description":"ICD-CECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEF0","description":"ICD-MLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76019","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","description":"CPT-76019","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAD0","description":"ICD-NHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reopening of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49002","description":"Reopening of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl measr scales jaw motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1702","description":"Repl measr scales jaw motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55700","description":"Biopsy of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOA0","description":"ICD-KDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caster pin lock each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0073","description":"Caster pin lock each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAID1","description":"ICD-NAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace quadlat socket brim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4020","description":"Replace quadlat socket brim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental Case Management - Patients With Special Health Care Needs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9997","description":"Dental Case Management - Patients With Special Health Care Needs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVA0","description":"ICD-CAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABD1","description":"ICD-EABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYE0","description":"ICD-KCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise wrist tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25118","description":"Excise wrist tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOA0","description":"ICD-GEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-131 iodide cap_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9528","description":"Iodine i-131 iodide cap_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic ring fracture uni/bil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0413","description":"Pelvic ring fracture uni/bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCA1","description":"ICD-EHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYC0","description":"ICD-GIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCED0","description":"ICD-OCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound srfc culturetech used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4260F","description":"Wound srfc culturetech used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA46","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphere bifocal 7.12-20.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2202","description":"Lens sphere bifocal 7.12-20.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNE0","description":"ICD-BFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPA0","description":"ICD-GFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQF1","description":"ICD-PJQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Folding ped wc tilt-in-space","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1232","description":"Folding ped wc tilt-in-space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67921","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEF0","description":"ICD-NHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist joint cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25107","description":"Remove wrist joint cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOC1","description":"ICD-HGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDE1","description":"ICD-KCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30160","description":"Removal of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB11","description":"ICD-1JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDC0","description":"ICD-JEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Press pad alternating w/ pum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0181","description":"Press pad alternating w/ pum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ low density flat foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6604","description":"Gradient compression bandaging supply_ low density flat foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNA0","description":"ICD-KDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0343U","description":"Oncology (prostate)_ exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFD1","description":"ICD-JDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHC0","description":"ICD-OBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gallium ga-68_ dotatate_ diagnostic_ 0.1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9587","description":"Gallium ga-68_ dotatate_ diagnostic_ 0.1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSF0","description":"ICD-OFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Graft repair of spine defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63710","description":"Graft repair of spine defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Tedizolid Phosphate_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9446","description":"Injection_ Tedizolid Phosphate_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKF1","description":"ICD-JBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJB1","description":"ICD-BIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01740","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","description":"CPT-01740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adalimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0135","description":"Adalimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDF0","description":"ICD-MDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD124","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHA1","description":"ICD-AGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCA1","description":"ICD-JCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBE1","description":"ICD-AGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYD1","description":"ICD-LAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Range of motion measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95851","description":"Range of motion measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1114","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAA0","description":"ICD-NCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMF1","description":"ICD-MFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETF0","description":"ICD-FETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOD1","description":"ICD-PJOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1331","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALB1","description":"ICD-GALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUC1","description":"ICD-FGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHD0","description":"ICD-FFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete cbc automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85027","description":"Complete cbc automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup hip spica plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4025","description":"Cast sup hip spica plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJD0","description":"ICD-KBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electro-uroflowmetry first","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51741","description":"Electro-uroflowmetry first","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAE1","description":"ICD-AIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01670","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","description":"CPT-01670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLB1","description":"ICD-NBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALA1","description":"ICD-JALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33771","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29705","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKE0","description":"ICD-NCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Battery chrgr 12 volt utah/e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7366","description":"Battery chrgr 12 volt utah/e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXC1","description":"ICD-OLXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPE0","description":"ICD-CAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANA0","description":"ICD-NANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYE1","description":"ICD-DFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX22","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD204","description":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9849","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo tibial fracture rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2116","description":"Afo tibial fracture rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24566","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHD1","description":"ICD-AAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressants class 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80332","description":"Antidepressants class 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transportation costs to and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9992","description":"Transportation costs to and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60520","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHD0","description":"ICD-JDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coagulation time activated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85347","description":"Coagulation time activated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQF1","description":"ICD-OLQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIID0","description":"ICD-FIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKB0","description":"ICD-GIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILD1","description":"ICD-CILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vaporizer room type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0605","description":"Vaporizer room type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excis uppr jaw cyst w/repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21049","description":"Excis uppr jaw cyst w/repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mult mech switches","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2322","description":"Mult mech switches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKB1","description":"ICD-CHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRF0","description":"ICD-PFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Isoproterenol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7658","description":"Isoproterenol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXF0","description":"ICD-ODXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Construct bladder opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51980","description":"Construct bladder opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINC0","description":"ICD-JINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0366U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria x10sv endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33266","description":"Ablate atria x10sv endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYF1","description":"ICD-CFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA07","description":"High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venous m-thrombectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37188","description":"Venous m-thrombectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0205","description":"HCPCS-C0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEB0","description":"ICD-OFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin full grft face/genit/hf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15240","description":"Skin full grft face/genit/hf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUB1","description":"ICD-FHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth skull drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21251","description":"Anesth skull drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31086","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm adult plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4009","description":"Cast sup sht arm adult plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49000","description":"Exploration of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIC0","description":"ICD-IGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rep perf anoper/vestib fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46716","description":"Rep perf anoper/vestib fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASF0","description":"ICD-CASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAB0","description":"ICD-MIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD145","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUF1","description":"ICD-NAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLA1","description":"ICD-NGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHA1","description":"ICD-GAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPA1","description":"ICD-KIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMB1","description":"ICD-EIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOF1","description":"ICD-LIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVC0","description":"ICD-FCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg pain was measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months) post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1053","description":"Leg pain was measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months) post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12A","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTD0","description":"ICD-KHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHC0","description":"ICD-OJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy_ with removal of tissue from the sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31259","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy_ with removal of tissue from the sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICE0","description":"ICD-OICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWE1","description":"ICD-GBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Habil res waiver 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2017","description":"Habil res waiver 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seizure type& frequ docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1200F","description":"Seizure type& frequ docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test for blood flow in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15860","description":"Test for blood flow in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8918","description":"Mra w/cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3501","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC51","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGE1","description":"ICD-NEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIE0","description":"ICD-NJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aprotonin_ 10_000 kiu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0365","description":"Aprotonin_ 10_000 kiu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body-worn hearing aid air","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5030","description":"Body-worn hearing aid air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWE0","description":"ICD-OKWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRE0","description":"ICD-CIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCB1","description":"ICD-ACCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA36","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86413","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB06","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSC1","description":"ICD-PDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX25","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special childcare waiver/d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2026","description":"Special childcare waiver/d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCA0","description":"ICD-ECCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBC1","description":"ICD-BHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIID1","description":"ICD-CIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBD0","description":"ICD-KDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJC0","description":"ICD-OLJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28312","description":"Revision of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOC0","description":"ICD-DFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHE0","description":"ICD-BFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recement cast or prefab post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2915","description":"Recement cast or prefab post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIB0","description":"ICD-NBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE224","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40490","description":"Biopsy of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported)_ upper extremity(ies)_ lower extremity(ies) and/or trunk_ initial orthotic(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97760","description":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported)_ upper extremity(ies)_ lower extremity(ies) and/or trunk_ initial orthotic(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44147","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/revise male sling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53442","description":"Remove/revise male sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shlder disart int lock elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6300","description":"Shlder disart int lock elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLF0","description":"ICD-CBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calc bmi norm parameters","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8420","description":"Calc bmi norm parameters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBB0","description":"ICD-GDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEB0","description":"ICD-CCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of mastoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70130","description":"X-ray exam of mastoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No tdap or td or 1tet/dipth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9417","description":"No tdap or td or 1tet/dipth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEED0","description":"ICD-GEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC42","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home environment assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1028","description":"Home environment assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJA1","description":"ICD-CEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emr hd pmp elec/combo_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0494","description":"Emr hd pmp elec/combo_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHE0","description":"ICD-CCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBB1","description":"ICD-OLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professiona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93792","description":"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Umbilical artery echo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76820","description":"Umbilical artery echo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip disart sach laminat mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5600","description":"Hip disart sach laminat mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFA1","description":"ICD-KEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB12","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreservation oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89337","description":"Cryopreservation oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had only urgent care visits during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1021","description":"Patient had only urgent care visits during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Keramatrix_ per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4165","description":"Keramatrix_ per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0011","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFF1","description":"ICD-KDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEB0","description":"ICD-IAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFA0","description":"ICD-NBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RAS (KRAS or NRAS) gene mutation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9843","description":"RAS (KRAS or NRAS) gene mutation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAA0","description":"ICD-EHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC31","description":"ICD-3CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ltwt portbl power whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0012","description":"Ltwt portbl power whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11A","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal m1 w/mets prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9094","description":"Onc dx rectal m1 w/mets prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD144","description":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18H","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel new leather standa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3455","description":"Shoe heel new leather standa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMC1","description":"ICD-KBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAD1","description":"ICD-NAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGC1","description":"ICD-BIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy ligate perf veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37500","description":"Endoscopy ligate perf veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOA0","description":"ICD-PDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93641","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALC0","description":"ICD-CALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fit spectacles monofocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92340","description":"Fit spectacles monofocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJA1","description":"ICD-JEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGB0","description":"ICD-JIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMD0","description":"ICD-OHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETA1","description":"ICD-FETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDF1","description":"ICD-MDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1601","description":"HCPCS-A1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFED1","description":"ICD-NFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDA1","description":"ICD-FFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDA0","description":"ICD-OJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10B","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE136","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBB1","description":"ICD-JFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFA0","description":"ICD-JGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst w/uro repair compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58293","description":"Vag hyst w/uro repair compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Personal care ser per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1019","description":"Personal care ser per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKF0","description":"ICD-OLKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med reas rpt no histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9423","description":"Med reas rpt no histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BioNextPATCH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4228","description":"BioNextPATCH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8X","description":"Low Rehab_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBA0","description":"ICD-ECBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4398","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","description":"HCPCS-Q4398","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Segesterone acetate and ethinyl estradiol 0.15 mg_ 0.013 mgper 24 hours; yearly vaginal system_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7294","description":"Segesterone acetate and ethinyl estradiol 0.15 mg_ 0.013 mgper 24 hours; yearly vaginal system_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of cervical canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57800","description":"Dilation of cervical canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQF0","description":"ICD-PJQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRA0","description":"ICD-CFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUF1","description":"ICD-BBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOE0","description":"ICD-HHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj multihance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9577","description":"Inj multihance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEF0","description":"ICD-MJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENA1","description":"ICD-CENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCC1","description":"ICD-JFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDF0","description":"ICD-JFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHC0","description":"ICD-NGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); diagnostic_ including collection of specimen(s) by brushing or washing when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6027","description":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); diagnostic_ including collection of specimen(s) by brushing or washing when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUB1","description":"ICD-NEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXA0","description":"ICD-FGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88005","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfusion procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86999","description":"Transfusion procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unite biomatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4129","description":"Unite biomatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate clinical met","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9133","description":"Onc dx prostate clinical met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74475","description":"Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCF1","description":"ICD-GCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of hip casts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29325","description":"Application of hip casts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sh","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB06","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open thrombect av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36831","description":"Open thrombect av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise & drain bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51040","description":"Incise & drain bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_c-131","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2643","description":"Brachytx_ non-stranded_c-131","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59855","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0106","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0106","description":"CDT-D0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTE0","description":"ICD-NCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINF0","description":"ICD-NINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95071","description":"Bronchial allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIB1","description":"ICD-AIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00162","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","description":"CPT-00162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sho heel count plast reinfor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3430","description":"Sho heel count plast reinfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKD0","description":"ICD-NEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB45","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERE1","description":"ICD-CERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise kneecap with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27438","description":"Revise kneecap with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55150","description":"Removal of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50546","description":"Laparoscopic nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult companioncare per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5136","description":"Adult companioncare per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEB1","description":"ICD-MFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDF1","description":"ICD-MLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJB0","description":"ICD-NBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEF1","description":"ICD-JBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECA0","description":"ICD-BECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit tpn 2 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9366","description":"Hit tpn 2 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTC0","description":"ICD-GFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOF0","description":"ICD-LHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEID1","description":"ICD-BEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPB1","description":"ICD-JAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0954T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","description":"CPT-0954T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intro gastrointestinal tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44500","description":"Intro gastrointestinal tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20B","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","description":"CPT-92635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB15","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryptosporidium ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87272","description":"Cryptosporidium ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILB1","description":"ICD-KILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr pck base combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0489","description":"Pwr pck base combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUF1","description":"ICD-CAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDE0","description":"ICD-FBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHID1","description":"ICD-EHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFD0","description":"ICD-NJFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWA0","description":"ICD-LFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by infraclavicular or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34716","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by infraclavicular or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWB1","description":"ICD-OJWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home vent non-invasive inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0466","description":"Home vent non-invasive inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung ventilation imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78579","description":"Lung ventilation imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITE0","description":"ICD-GITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67902","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Womans shoe oxford brace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3224","description":"Womans shoe oxford brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx cml remission","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9126","description":"Onc dx cml remission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PSYC GEN ALYS PANEL 14 GENES","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0173U","description":"PSYC GEN ALYS PANEL 14 GENES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bezlotoxumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0565","description":"Injection_ bezlotoxumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKB0","description":"ICD-FHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Forearm crutch platform atta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0153","description":"Forearm crutch platform atta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAE0","description":"ICD-NFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYC0","description":"ICD-KDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBE0","description":"ICD-EFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ekg for initial prevent exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0403","description":"Ekg for initial prevent exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUA0","description":"ICD-EIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIA0","description":"ICD-NJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36582","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLE1","description":"ICD-BCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKA1","description":"ICD-JDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES246","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX22","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Floxuridine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9200","description":"Floxuridine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMC1","description":"ICD-BDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUC0","description":"ICD-CBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILD1","description":"ICD-EILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAC1","description":"ICD-JHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJF0","description":"ICD-ODJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64657","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","description":"CPT-64657","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oth resp proc_ group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0239","description":"Oth resp proc_ group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRA1","description":"ICD-CHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCB0","description":"ICD-OKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGE0","description":"ICD-FDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBC1","description":"ICD-JFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGE1","description":"ICD-FIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTB1","description":"ICD-JHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHF1","description":"ICD-KCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIA0","description":"ICD-MDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac MRI w/stress img","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75559","description":"Cardiac MRI w/stress img","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCA0","description":"ICD-IFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKB1","description":"ICD-JFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAC0","description":"ICD-AAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient-Months Where There Are More Than One Medicare Capitated Payment (Mcp) Provider Listed For The Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1025","description":"Patient-Months Where There Are More Than One Medicare Capitated Payment (Mcp) Provider Listed For The Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGC1","description":"ICD-BBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJA0","description":"ICD-GBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-rays transcath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75894","description":"X-rays transcath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Same day nb discharge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99463","description":"Same day nb discharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replantation thumb complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20827","description":"Replantation thumb complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ plasma analysis of 388 proteins_ using aptamer-based proteomics technology_ predictive algorithm reported as clinical benefit from immune checkpoint inhibitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0436U","description":"Oncology (lung)_ plasma analysis of 388 proteins_ using aptamer-based proteomics technology_ predictive algorithm reported as clinical benefit from immune checkpoint inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECD1","description":"ICD-BECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spkt/v less than 1. 2 (single-pool clearance of urea [kt] / volume [v])_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8717","description":"Spkt/v less than 1. 2 (single-pool clearance of urea [kt] / volume [v])_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDD0","description":"ICD-BEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy wbx sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32604","description":"Thoracoscopy wbx sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal foreign body mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40804","description":"Removal foreign body mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMD1","description":"ICD-EDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLB0","description":"ICD-MFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJME0","description":"ICD-NJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime_ mouthpiece each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4594","description":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime_ mouthpiece each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate t2no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9078","description":"Onc dx prostate t2no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAE0","description":"ICD-JCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33410","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHME0","description":"ICD-GHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exsufflation belt_ includes all supplies and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1021","description":"Exsufflation belt_ includes all supplies and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEC1","description":"ICD-GHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ genital region_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6570","description":"Gradient compression garment_ genital region_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXA1","description":"ICD-BGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBME1","description":"ICD-OBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQB0","description":"ICD-PGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25105","description":"Remove wrist joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HER2-targeted therapies not administered during the initial course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9827","description":"HER2-targeted therapies not administered during the initial course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; each additional vessel (list separately in addition t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37251","description":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; each additional vessel (list separately in addition t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCB0","description":"ICD-GFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSF1","description":"ICD-GGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB11","description":"ICD-4LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cleft palate repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17251","description":"Anesth cleft palate repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPC1","description":"ICD-KHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALF0","description":"ICD-KALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct hrt w/o dye w/ca test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75571","description":"Ct hrt w/o dye w/ca test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse liver duct & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47802","description":"Fuse liver duct & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQE0","description":"ICD-DBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYE1","description":"ICD-LBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High activity knee frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5930","description":"High activity knee frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear canal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69145","description":"Remove ear canal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable cycler set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4671","description":"Disposable cycler set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHD1","description":"ICD-IGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIID1","description":"ICD-NIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alginate drsg >16 <=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6197","description":"Alginate drsg >16 <=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINC1","description":"ICD-FINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRF0","description":"ICD-CIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPC1","description":"ICD-BFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAB0","description":"ICD-FEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITC1","description":"ICD-MITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOA1","description":"ICD-DCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYC1","description":"ICD-KAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rad w/o backup non-inv intfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0470","description":"Rad w/o backup non-inv intfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home care supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99339","description":"Domicil/r-home care supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABE0","description":"ICD-JABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Embolization protect syst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1884","description":"Embolization protect syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not On A Daily Aspirin Or Other Antiplatelet (E.G. History Of Gastrointestinal Bleed_ Intra-Cranial Bleed_ Blood Disorders_ Idiopathic T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2128","description":"Documentation Of Medical Reason(S) For Not On A Daily Aspirin Or Other Antiplatelet (E.G. History Of Gastrointestinal Bleed_ Intra-Cranial Bleed_ Blood Disorders_ Idiopathic T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disease progn ra poor docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3475F","description":"Disease progn ra poor docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meals for clinical trial par","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9996","description":"Meals for clinical trial par","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25B","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9941","description":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEC1","description":"ICD-JFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28645","description":"Repair toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound filler gel/paste /oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6261","description":"Wound filler gel/paste /oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92250","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj heparin sodium per 1000u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1644","description":"Inj heparin sodium per 1000u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFA1","description":"ICD-NCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJC1","description":"ICD-GGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clsd reduct compd maxilla fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7720","description":"Clsd reduct compd maxilla fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBB1","description":"ICD-IHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWA0","description":"ICD-OHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus and fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43312","description":"Repair esophagus and fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pelvis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26990","description":"Drainage of pelvis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFD0","description":"ICD-CCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3C","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEF1","description":"ICD-GEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOF1","description":"ICD-KGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv)_ includes hiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0011","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv)_ includes hiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77333","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKC0","description":"ICD-CCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQC1","description":"ICD-OHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete removal of vulva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56625","description":"Complete removal of vulva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vascular access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53251","description":"Anesth vascular access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAF0","description":"ICD-KIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC31","description":"ICD-4KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self-mgmt educ/train 2-4 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98961","description":"Self-mgmt educ/train 2-4 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEA0","description":"ICD-BGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NFCT DS RNA 4 TARGETS UPPER RESPIRATORY SPECIMEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0241U","description":"NFCT DS RNA 4 TARGETS UPPER RESPIRATORY SPECIMEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/o dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3761F","description":"Pt w/o dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHF0","description":"ICD-KDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA110","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic compression controller without calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0681","description":"Non-pneumatic compression controller without calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEB0","description":"ICD-MIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB235","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg >16 <=48 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6252","description":"Absorpt drg >16 <=48 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHC1","description":"ICD-EFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFF1","description":"ICD-OIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmi is documented below normal parameters and a follow-up plan is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1287","description":"Bmi is documented below normal parameters and a follow-up plan is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6120","description":"Implant Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise excess skin & tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15839","description":"Excise excess skin & tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEC0","description":"ICD-FBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEB1","description":"ICD-OJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27519","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTA1","description":"ICD-EHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary rubber pouch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4383","description":"Urinary rubber pouch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDD1","description":"ICD-MCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove by ligat int hem grps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46946","description":"Remove by ligat int hem grps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENE1","description":"ICD-NENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg > 48 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6253","description":"Absorpt drg > 48 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rec ace/arb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8506","description":"Pt rec ace/arb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXD1","description":"ICD-CCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBB1","description":"ICD-CFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIF0","description":"ICD-KHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOB1","description":"ICD-PBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapy exercise joint rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4018F","description":"Therapy exercise joint rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWC1","description":"ICD-PGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB20","description":"Very High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD126","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEA0","description":"ICD-IGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-93146","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","description":"CPT-93146","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLE1","description":"ICD-AGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOD0","description":"ICD-HFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOE0","description":"ICD-PBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onco (ovar) two proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81500","description":"Onco (ovar) two proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1902","description":"HCPCS-A1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKC1","description":"ICD-JHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMC0","description":"ICD-CIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain lower leg lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27603","description":"Drain lower leg lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOA0","description":"ICD-KAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLF0","description":"ICD-MFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITC0","description":"ICD-OITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg_ mapping) of sentinel lymph node(s) including injection of non-radioactive dye when per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7503","description":"Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg_ mapping) of sentinel lymph node(s) including injection of non-radioactive dye when per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEF0","description":"ICD-NJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHF0","description":"ICD-JGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reteplase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2993","description":"Reteplase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXD0","description":"ICD-JGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUE0","description":"ICD-EDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnosticmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0206","description":"Diagnosticmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ hydroxyprogesterone caproate_ (Makena)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1726","description":"Injection_ hydroxyprogesterone caproate_ (Makena)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFE1","description":"ICD-KBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUB0","description":"ICD-GEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUC1","description":"ICD-GFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB21","description":"ICD-2JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERB0","description":"ICD-GERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMA0","description":"ICD-KHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCE1","description":"ICD-AGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac Tx Nsg Fac Res Fl/Elct Do/Deh Bill Sid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9683","description":"Onsite Ac Tx Nsg Fac Res Fl/Elct Do/Deh Bill Sid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHND1","description":"ICD-GHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHF1","description":"ICD-BDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJA1","description":"ICD-NAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 3 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3378F","description":"Ajcc brstcncr stage 3 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc hip/pelvis les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27047","description":"Exc hip/pelvis les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUB1","description":"ICD-NDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla ii type 1 ag equiv lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81377","description":"Hla ii type 1 ag equiv lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBE0","description":"ICD-JIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Androstanediol glucuronide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82154","description":"Androstanediol glucuronide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLD1","description":"ICD-MDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90483","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","description":"CPT-90483","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBE0","description":"ICD-MCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQB1","description":"ICD-OEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCB1","description":"ICD-GGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTF0","description":"ICD-CBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immed max part denture resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5221","description":"Immed max part denture resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHB0","description":"ICD-FEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYA0","description":"ICD-HIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSB1","description":"ICD-OFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTA1","description":"ICD-EDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"H2o stat docd normal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2030F","description":"H2o stat docd normal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJE0","description":"ICD-GCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCA0","description":"ICD-ABCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGD1","description":"ICD-CEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPC0","description":"ICD-FEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUF1","description":"ICD-MDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMA0","description":"ICD-GHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for wrist x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25246","description":"Injection for wrist x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAF1","description":"ICD-AAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Receiver (Monitor)_ dedicated_ for use with therapeutic continuous glucose mnitor system.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0554","description":"Receiver (Monitor)_ dedicated_ for use with therapeutic continuous glucose mnitor system.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply forearm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29125","description":"Apply forearm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMC0","description":"ICD-GHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEC0","description":"ICD-JGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44370","description":"Small bowel endoscopy/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for salivary x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42550","description":"Injection for salivary x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOB0","description":"ICD-PKOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01969","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","description":"CPT-01969","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKB1","description":"ICD-FIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBB1","description":"ICD-KCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Halo cervical into body jack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0820","description":"Halo cervical into body jack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art trnsposj vertbrl carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35691","description":"Art trnsposj vertbrl carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWB1","description":"ICD-HAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTC0","description":"ICD-BFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPF0","description":"ICD-FAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlorpromazine hcl 5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0161","description":"Chlorpromazine hcl 5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFA0","description":"ICD-GBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81167","description":"BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 3 genotyping (HPA-3)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex]_ antigen CD41 [GPIIb]) (eg_ neonatal alloimmune thrombo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81107","description":"Human Platelet Antigen 3 genotyping (HPA-3)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex]_ antigen CD41 [GPIIb]) (eg_ neonatal alloimmune thrombo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKA1","description":"ICD-OBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spleen imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78185","description":"Spleen imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1740","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1740","description":"HCPCS-C1740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heavy duty control cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6660","description":"Heavy duty control cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHD1","description":"ICD-JFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clamp neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61703","description":"Clamp neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elevate footrest articulate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0053","description":"Elevate footrest articulate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLE1","description":"ICD-IBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTB1","description":"ICD-BHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2390","description":"Solid drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBB0","description":"ICD-CHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42210","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain canal shunt procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61070","description":"Brain canal shunt procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 4 vsts p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90957","description":"Esrd srv 4 vsts p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVB0","description":"ICD-GGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICE0","description":"ICD-BICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLD1","description":"ICD-NLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRC0","description":"ICD-KBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATF0","description":"ICD-BATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70360","description":"X-ray exam of neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSB1","description":"ICD-LFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular disease (acute coronary syndrome [ACS])_ IL-16_ FAS_ FASLigand_ HGF_ CTACK_ EOTAXIN_ and MCP-3 by immunoassay combined with age_ sex_ family history_ and person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0415U","description":"Cardiovascular disease (acute coronary syndrome [ACS])_ IL-16_ FAS_ FASLigand_ HGF_ CTACK_ EOTAXIN_ and MCP-3 by immunoassay combined with age_ sex_ family history_ and person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELE0","description":"ICD-EELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFA0","description":"ICD-FHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETD1","description":"ICD-FETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUB0","description":"ICD-MLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEE1","description":"ICD-AIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCA1","description":"ICD-BGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TAG_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4261","description":"TAG_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDE1","description":"ICD-KIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLF1","description":"ICD-CHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq stent/chest vert art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0075T","description":"Perq stent/chest vert art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical boot each child","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3209","description":"Surgical boot each child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAC1","description":"ICD-CDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No recd cortico>=10mg/d >60d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9468","description":"No recd cortico>=10mg/d >60d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMD1","description":"ICD-FCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMF0","description":"ICD-FCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8G","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic resorbable wound dressing_ sterile_ pad size 16 sq in or less_ without adhesive border_ each dressing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6460","description":"Synthetic resorbable wound dressing_ sterile_ pad size 16 sq in or less_ without adhesive border_ each dressing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultralightweight wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0005","description":"Ultralightweight wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGND0","description":"ICD-FGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1C","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJC1","description":"ICD-NKJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress spinal cord thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63064","description":"Decompress spinal cord thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1436","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","description":"HCPCS-M1436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXC0","description":"ICD-JFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg > 48 sq in w/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6247","description":"Hydrogel drg > 48 sq in w/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCF0","description":"ICD-NKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOD1","description":"ICD-DFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTF1","description":"ICD-BBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5259","description":"Hearing aid_ digit_ bin_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No ster wd ifx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8572","description":"No ster wd ifx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8F","description":"Very High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJE0","description":"ICD-NIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHA0","description":"ICD-AGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOC1","description":"ICD-CIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85415","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin test candida","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86485","description":"Skin test candida","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acellular derm matrix implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15777","description":"Acellular derm matrix implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 1 genotyping (HPA-1)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81105","description":"Human Platelet Antigen 1 genotyping (HPA-1)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RARE DS XOM DNA ALYS PROBAND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0214U","description":"RARE DS XOM DNA ALYS PROBAND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65730","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15A","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77605","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11401","description":"Exc tr-ext b9+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOA0","description":"ICD-KHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIB1","description":"ICD-ACIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Waterjet prostate abltj cmpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0421T","description":"Waterjet prostate abltj cmpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated-aucl_ (Jivi)_ 1U","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7208","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated-aucl_ (Jivi)_ 1U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antihist/decong rx/recom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4133F","description":"Antihist/decong rx/recom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJD0","description":"ICD-CHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADC1","description":"ICD-EADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD134","description":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1447","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","description":"HCPCS-M1447","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNA1","description":"ICD-OJNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar derotation pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1240","description":"Lumbar derotation pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Progressive lens per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2781","description":"Progressive lens per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNA0","description":"ICD-BBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE130","description":"Special Care Low _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/curett of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57454","description":"Bx/curett of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXB1","description":"ICD-CCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27334","description":"Remove knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51050","description":"Removal of bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0144","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLC1","description":"ICD-OKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYC0","description":"ICD-OEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLC1","description":"ICD-EDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmprs burngarment foot-thigh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6508","description":"Cmprs burngarment foot-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBC0","description":"ICD-MJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBND1","description":"ICD-FBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBA1","description":"ICD-JBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWD0","description":"ICD-LBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLE0","description":"ICD-NFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMD0","description":"ICD-MLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRB0","description":"ICD-PKRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJD0","description":"ICD-NLJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOA0","description":"ICD-OBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC01","description":"High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCA1","description":"ICD-IHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAF0","description":"ICD-GFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTC0","description":"ICD-BCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAD1","description":"ICD-EEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBA0","description":"ICD-ACBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA53","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLB0","description":"ICD-ECLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant hormone pellet(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11980","description":"Implant hormone pellet(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIF0","description":"ICD-OIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUC0","description":"ICD-EFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTF1","description":"ICD-FCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGD0","description":"ICD-BAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23156","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATF1","description":"ICD-KATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm aud input receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5285","description":"Ald fm/dm aud input receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVB0","description":"ICD-KFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary rehab rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4033F","description":"Pulmonary rehab rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lyme dis dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87476","description":"Lyme dis dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TDD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5272","description":"TDD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRC1","description":"ICD-CHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep bk ptb laminated socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5540","description":"Prep bk ptb laminated socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPF0","description":"ICD-CDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRC1","description":"ICD-OGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRD0","description":"ICD-CBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOE1","description":"ICD-KFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvef assess planpost dschrge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3019F","description":"Lvef assess planpost dschrge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3d render w/intrp postproces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76376","description":"3d render w/intrp postproces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKD1","description":"ICD-NGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWD0","description":"ICD-HIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ udenyca 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5111","description":"Injection_ udenyca 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHA0","description":"ICD-MGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBA0","description":"ICD-GFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement pressure alarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1540","description":"Replacement pressure alarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOF0","description":"ICD-DIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vaccinia (smallpox) virus vaccine_ live_ lyophilized_ 0.3 mL dosage_ for percutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90622","description":"Vaccinia (smallpox) virus vaccine_ live_ lyophilized_ 0.3 mL dosage_ for percutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYD0","description":"ICD-GDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","description":"HCPCS-J2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDED1","description":"ICD-NDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBE0","description":"ICD-BDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed fx ht w/o rail w/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0291","description":"Hosp bed fx ht w/o rail w/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHD1","description":"ICD-KAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFC0","description":"ICD-OHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWD0","description":"ICD-CHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACC1","description":"ICD-NACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKA0","description":"ICD-BHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amiodarone hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0282","description":"Amiodarone hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIME0","description":"ICD-CIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thera&Couns Svcs (Counseling Svcs)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0093","description":"Thera&Couns Svcs (Counseling Svcs)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lithium ion battery charger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7368","description":"Lithium ion battery charger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acoustic immitance testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92570","description":"Acoustic immitance testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYB0","description":"ICD-GGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC13","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA11","description":"ICD-3FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPB0","description":"ICD-CBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open tx dprsd front sinus fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21343","description":"Open tx dprsd front sinus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med ind for induction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9361","description":"Med ind for induction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPA0","description":"ICD-ODPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGB1","description":"ICD-NDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrolyte panel this panel must include the following: carbon dioxide (82374) chloride (82435) potassium (84132) sodium (84295)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80051","description":"Electrolyte panel this panel must include the following: carbon dioxide (82374) chloride (82435) potassium (84132) sodium (84295)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAC0","description":"ICD-BGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJE1","description":"ICD-NKJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVC1","description":"ICD-OCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHA0","description":"ICD-KFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEA0","description":"ICD-IBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPA1","description":"ICD-GDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51590","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMD1","description":"ICD-IEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB245","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAB0","description":"ICD-CAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFD1","description":"ICD-CFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8H","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removable insert each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6691","description":"Removable insert each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXF0","description":"ICD-FGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEF0","description":"ICD-EEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPA0","description":"ICD-JFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABF0","description":"ICD-JABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIB1","description":"ICD-GCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home vent mgmt supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94005","description":"Home vent mgmt supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00104","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","description":"CPT-00104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt edu re alcoh drnkng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4158F","description":"Pt edu re alcoh drnkng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver elastography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91200","description":"Liver elastography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRF1","description":"ICD-CGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPA1","description":"ICD-JBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cid transmit coil and cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8629","description":"Cid transmit coil and cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2035","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","description":"HCPCS-A2035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0137U","description":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFE0","description":"ICD-BEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hgb lvl 11-12.9 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3280F","description":"Hgb lvl 11-12.9 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo by other than infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0083","description":"Chemo by other than infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML30","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCE0","description":"ICD-CFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-93897","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","description":"CPT-93897","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJB1","description":"ICD-NFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System With Interim Analysis_ Review(S) And Report(S) By A P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0578T","description":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System With Interim Analysis_ Review(S) And Report(S) By A P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTB1","description":"ICD-AHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIB0","description":"ICD-OBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWF1","description":"ICD-GIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCA0","description":"ICD-MDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adj skin pro w/c cus wd<22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2622","description":"Adj skin pro w/c cus wd<22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUC0","description":"ICD-CDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFA0","description":"ICD-CHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGF0","description":"ICD-FGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8D","description":"Low Rehab_ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRB0","description":"ICD-DFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped term dev_ hand_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6714","description":"Ped term dev_ hand_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCC0","description":"ICD-ODCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92285","description":"Eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHE1","description":"ICD-ADHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUE1","description":"ICD-MKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iodine I-131_ Iobenguane_ 1 Millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9590","description":"Iodine I-131_ Iobenguane_ 1 Millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYE0","description":"ICD-CBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L2221","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","description":"HCPCS-L2221","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB53","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAD0","description":"ICD-KGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Female patients unable to bear children","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1016","description":"Female patients unable to bear children","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAF1","description":"ICD-EBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX45","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYD0","description":"ICD-PHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCC0","description":"ICD-ABCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65220","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMB0","description":"ICD-KAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUD1","description":"ICD-MAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHD0","description":"ICD-IEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWE0","description":"ICD-CBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyperbaric oxygen therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99183","description":"Hyperbaric oxygen therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm splint fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4022","description":"Cast sup sht arm splint fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped dynamic seating frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2295","description":"Ped dynamic seating frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQD1","description":"ICD-LBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQC0","description":"ICD-OKQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46942","description":"Treatment of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMD1","description":"ICD-ADMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYC0","description":"ICD-HEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCC0","description":"ICD-MDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC17","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHE0","description":"ICD-KEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Md doc_ door to punc tm >2hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9581","description":"Md doc_ door to punc tm >2hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAE0","description":"ICD-GCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of pyruvate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84210","description":"Assay of pyruvate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPC1","description":"ICD-NCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUF1","description":"ICD-EDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEA1","description":"ICD-ABEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRF0","description":"ICD-DGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vkorc1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81355","description":"Vkorc1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOE1","description":"ICD-GHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA43","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNE0","description":"ICD-JHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYF1","description":"ICD-PHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain stem w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70552","description":"MRI brain stem w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQE0","description":"ICD-KGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35226","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUD0","description":"ICD-ACUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC46","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Composite byp grft 3/> segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35683","description":"Composite byp grft 3/> segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Lynch syndrome)_ genomic DNA sequence analysis of MLH1_ MSH2_ MSH6_ PMS2_ and EPCAM_ including small sequence changes in exonic and intronic regions_ deletions_ dupl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0238U","description":"Oncology (Lynch syndrome)_ genomic DNA sequence analysis of MLH1_ MSH2_ MSH6_ PMS2_ and EPCAM_ including small sequence changes in exonic and intronic regions_ deletions_ dupl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cltx thigh fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27268","description":"Cltx thigh fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"WoundEx Flow_ BioSkin Flow_ 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4162","description":"WoundEx Flow_ BioSkin Flow_ 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAD0","description":"ICD-IAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epcoritamab-bysp_ 0.16 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9321","description":"Injection_ epcoritamab-bysp_ 0.16 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTA1","description":"ICD-ODTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUD0","description":"ICD-MCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult size brief/diaper med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4522","description":"Adult size brief/diaper med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC33","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPC1","description":"ICD-CCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRB0","description":"ICD-CFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVB0","description":"ICD-FGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Set-Up Fees)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7335","description":"Community Transition Svcs (Set-Up Fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4C","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAC1","description":"ICD-GAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLF1","description":"ICD-GBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1018","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCD1","description":"ICD-NHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental case management - addressing appointment compliance barriers","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9991","description":"Dental case management - addressing appointment compliance barriers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fev >/=40% predicted value","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3042F","description":"Fev >/=40% predicted value","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWB1","description":"ICD-OAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC21","description":"ICD-2AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSD1","description":"ICD-LHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLB1","description":"ICD-FFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGF1","description":"ICD-BCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap rmvl gastr adj all parts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43774","description":"Lap rmvl gastr adj all parts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 vhd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0863","description":"Pwc gp3 vhd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLB0","description":"ICD-JBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of arm muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24331","description":"Revision of arm muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWC0","description":"ICD-OHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALE0","description":"ICD-CALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVA0","description":"ICD-JFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare donor lung double","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32856","description":"Prepare donor lung double","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADA1","description":"ICD-BADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHE1","description":"ICD-OAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moisture exchanger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4483","description":"Moisture exchanger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVE1","description":"ICD-NGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23655","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43289","description":"Laparoscope proc esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Back upholstery_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0982","description":"Back upholstery_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Current tobacco smoker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1034F","description":"Current tobacco smoker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proton trmt simple w/comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77522","description":"Proton trmt simple w/comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSE0","description":"ICD-OLSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incontinence product_ disposable_ penile wrap_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4545","description":"Incontinence product_ disposable_ penile wrap_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHE1","description":"ICD-MFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXC0","description":"ICD-GFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBC0","description":"ICD-MEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ace/arb thxpy not rxd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8475","description":"Ace/arb thxpy not rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKA1","description":"ICD-NLKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AmnioTX_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4324","description":"AmnioTX_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYB0","description":"ICD-GEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB230","description":"Special Care High _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAD0","description":"ICD-OHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJD1","description":"ICD-OGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDC1","description":"ICD-OEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Received An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2163","description":"Patient Received An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"<50% of total number of a patient_s outpatient RA encounters assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1008","description":"<50% of total number of a patient_s outpatient RA encounters assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXE1","description":"ICD-KDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIE1","description":"ICD-EEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Feeding aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5951","description":"Feeding aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-81558","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","description":"CPT-81558","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADC0","description":"ICD-BADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB144","description":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGED1","description":"ICD-CGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kyphosis pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1020","description":"Kyphosis pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHD1","description":"ICD-CFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Disease_ Bacterial Vaginosis And Vaginitis_ Quantitative Real-Time Amplification Of Dna Markers For Gardnerella Vaginalis_ Atopobium Vaginae_ Megasphaera Type 1_ Ba","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81514","description":"Infectious Disease_ Bacterial Vaginosis And Vaginitis_ Quantitative Real-Time Amplification Of Dna Markers For Gardnerella Vaginalis_ Atopobium Vaginae_ Megasphaera Type 1_ Ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHA1","description":"ICD-ICHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBD1","description":"ICD-AGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJD0","description":"ICD-GCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0958T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","description":"CPT-0958T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAA1","description":"ICD-CDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHF1","description":"ICD-EAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBD0","description":"ICD-IIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUE1","description":"ICD-MBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJF1","description":"ICD-ODJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAF1","description":"ICD-MAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPE0","description":"ICD-OGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy treat blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31641","description":"Bronchoscopy treat blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic appliance half arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0655","description":"Pneumatic appliance half arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLC0","description":"ICD-IBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFE0","description":"ICD-FBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7351","description":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXE1","description":"ICD-OHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIND0","description":"ICD-GIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99151","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice_ inpatient hospital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5005","description":"Hospice_ inpatient hospital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAA0","description":"ICD-IAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gemcitabine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9201","description":"Gemcitabine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52330","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whlchr stand fxd arm ft rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1130","description":"Whlchr stand fxd arm ft rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46730","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUF0","description":"ICD-FHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PolyCyte_ for topical use only_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4241","description":"PolyCyte_ for topical use only_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJE1","description":"ICD-OFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEC0","description":"ICD-CDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing care_ in the home; b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9124","description":"Nursing care_ in the home; b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor fletcher fact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85292","description":"Clot factor fletcher fact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecallantide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1290","description":"Ecallantide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCE1","description":"ICD-BHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rev_ comm_ track_ doc biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8883","description":"Rev_ comm_ track_ doc biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Histotripsy (Ie_ Non-Thermal Ablation Via Acoustic Energy Delivery) Of Malignant Hepatocellular Tissue_ Including Image Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0686T","description":"Histotripsy (Ie_ Non-Thermal Ablation Via Acoustic Energy Delivery) Of Malignant Hepatocellular Tissue_ Including Image Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31755","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43633","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEA1","description":"ICD-EBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANF0","description":"ICD-FANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srs cran les simple addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61797","description":"Srs cran les simple addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGME0","description":"ICD-IGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLE1","description":"ICD-FBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNE1","description":"ICD-NJNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHE0","description":"ICD-MIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27727","description":"Repair of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKF0","description":"ICD-OCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62302","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD116","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEF1","description":"ICD-CFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJA1","description":"ICD-CAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18G","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ central nervous system pathogen_ metagenomic next-generation sequencing_ cerebrospinal fluid (CSF)_ identification of","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0323U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ central nervous system pathogen_ metagenomic next-generation sequencing_ cerebrospinal fluid (CSF)_ identification of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOF1","description":"ICD-GCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy for aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31515","description":"Laryngoscopy for aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYE1","description":"ICD-PGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TB screening performed and results interpreted within 12 months prior to initiation of first-time biologic disease modifying an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1003","description":"TB screening performed and results interpreted within 12 months prior to initiation of first-time biologic disease modifying an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bh ltc res r&b_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2048","description":"Bh ltc res r&b_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMA0","description":"ICD-MEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43887","description":"Remove gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ercp duct stent placement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43274","description":"Ercp duct stent placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAF1","description":"ICD-CHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair lead pace-defib one","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33218","description":"Repair lead pace-defib one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMC1","description":"ICD-FGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0670T","description":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUE1","description":"ICD-KEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Larynscop w/tumr exc + scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31541","description":"Larynscop w/tumr exc + scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine accessory nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63191","description":"Incise spine accessory nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYC0","description":"ICD-DFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWB1","description":"ICD-PKWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25445","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62223","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE104","description":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAF1","description":"ICD-NLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0007","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJD0","description":"ICD-JEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWA0","description":"ICD-GEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc taa repr incl subcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33880","description":"Endovasc taa repr incl subcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88164","description":"Cytopath tbs c/v manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intraoral procedures_ including biopsy; radical surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0126U","description":"Anesthesia for intraoral procedures_ including biopsy; radical surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLA0","description":"ICD-NKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRE1","description":"ICD-LIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADD1","description":"ICD-NADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0576U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","description":"CPT-0576U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAF1","description":"ICD-JGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEND0","description":"ICD-BEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPA1","description":"ICD-BCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJA1","description":"ICD-CFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ovrsght xtrcorp liv asst pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0405T","description":"Ovrsght xtrcorp liv asst pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAE0","description":"ICD-CAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a suicide safety plan initiated_ reviewed_ or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1354","description":"Patients who did not have a suicide safety plan initiated_ reviewed_ or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ic lbw inf 1500-2500 g subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99479","description":"Ic lbw inf 1500-2500 g subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC11","description":"ICD-2JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd trach dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87492","description":"Chylmd trach dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6562","description":"Gradient compression stocking_ waist length_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29892","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFE1","description":"ICD-NDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98986","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","description":"CPT-98986","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Provisional pontic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6253","description":"Provisional pontic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28I","description":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43855","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOA0","description":"ICD-OKOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEC1","description":"ICD-KAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd pneum dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87487","description":"Chylmd pneum dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEE0","description":"ICD-NJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLE0","description":"ICD-NGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ftl cgen abnor four anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81511","description":"Ftl cgen abnor four anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUF1","description":"ICD-OCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of thyroid activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84442","description":"Assay of thyroid activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0623U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","description":"CPT-0623U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIC1","description":"ICD-EBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYD0","description":"ICD-LDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sm 153 lexidronam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9604","description":"Sm 153 lexidronam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBID0","description":"ICD-JBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAC1","description":"ICD-ADAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAB1","description":"ICD-AFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECD0","description":"ICD-JECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIE1","description":"ICD-AFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUA0","description":"ICD-NJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXD1","description":"ICD-CFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28G","description":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXF0","description":"ICD-OJXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGF0","description":"ICD-NIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthroereisis_ subtalar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2117","description":"Arthroereisis_ subtalar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fecal blood scrn immunoassay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0328","description":"Fecal blood scrn immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1101","description":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYF1","description":"ICD-GBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVB0","description":"ICD-OKVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9963","description":"Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of feces for trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84490","description":"Assay of feces for trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1282","description":"Patient screened for tobacco use and identified as a tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHD0","description":"ICD-KCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUB0","description":"ICD-NKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHED0","description":"ICD-FHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYA0","description":"ICD-HHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBME1","description":"ICD-JBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHF0","description":"ICD-MLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29530","description":"Strapping of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDME0","description":"ICD-GDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Create new tubal opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58770","description":"Create new tubal opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA21","description":"ICD-2KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJD0","description":"ICD-BHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Room and Board Rate - A flat per diem rate before area wage adjustment for patients whose home is a nursing home.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0606","description":"Room and Board Rate - A flat per diem rate before area wage adjustment for patients whose home is a nursing home.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB32","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFD1","description":"ICD-CIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Talk re uv light pt/crgvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4176F","description":"Talk re uv light pt/crgvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADA1","description":"ICD-GADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD221","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76604","description":"Us exam chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDA1","description":"ICD-CCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUE1","description":"ICD-MHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid frame pre subclav","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0470","description":"Tlso rigid frame pre subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7176","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7176","description":"HCPCS-J7176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0673U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673U","description":"CPT-0673U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEA1","description":"ICD-OGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETF1","description":"ICD-KETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWA0","description":"ICD-HGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M.tuberculo dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87557","description":"M.tuberculo dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace lithium battery 1.5v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4602","description":"Replace lithium battery 1.5v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj phrenic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64410","description":"N block inj phrenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Known Familial Variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81353","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Known Familial Variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1B","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIF1","description":"ICD-BAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRE0","description":"ICD-DCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTA1","description":"ICD-CFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydration status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2018F","description":"Hydration status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFD0","description":"ICD-NBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve repair w/allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64910","description":"Nerve repair w/allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crgvr prov w/ ed addl rsrcs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4322F","description":"Crgvr prov w/ ed addl rsrcs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ avelumab_ 10mg (bavencio)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9491","description":"Injection_ avelumab_ 10mg (bavencio)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asthma symptoms evaluate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1005F","description":"Asthma symptoms evaluate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg perthes orth toronto typ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1700","description":"Leg perthes orth toronto typ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOC0","description":"ICD-CIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAA0","description":"ICD-EFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITD1","description":"ICD-CITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with transvenous sensing and stimulation leads","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1823","description":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with transvenous sensing and stimulation leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thrombin time titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85675","description":"Thrombin time titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13A","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald neck_ loop ind receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5283","description":"Ald neck_ loop ind receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28234","description":"Incision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGND0","description":"ICD-CGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not trans to hosp at d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8915","description":"Pt not trans to hosp at d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonpneumatic compression controller with sequential calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1024","description":"Nonpneumatic compression controller with sequential calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELD0","description":"ICD-IELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject spine lumbar/sacral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62311","description":"Inject spine lumbar/sacral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJE1","description":"ICD-CBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1806","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1806","description":"CDT-D1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whchr h-duty det arm leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1280","description":"Whchr h-duty det arm leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9838","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup body cast fiberglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4002","description":"Cast sup body cast fiberglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIA1","description":"ICD-GAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72146","description":"MRI chest spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIE0","description":"ICD-OGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCB0","description":"ICD-CFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHC0","description":"ICD-IBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMF1","description":"ICD-OFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYC1","description":"ICD-OEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVC1","description":"ICD-OBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQA0","description":"ICD-ODQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Micro exam prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0473","description":"Micro exam prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ for screening for peripheral arterial disease_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0860T","description":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ for screening for peripheral arterial disease_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25A","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE104","description":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDF1","description":"ICD-KHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optic nerve head eval done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2027F","description":"Optic nerve head eval done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ inotuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9028","description":"Injection_ inotuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUA1","description":"ICD-ABUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93592","description":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNE1","description":"ICD-CCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPF0","description":"ICD-OIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth kidney stone destruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87251","description":"Anesth kidney stone destruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD115","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGB0","description":"ICD-NGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDND0","description":"ICD-BDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bladder calculi irrig sol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2004","description":"Bladder calculi irrig sol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYF0","description":"ICD-CDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGB1","description":"ICD-GEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTD0","description":"ICD-MBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision subvalvular tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33415","description":"Revision subvalvular tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYF0","description":"ICD-GGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMB1","description":"ICD-GCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEC0","description":"ICD-MAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23B","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHE1","description":"ICD-FIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27245","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFF0","description":"ICD-OIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of toe tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28232","description":"Incision of toe tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gardner vag dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87510","description":"Gardner vag dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exchange lens prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66986","description":"Exchange lens prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reuse diaper/brief any size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4539","description":"Reuse diaper/brief any size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCC1","description":"ICD-ODCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40701","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meningococcal recombinant protein and outer membrane vesicle vaccine_ serogroup B (MenB-4C)_ 2 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90620","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine_ serogroup B (MenB-4C)_ 2 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOE0","description":"ICD-KBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCME0","description":"ICD-OCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0103","description":"HCPCS-C0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIA1","description":"ICD-EIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIF1","description":"ICD-MAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGD0","description":"ICD-NEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11C","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUB1","description":"ICD-OAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artificial insemination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58322","description":"Artificial insemination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBA1","description":"ICD-CHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11451","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNF0","description":"ICD-OHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63268","description":"Excise intrspinl lesion scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art pressure waveform analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93050","description":"Art pressure waveform analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; each additional 30 minutes of technician time (List separate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0367T","description":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; each additional 30 minutes of technician time (List separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOF0","description":"ICD-CGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1902","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1902","description":"CDT-D1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radium ra223 dichloride ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9606","description":"Radium ra223 dichloride ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWC1","description":"ICD-LIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical placement: zygomatic implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7994","description":"Surgical placement: zygomatic implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ankle ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27696","description":"Repair of ankle ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWF1","description":"ICD-LFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDC0","description":"ICD-OCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBID0","description":"ICD-FBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable catheter tips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4860","description":"Disposable catheter tips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRD1","description":"ICD-KDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43118","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc no pain comfort 48hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9251","description":"Doc no pain comfort 48hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multi-axial rotation unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5986","description":"Multi-axial rotation unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 1 vst p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90959","description":"Esrd serv 1 vst p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPD1","description":"ICD-KAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-bvzr_ biosimilar_ (Zirabev)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5118","description":"Injection_ bevacizumab-bvzr_ biosimilar_ (Zirabev)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; assessment of bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0556T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; assessment of bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IDH2 (isocitrate dehydrogenase 2 [NADP+]_ mitochondrial) (eg_ glioma)_ common variants (eg_ R140W_ R172M)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81121","description":"IDH2 (isocitrate dehydrogenase 2 [NADP+]_ mitochondrial) (eg_ glioma)_ common variants (eg_ R140W_ R172M)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUF0","description":"ICD-KFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5008","description":"Hearing screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWC0","description":"ICD-DDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGE1","description":"ICD-FAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAF0","description":"ICD-NKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEC0","description":"ICD-KFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHF0","description":"ICD-EIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHB1","description":"ICD-BGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90481","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","description":"CPT-90481","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroscopic procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76496","description":"Fluoroscopic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise kidney blood vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50100","description":"Revise kidney blood vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening cocaine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80353","description":"Drug screening cocaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC131","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB53","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc w burn prior to d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8908","description":"Pt doc w burn prior to d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFA1","description":"ICD-OJFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair testis injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54670","description":"Repair testis injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auricular prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5914","description":"Auricular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantable tissue marker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4648","description":"Implantable tissue marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mobile arm supports reclinin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2628","description":"Mobile arm supports reclinin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAA0","description":"ICD-JBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRF1","description":"ICD-OKRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDB0","description":"ICD-MEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Including Rib(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21601","description":"Excision Of Chest Wall Tumor Including Rib(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUE0","description":"ICD-CBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIF1","description":"ICD-EEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJA1","description":"ICD-KHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKA1","description":"ICD-OEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1A","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUF0","description":"ICD-CFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJC0","description":"ICD-JDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIF0","description":"ICD-GGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOB0","description":"ICD-PHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDED1","description":"ICD-MDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRB0","description":"ICD-PDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUC1","description":"ICD-CHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBF0","description":"ICD-MIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67040","description":"Laser treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Female condom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4268","description":"Female condom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remov vert idrl bdy thrclmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63306","description":"Remov vert idrl bdy thrclmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1783","description":"vaccine administration-human papillomavirus - Dose 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24360","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"R&l hrt art/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93460","description":"R&l hrt art/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUB0","description":"ICD-JBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic & hip control thigh c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1680","description":"Pelvic & hip control thigh c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing complete lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81372","description":"Hla i typing complete lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATE0","description":"ICD-GATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAF0","description":"ICD-MIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIA1","description":"ICD-OFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWD1","description":"ICD-GAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below elbow myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6935","description":"Below elbow myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNF1","description":"ICD-GDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUA1","description":"ICD-MLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ ultra-rapid sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0426U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ ultra-rapid sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBF0","description":"ICD-NDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOE1","description":"ICD-CIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECD0","description":"ICD-BECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGF1","description":"ICD-JEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92990","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGD1","description":"ICD-FDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22103","description":"Remove extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensve oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0150","description":"Comprehensve oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWB0","description":"ICD-PGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHD0","description":"ICD-CBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin D_ 25 hydroxy D2 and D3_ by LC-MS/MS_ serum microsample_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0038U","description":"Vitamin D_ 25 hydroxy D2 and D3_ by LC-MS/MS_ serum microsample_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93975","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein byp fem-tibial peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35585","description":"Vein byp fem-tibial peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIE0","description":"ICD-FGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42235","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWC1","description":"ICD-OJWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLB1","description":"ICD-JFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph bx rprt w/dyspl info","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3126F","description":"Esoph bx rprt w/dyspl info","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of myoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83874","description":"Assay of myoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL46","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMD0","description":"ICD-ADMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEE0","description":"ICD-CFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKC0","description":"ICD-BFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21610","description":"Partial removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible; proximal to splenic flexure; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6024","description":"Colonoscopy_ flexible; proximal to splenic flexure; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v auto in fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88174","description":"Cytopath c/v auto in fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg_ carrier testing)_ includes SMN2 (survival of motor neur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81329","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg_ carrier testing)_ includes SMN2 (survival of motor neur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLE0","description":"ICD-KHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Holster elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0498","description":"Holster elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABC0","description":"ICD-OABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11A","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6059","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIA1","description":"ICD-ADIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFF1","description":"ICD-GIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ femur_ two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73550","description":"Radiologic examination_ femur_ two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUA0","description":"ICD-IHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"(Rapivab) Injection_ Peramivir_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9451","description":"(Rapivab) Injection_ Peramivir_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNB0","description":"ICD-NKNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA125","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/o dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8932","description":"Mra_ w/o dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"2high risk no ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9368","description":"2high risk no ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJID0","description":"ICD-OJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEC0","description":"ICD-EEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOF1","description":"ICD-HAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Etanercept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1438","description":"Etanercept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66172","description":"Incision of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEE1","description":"ICD-CBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dark adaptation eye exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92284","description":"Dark adaptation eye exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA GIARDIA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87329","description":"IAAD IA GIARDIA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise prosth vag graft lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57426","description":"Revise prosth vag graft lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot_ adductus positioning device_ adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3161","description":"Foot_ adductus positioning device_ adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnioband_ guardian 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4151","description":"Amnioband_ guardian 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/bone grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21408","description":"Opn tx orbit fx w/bone grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSF0","description":"ICD-CHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB216","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQF0","description":"ICD-HAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKE1","description":"ICD-FCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban_ 1 mg (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0884","description":"Injection_ argatroban_ 1 mg (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26070","description":"Explore/treat hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOA0","description":"ICD-GAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo pos solid ank plastic mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1960","description":"Afo pos solid ank plastic mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWC1","description":"ICD-GHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy trisom risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0009M","description":"Fetal aneuploidy trisom risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACA1","description":"ICD-EACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sgmdsc w/band ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45350","description":"Sgmdsc w/band ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57530","description":"Removal of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec seat depth/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1298","description":"Wheelchair spec seat depth/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I & d of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56405","description":"I & d of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBF0","description":"ICD-BEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB20","description":"High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48154","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40840","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTD0","description":"ICD-FDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53265","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Symes type ptb brim design s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5632","description":"Symes type ptb brim design s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pelvis bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26991","description":"Drainage of pelvis bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icm device interrogat remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93297","description":"Icm device interrogat remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDF0","description":"ICD-FBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATC0","description":"ICD-KATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEF0","description":"ICD-KAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0622U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","description":"CPT-0622U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB254","description":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantable/insertable device for device intensive procedure_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1889","description":"Implantable/insertable device for device intensive procedure_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Belimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0490","description":"Belimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLB1","description":"ICD-CBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulm fx w/in 12 mon b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3038F","description":"Pulm fx w/in 12 mon b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compressor nondispos filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7014","description":"Compressor nondispos filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUE1","description":"ICD-EDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ekg interpret & report preve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0405","description":"Ekg interpret & report preve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIE1","description":"ICD-KBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB11","description":"ICD-2JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVD0","description":"ICD-JGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; unilateral placement_ including cystoscopy and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0549T","description":"Transperineal periurethral balloon continence device; unilateral placement_ including cystoscopy and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14B","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIC1","description":"ICD-OHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQB0","description":"ICD-LHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient recorded spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94015","description":"Patient recorded spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVF1","description":"ICD-OBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCE1","description":"ICD-CFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE201","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixation of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23700","description":"Fixation of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCE0","description":"ICD-BCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supplemental electrical test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92547","description":"Supplemental electrical test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUD0","description":"ICD-JGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOE0","description":"ICD-LHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9592","description":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17271","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9909","description":"Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB21","description":"ICD-2GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGF1","description":"ICD-CBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFB1","description":"ICD-OCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAF0","description":"ICD-NCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENC1","description":"ICD-NENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCC0","description":"ICD-GGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of metatarsal heads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28114","description":"Removal of metatarsal heads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFF1","description":"ICD-OJFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBB1","description":"ICD-GEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIE1","description":"ICD-ODIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC31","description":"ICD-3GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLE1","description":"ICD-KFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDE0","description":"ICD-JCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKE1","description":"ICD-OKKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programming Device Evaluation (In-Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0683T","description":"Programming Device Evaluation (In-Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49592","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEA0","description":"ICD-BAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"One-way allow prorated miles","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9603","description":"One-way allow prorated miles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASE1","description":"ICD-LASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49595","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITD1","description":"ICD-GITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUC1","description":"ICD-NEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEB1","description":"ICD-IDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD146","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","description":"HCPCS-J0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla ii typing 1 allele hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81383","description":"Hla ii typing 1 allele hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTC1","description":"ICD-OFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRF1","description":"ICD-DGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIE1","description":"ICD-MGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMA1","description":"ICD-KDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test feces for trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84488","description":"Test feces for trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fungi identification mold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87107","description":"Fungi identification mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDA0","description":"ICD-ACDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Symes ankle w/o (sach) foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5703","description":"Symes ankle w/o (sach) foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx px nfrosgrm &/urtrgrm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50431","description":"Njx px nfrosgrm &/urtrgrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reguard_ for topical use only_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4255","description":"Reguard_ for topical use only_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary rehab w exer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0424","description":"Pulmonary rehab w exer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHC0","description":"ICD-MIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4B","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBF1","description":"ICD-NCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag rigid frame cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0632","description":"Lso sag rigid frame cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJE0","description":"ICD-FAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWA0","description":"ICD-DCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair laminectomy defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63295","description":"Repair laminectomy defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vedolizumab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80280","description":"Vedolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQA0","description":"ICD-GEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryoprecipitatereducedplasma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9044","description":"Cryoprecipitatereducedplasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fit aphakia spectcl monofocl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92352","description":"Fit aphakia spectcl monofocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med admin_ not oral/inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1503","description":"Med admin_ not oral/inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic digital breast tomosynthesis_ unilateral or bilateral (list separately in addition to 77065-77067)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0279","description":"Diagnostic digital breast tomosynthesis_ unilateral or bilateral (list separately in addition to 77065-77067)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ circulating tumor cell selection_ identification_ morphological characterization_ detection and enumeration based on differential EpCAM_ cytokeratins 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0338U","description":"Oncology (solid tumor)_ circulating tumor cell selection_ identification_ morphological characterization_ detection and enumeration based on differential EpCAM_ cytokeratins 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEF0","description":"ICD-NDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61524","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24400","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45135","description":"Excision of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVD0","description":"ICD-KFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOC1","description":"ICD-PBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSF0","description":"ICD-LFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITD1","description":"ICD-OITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21C","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92851","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ deoxycholic acid_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0591","description":"Injection_ deoxycholic acid_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other immunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86325","description":"Other immunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAID0","description":"ICD-GAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGB0","description":"ICD-GHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTB1","description":"ICD-MLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9807","description":"HCPCS-C9807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB210","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMB1","description":"ICD-GHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCA0","description":"ICD-IHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace thrc unit hrt syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052T","description":"Replace thrc unit hrt syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28E","description":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPA0","description":"ICD-KFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAB1","description":"ICD-KDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ DNA_ next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy_ urine_ algorithms reported as minimal residual disease (MRD) status positive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0467U","description":"Oncology (bladder)_ DNA_ next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy_ urine_ algorithms reported as minimal residual disease (MRD) status positive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIE0","description":"ICD-AEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIID0","description":"ICD-EIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENC1","description":"ICD-OENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise/repair mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40814","description":"Excise/repair mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOF0","description":"ICD-LGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phenotype dna hiv w/culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87903","description":"Phenotype dna hiv w/culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48000","description":"Drainage of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx of cervix w/scope leep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57460","description":"Bx of cervix w/scope leep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0507","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of horseshoe kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50540","description":"Revision of horseshoe kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50949","description":"Laparoscope proc ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0952T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","description":"CPT-0952T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine incon characterized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1091F","description":"Urine incon characterized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIF1","description":"ICD-NBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTE0","description":"ICD-FBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intro/sheath_strble_non-peel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1766","description":"Intro/sheath_strble_non-peel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam infant hips static","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76886","description":"Us exam infant hips static","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin substitute_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4100","description":"Skin substitute_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTA1","description":"ICD-MCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGC1","description":"ICD-KCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLE1","description":"ICD-NDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMB1","description":"ICD-ICMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9488","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of femur 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73551","description":"X-ray exam of femur 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ob us nuchal meas add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76814","description":"Ob us nuchal meas add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0303","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0303","description":"CDT-D0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXE1","description":"ICD-KFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWA0","description":"ICD-LAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMB0","description":"ICD-NFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWD1","description":"ICD-OFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOD0","description":"ICD-CFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUF1","description":"ICD-JIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB21","description":"ICD-2HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAE0","description":"ICD-CIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTB1","description":"ICD-MJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAC0","description":"ICD-KGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBA0","description":"ICD-JGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICC1","description":"ICD-BICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain external ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69005","description":"Drain external ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAC0","description":"ICD-OGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDD1","description":"ICD-GFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21C","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETD1","description":"ICD-AETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection jaw joint x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21116","description":"Injection jaw joint x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB31","description":"ICD-2LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTC1","description":"ICD-GFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24C","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4544","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","description":"HCPCS-A4544","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUD1","description":"ICD-BBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replcmnt breast pump bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4285","description":"Replcmnt breast pump bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJC1","description":"ICD-NFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompressive lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61323","description":"Decompressive lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antibiot not rxd/given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4124F","description":"Antibiot not rxd/given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX11","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFC0","description":"ICD-CIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUC1","description":"ICD-JDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam ribs uni 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71100","description":"X-ray exam ribs uni 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD251","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCE0","description":"ICD-FFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTE1","description":"ICD-FGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ria nonantibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83519","description":"Ria nonantibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48152","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1250","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA07","description":"Medium Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glycopyrrolate comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7643","description":"Glycopyrrolate comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQF0","description":"ICD-PAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50360","description":"Transplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWC0","description":"ICD-PHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYB1","description":"ICD-GHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1101","description":"HCPCS-A1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ initial single antibody stain procedure (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0760T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ initial single antibody stain procedure (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enter infusion pump w/o alrm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9000","description":"Enter infusion pump w/o alrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18X","description":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esano a_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4272","description":"Esano a_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth blepharoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10351","description":"Anesth blepharoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANC1","description":"ICD-GANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC230","description":"Clinically Complex _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Csit perf on low chd rsk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8965","description":"Csit perf on low chd rsk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","description":"HCPCS-J3389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11A","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHID0","description":"ICD-EHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTA0","description":"ICD-NGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUC0","description":"ICD-CGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVB1","description":"ICD-OHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21087","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g._ porcine small intestine submocosa[SIS])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9796","description":"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g._ porcine small intestine submocosa[SIS])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKA0","description":"ICD-OCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0569","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","description":"HCPCS-G0569","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36575","description":"Repair tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIC0","description":"ICD-JGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAF1","description":"ICD-FDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWD1","description":"ICD-PCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54336","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJA1","description":"ICD-FFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMD1","description":"ICD-OHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc gastro 51 gene nomogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0007M","description":"Onc gastro 51 gene nomogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10A","description":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOF1","description":"ICD-GIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup hip spica ped fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4028","description":"Cast sup hip spica ped fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N-et; commerc carrier pass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2004","description":"N-et; commerc carrier pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHA1","description":"ICD-JBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQF0","description":"ICD-GFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYC0","description":"ICD-CFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES234","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Detach non-adjus hght armrst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0015","description":"Detach non-adjus hght armrst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEE0","description":"ICD-NBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHB0","description":"ICD-AGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Mrna_ Next-Generation Sequencing Gene Expression Profiling Of 70 Content Genes And 31 Housekeeping Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81523","description":"Oncology (Breast)_ Mrna_ Next-Generation Sequencing Gene Expression Profiling Of 70 Content Genes And 31 Housekeeping Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ edaravone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9493","description":"Injection_ edaravone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWF0","description":"ICD-PDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove femur lesion/bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27062","description":"Remove femur lesion/bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28D","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXF1","description":"ICD-OKXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47130","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt scrn dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3759F","description":"Pt scrn dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHND1","description":"ICD-NHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00164","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","description":"CPT-00164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICA0","description":"ICD-AICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg arterial two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33534","description":"Cabg arterial two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHA1","description":"ICD-IIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEF1","description":"ICD-MHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEB0","description":"ICD-MHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implnt/abut remov dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6110","description":"Implnt/abut remov dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQC1","description":"ICD-HDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVC1","description":"ICD-GBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAC1","description":"ICD-FIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSE0","description":"ICD-LCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ infliximab-dyyb (Zymfentra)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1748","description":"Injection_ infliximab-dyyb (Zymfentra)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0C","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUF0","description":"ICD-GCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37274","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","description":"CPT-37274","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76831","description":"Echo exam uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clin depres scrn no f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8511","description":"Clin depres scrn no f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect diaphragm complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39561","description":"Resect diaphragm complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 4 genotyping (HPA-4)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81108","description":"Human Platelet Antigen 4 genotyping (HPA-4)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam roll for bandage_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6602","description":"Gradient compression bandaging supply_ high density foam roll for bandage_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSC0","description":"ICD-LBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQD0","description":"ICD-OLQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHED1","description":"ICD-IHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA36","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recement inlay onlay or part","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2910","description":"Recement inlay onlay or part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0490U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","description":"CPT-0490U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enterovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86658","description":"Enterovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMD1","description":"ICD-CDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB31","description":"ICD-1JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJE0","description":"ICD-JGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spacer bag/reservoir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4627","description":"Spacer bag/reservoir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Space maintainer_ removable bilateral_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1527","description":"Space maintainer_ removable bilateral_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27827","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFA0","description":"ICD-CGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of scrotum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55120","description":"Removal of scrotum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAF1","description":"ICD-MBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJC0","description":"ICD-KHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOD0","description":"ICD-OJOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20A","description":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fracture frame dual w cross","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0946","description":"Fracture frame dual w cross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQB1","description":"ICD-LFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCC1","description":"ICD-NCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2A","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTF0","description":"ICD-OHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97002","description":"Pt re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDF0","description":"ICD-OFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLC1","description":"ICD-GFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient is using hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9714","description":"Patient is using hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYA0","description":"ICD-CHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERA0","description":"ICD-PERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g._ patients with dementia or tracheostomy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1215","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g._ patients with dementia or tracheostomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMF0","description":"ICD-GGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELD0","description":"ICD-AELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWE0","description":"ICD-GGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTB0","description":"ICD-GDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lift assist for elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6635","description":"Lift assist for elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJD0","description":"ICD-OHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25D","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95977","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral; with deployment of intragastric bariatric balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43290","description":"Esophagogastroduodenoscopy_ flexible_ transoral; with deployment of intragastric bariatric balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1084T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1084T","description":"CPT-1084T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55175","description":"Revision of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Placental lactogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83632","description":"Placental lactogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63273","description":"Excise intrspinl lesion scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAE1","description":"ICD-KEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36561","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSF1","description":"ICD-KGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA11","description":"ICD-2JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBND0","description":"ICD-BBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair webbed toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28345","description":"Repair webbed toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMB1","description":"ICD-NGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIB1","description":"ICD-AHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWC0","description":"ICD-LAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENA1","description":"ICD-OENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAD0","description":"ICD-OJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASE0","description":"ICD-CASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gene test sickle cell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3850","description":"Gene test sickle cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96567","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25C","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin long acting 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5553","description":"Insulin long acting 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ATN1 (atrophin 1) (eg_ dentatorubral-pallidoluysian atrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81177","description":"ATN1 (atrophin 1) (eg_ dentatorubral-pallidoluysian atrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQF1","description":"ICD-DAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFF0","description":"ICD-JIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDF1","description":"ICD-EDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial mastectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19301","description":"Partial mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDE1","description":"ICD-MHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8E","description":"Very High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8E","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programmable_ transient_ orally ingested capsule_ for use with external programmer_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9269","description":"Programmable_ transient_ orally ingested capsule_ for use with external programmer_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1196","description":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAE0","description":"ICD-MLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4341","description":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12007","description":"Rpr s/n/ax/gen/trnk >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLF1","description":"ICD-AFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANA1","description":"ICD-BANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSB0","description":"ICD-OCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITE0","description":"ICD-CITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTF0","description":"ICD-OBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCC0","description":"ICD-IDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cad cxr with interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174T","description":"Cad cxr with interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gauze > 48 sq in water/salne","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6230","description":"Gauze > 48 sq in water/salne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27610","description":"Explore/treat ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debride genit/per/abdom wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11006","description":"Debride genit/per/abdom wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries_ including right heart catheterization_ pulmonary artery angiography_ and all imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0793T","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries_ including right heart catheterization_ pulmonary artery angiography_ and all imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In ear binaural hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5130","description":"In ear binaural hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXE1","description":"ICD-JBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKC0","description":"ICD-GDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27514","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD160","description":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGA0","description":"ICD-JAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling_ ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1310","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling_ ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of abdominal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27100","description":"Transfer of abdominal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOA1","description":"ICD-HFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHB0","description":"ICD-NCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath ren art 1st unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36251","description":"Ins cath ren art 1st unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYA0","description":"ICD-GDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVD0","description":"ICD-FHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIE0","description":"ICD-EGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology work-up evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9050","description":"Oncology work-up evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAE0","description":"ICD-IEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3B","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGF0","description":"ICD-NAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB246","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumat walking boot pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4360","description":"Pneumat walking boot pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDD1","description":"ICD-NFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12C","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBD1","description":"ICD-CGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBC0","description":"ICD-JFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0102","description":"HCPCS-C0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUA1","description":"ICD-AEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln part maxil chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5740","description":"Denture reln part maxil chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAC1","description":"ICD-FCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDC0","description":"ICD-AIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQA0","description":"ICD-OEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open brachial artery exposure for delivery of endovascular prosthesis_ unilateral (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34834","description":"Open brachial artery exposure for delivery of endovascular prosthesis_ unilateral (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJB0","description":"ICD-KHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX13","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAED0","description":"ICD-KAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLD0","description":"ICD-KFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHF1","description":"ICD-NDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBF0","description":"ICD-GDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDF0","description":"ICD-FIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart image (pet) multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78492","description":"Heart image (pet) multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHC1","description":"ICD-ABHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX15","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hpv combo assay ca screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0476","description":"Hpv combo assay ca screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diab manage trn  per indiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0108","description":"Diab manage trn  per indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA206","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIB1","description":"ICD-ICIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUA0","description":"ICD-ODUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAA1","description":"ICD-FAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHB1","description":"ICD-FBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ melphalan (hepzato)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9248","description":"Injection_ melphalan (hepzato)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXB0","description":"ICD-GCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMC0","description":"ICD-JFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDD0","description":"ICD-CFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBND0","description":"ICD-JBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Delay flap eye/nos/ear/lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15630","description":"Delay flap eye/nos/ear/lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD113","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit fecal/enema mgmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99511","description":"Home visit fecal/enema mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTD0","description":"ICD-EDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuromuscular reeducation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97112","description":"Neuromuscular reeducation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl met band kafo-afo calf/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4090","description":"Repl met band kafo-afo calf/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSC0","description":"ICD-KFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9129","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9129","description":"CDT-D9129","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1339","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74247","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQF0","description":"ICD-KDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIC0","description":"ICD-NDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWA0","description":"ICD-GFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXF0","description":"ICD-FAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart first pass multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78483","description":"Heart first pass multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHC1","description":"ICD-IEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFA1","description":"ICD-CEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18D","description":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCF1","description":"ICD-MKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVA1","description":"ICD-JCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine creatinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82570","description":"Assay of urine creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKA0","description":"ICD-CAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCC0","description":"ICD-KBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECF0","description":"ICD-NECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTD0","description":"ICD-FGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shwr cov elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0501","description":"Shwr cov elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHF1","description":"ICD-IIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVB0","description":"ICD-ODVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMB0","description":"ICD-GEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sialolithotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7980","description":"Sialolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUB1","description":"ICD-GBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDE0","description":"ICD-FIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGB1","description":"ICD-CBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB35","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHE0","description":"ICD-GAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep c screen high risk/other","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0472","description":"Hep c screen high risk/other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physical Therapy/Occupational Therapy Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4026","description":"Physical Therapy/Occupational Therapy Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0229T","description":"Njx tfrml eprl w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJE1","description":"ICD-OKJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laundry serv_ext_prof_/order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5175","description":"Laundry serv_ext_prof_/order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGE0","description":"ICD-GGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31603","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXE1","description":"ICD-JEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYD0","description":"ICD-LFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRA1","description":"ICD-CIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10C","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Guide nerv destr elec stim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95873","description":"Guide nerv destr elec stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm ped plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4011","description":"Cast sup sht arm ped plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEC0","description":"ICD-KIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCC1","description":"ICD-KGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sleeve pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32442","description":"Sleeve pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIC0","description":"ICD-BDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSD1","description":"ICD-PFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg_ drug metabolism)_ gene analysis_ common variant(s) (eg_ *2_ *22)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81230","description":"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg_ drug metabolism)_ gene analysis_ common variant(s) (eg_ *2_ *22)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70390","description":"X-ray exam of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy speaking valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8501","description":"Tracheostomy speaking valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD114","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFB0","description":"ICD-OFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAF0","description":"ICD-AAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker crutch attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0157","description":"Walker crutch attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLD0","description":"ICD-NLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANC1","description":"ICD-FANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRF0","description":"ICD-DCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFB0","description":"ICD-OGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXB1","description":"ICD-BIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA13","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo ak/hip alignable system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5920","description":"Endo ak/hip alignable system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLA0","description":"ICD-EFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct scan for needle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77012","description":"Ct scan for needle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXD0","description":"ICD-CHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFND1","description":"ICD-KFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tumor imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78804","description":"Tumor imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWB1","description":"ICD-GCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAE0","description":"ICD-FDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB60","description":"Ultra High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPB0","description":"ICD-CHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo urethral suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51990","description":"Laparo urethral suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOC1","description":"ICD-DHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mycobacteria culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87116","description":"Mycobacteria culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWE1","description":"ICD-CCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGF1","description":"ICD-OJGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Splint digit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8450","description":"Splint digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCD1","description":"ICD-ODCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKE0","description":"ICD-CIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFC0","description":"ICD-FHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt hx act drain prev 90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8560","description":"Pt hx act drain prev 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin b-12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82607","description":"Vitamin b-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJF0","description":"ICD-JGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRB0","description":"ICD-KGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza immunization administered or previously received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1299","description":"Influenza immunization administered or previously received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFA0","description":"ICD-KCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXD1","description":"ICD-OIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB234","description":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay everolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80169","description":"Drug assay everolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCF0","description":"ICD-ICCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 10 MCG/0.2 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0154A","description":"IMM ADMN SARSCOV2 BIVALENT 10 MCG/0.2 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBD0","description":"ICD-BBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVD1","description":"ICD-OGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTC1","description":"ICD-GHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUF0","description":"ICD-BIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA14","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC05","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2134","description":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/singl lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33240","description":"Insrt pulse gen w/singl lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMF0","description":"ICD-CCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ epirubicin hcl_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9178","description":"Inj_ epirubicin hcl_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYD0","description":"ICD-PLYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyperbaric o2 chamber disps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4575","description":"Hyperbaric o2 chamber disps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFD0","description":"ICD-JIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKF1","description":"ICD-FFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA11","description":"ICD-3BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1089T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1089T","description":"CPT-1089T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0A","description":"Very High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKC0","description":"ICD-NJKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJD0","description":"ICD-BDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUB0","description":"ICD-CDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILD0","description":"ICD-OILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft hepatorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35535","description":"Art byp grft hepatorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCD0","description":"ICD-OKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCB1","description":"ICD-NFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXB1","description":"ICD-NEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0D","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical home level 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9148","description":"Medical home level 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 4 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0871","description":"Pwc gp 4 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUB0","description":"ICD-MHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove collar bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23180","description":"Remove collar bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYF0","description":"ICD-KEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1603","description":"HCPCS-B1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smallpox and monkeypox vaccine_ attenuated vaccinia virus_ live_ non-replicating_ preservative free_ 0.5 mL dosage_ suspension_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90611","description":"Smallpox and monkeypox vaccine_ attenuated vaccinia virus_ live_ non-replicating_ preservative free_ 0.5 mL dosage_ suspension_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHC0","description":"ICD-OLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBC1","description":"ICD-AIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESE1","description":"ICD-PESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD230","description":"Reduced Physical Function _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCID1","description":"ICD-OCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78205","description":"Liver imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27829","description":"Treat lower leg joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 50MCG/0.25MLBST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0064A","description":"ADM SARSCOV2 50MCG/0.25MLBST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUF1","description":"ICD-ICUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Establish access to artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36120","description":"Establish access to artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23525","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thromboplastin time partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85732","description":"Thromboplastin time partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB231","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGF1","description":"ICD-OIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKC0","description":"ICD-BGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUB1","description":"ICD-ACUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKE1","description":"ICD-CBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTE1","description":"ICD-EHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion 2 or more 3d images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0395","description":"Fusion 2 or more 3d images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imm admin by intramusc injection of  (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 2nd dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0022A","description":"Imm admin by intramusc injection of  (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 2nd dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12C","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD145","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCND0","description":"ICD-NCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gravity assisted traction de","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0941","description":"Gravity assisted traction de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-ss pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0456","description":"Tlso flex trnk sj-ss pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA06","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGC1","description":"ICD-OGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mmrv vaccine sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90710","description":"Mmrv vaccine sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Augmentation of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21208","description":"Augmentation of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA60","description":"Medium Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exercise w/hemodynamic meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93464","description":"Exercise w/hemodynamic meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDF1","description":"ICD-JDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYE1","description":"ICD-PHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol wipes per box","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4245","description":"Alcohol wipes per box","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNF1","description":"ICD-FDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLD0","description":"ICD-MDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJC1","description":"ICD-KFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak/knee disartic acrylic soc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5631","description":"Ak/knee disartic acrylic soc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOA0","description":"ICD-HBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00540","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","description":"CPT-00540","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLD1","description":"ICD-GFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Most recent tobacco status is not tobacco free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9792","description":"Most recent tobacco status is not tobacco free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove infected skull bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61501","description":"Remove infected skull bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electro hearng aid test one","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92594","description":"Electro hearng aid test one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAC1","description":"ICD-OJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI w/cont_ breast_  bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8906","description":"MRI w/cont_ breast_  bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31582","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Formoterol fumarate_ inh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7606","description":"Formoterol fumarate_ inh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oscillating tracking test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92545","description":"Oscillating tracking test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pmp22 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81326","description":"Pmp22 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOD0","description":"ICD-HEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUC1","description":"ICD-JIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACB0","description":"ICD-GACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9534","description":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiological examination_ surgical specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76098","description":"Radiological examination_ surgical specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES317","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAA1","description":"ICD-NEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLE0","description":"ICD-FHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAC0","description":"ICD-KIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPA0","description":"ICD-OGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQA0","description":"ICD-PJQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1704","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1704","description":"CDT-D1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9611","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","description":"HCPCS-A9611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10A","description":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc neck tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21556","description":"Exc neck tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELB0","description":"ICD-FELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59120","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27600","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVD1","description":"ICD-OCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21454","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMD0","description":"ICD-FAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWE1","description":"ICD-OLWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAB1","description":"ICD-NEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0503","description":"HCPCS-C0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0506","description":"Non-traumatic spinal cord injury with Motor <23.75._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty w/cp bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33403","description":"Valvuloplasty w/cp bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair stomach opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43870","description":"Repair stomach opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAA0","description":"ICD-OLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Galectin-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82777","description":"Galectin-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99424","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTE1","description":"ICD-IHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWF1","description":"ICD-GHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHE1","description":"ICD-OFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ evaluation for mutations of APC_ BRAF_ CTNNB1_ KRAS_ NRAS_ PIK3CA_ SMAD4_ and TP53_ and methylation markers (MYO1G_ KCNQ5_ C9ORF50_ FLI1_ CLIP4_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0368U","description":"Oncology (colorectal cancer)_ evaluation for mutations of APC_ BRAF_ CTNNB1_ KRAS_ NRAS_ PIK3CA_ SMAD4_ and TP53_ and methylation markers (MYO1G_ KCNQ5_ C9ORF50_ FLI1_ CLIP4_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDE0","description":"ICD-OJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSE0","description":"ICD-KFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABD1","description":"ICD-CABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Direct immunofluorescence","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0482","description":"Direct immunofluorescence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTF1","description":"ICD-OFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Forensic cytopathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88125","description":"Forensic cytopathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive med svc 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2010","description":"Comprehensive med svc 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJC0","description":"ICD-BIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD260","description":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colorectal cancer screening; blood-based biomarker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0327","description":"Colorectal cancer screening; blood-based biomarker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAME0","description":"ICD-MAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anemia plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0516F","description":"Anemia plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria w/o bypass ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33255","description":"Ablate atria w/o bypass ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std seat elevate s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0830","description":"Pwc gp2 std seat elevate s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEA1","description":"ICD-BBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mechanical traction therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97012","description":"Mechanical traction therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMC0","description":"ICD-CBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam drg >16<=48 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6213","description":"Foam drg >16<=48 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj lo_ initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9004","description":"Mccd_ risk adj lo_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYE0","description":"ICD-OEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free DNA_ analysis of 311 or more genes_ interrogation for sequence variants_ including substitutions_ ins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0239U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free DNA_ analysis of 311 or more genes_ interrogation for sequence variants_ including substitutions_ ins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFA0","description":"ICD-NIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB31","description":"ICD-2KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem nonodonto cyst > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7461","description":"Rem nonodonto cyst > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct abd & pelv w/contrast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74177","description":"Ct abd & pelv w/contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ 1 mg (Aristada)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9470","description":"Injection_ aripiprazole lauroxil_ 1 mg (Aristada)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHD0","description":"ICD-ODHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDE0","description":"ICD-FEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGC1","description":"ICD-JCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cefoxitin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0694","description":"Cefoxitin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUC1","description":"ICD-OKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTF0","description":"ICD-IDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC213","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOC0","description":"ICD-KEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55810","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/stent plcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45389","description":"Colonoscopy w/stent plcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQD1","description":"ICD-PDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFB0","description":"ICD-JGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise vag graft open abd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57296","description":"Revise vag graft open abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNB0","description":"ICD-GCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Md recertification hha pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0179","description":"Md recertification hha pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISB1","description":"ICD-KISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIB1","description":"ICD-OLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 3 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64495","description":"Inj paravert f jnt l/s 3 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHB1","description":"ICD-JEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMC0","description":"ICD-FCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g._ pregnancy_ history of angioedema to ace-i_ oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1201","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g._ pregnancy_ history of angioedema to ace-i_ oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUF1","description":"ICD-IEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4367","description":"Ostomy belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and atherectomy_ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9766","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and atherectomy_ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dimecaprol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0470","description":"Dimecaprol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac rehabilitation progr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9472","description":"Cardiac rehabilitation progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJE1","description":"ICD-NCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFF0","description":"ICD-GCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9938","description":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINB1","description":"ICD-OINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCB1","description":"ICD-BDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc hip/pelv tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27048","description":"Exc hip/pelv tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIC1","description":"ICD-MFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENF1","description":"ICD-KENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHE0","description":"ICD-FDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA21","description":"ICD-4FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCD1","description":"ICD-NLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4015","description":"Neurology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCA1","description":"ICD-OFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Each addtnl cast post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2953","description":"Each addtnl cast post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCB1","description":"ICD-FBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFF1","description":"ICD-JCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ ureteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1758","description":"Catheter_ ureteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial custom socket insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5683","description":"Initial custom socket insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Molecular diagnostic test reader_ nonprescription self-administered and self-collected use_ fda approved_ authorized or cleared","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1035","description":"Molecular diagnostic test reader_ nonprescription self-administered and self-collected use_ fda approved_ authorized or cleared","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOB0","description":"ICD-KIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise/drain tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68400","description":"Incise/drain tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHB0","description":"ICD-MKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser surg penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54057","description":"Laser surg penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor stent ather br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9603","description":"Perc d-e cor stent ather br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ortho shoe add half sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3530","description":"Ortho shoe add half sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRC1","description":"ICD-LHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACF0","description":"ICD-KACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSA1","description":"ICD-KGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGF0","description":"ICD-FEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX32","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSD1","description":"ICD-LGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMC0","description":"ICD-MDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"New lenses in pts old frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0595","description":"New lenses in pts old frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15B","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair mngment training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97542","description":"Wheelchair mngment training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled air analysis o2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94680","description":"Exhaled air analysis o2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGC1","description":"ICD-BHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVA1","description":"ICD-NFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFA0","description":"ICD-OAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ benralizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9466","description":"Injection_ benralizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRD0","description":"ICD-ODRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETE1","description":"ICD-KETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins mark abd/pel for rt perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49411","description":"Ins mark abd/pel for rt perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Nasal Naloxone; 2-Pack Of 8Mg Per 0.1 Ml Nasal Spray (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1028","description":"Take-Home Supply Of Nasal Naloxone; 2-Pack Of 8Mg Per 0.1 Ml Nasal Spray (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPA0","description":"ICD-OCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Graftjacket xpress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4113","description":"Graftjacket xpress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8535","description":"Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77048","description":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13120","description":"Cmplx rpr s/a/l 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNB0","description":"ICD-GDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMC1","description":"ICD-CCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLA1","description":"ICD-GFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC120","description":"Reduced Physical Function _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOA0","description":"ICD-HIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rep partial denture clasp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5630","description":"Rep partial denture clasp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01654","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","description":"CPT-01654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAB0","description":"ICD-CIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95711","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng anti r-viral thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4270F","description":"Pt rcvng anti r-viral thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADB1","description":"ICD-EADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEB0","description":"ICD-BGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28I","description":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEE0","description":"ICD-OAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compres burn garment jacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6509","description":"Compres burn garment jacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPC0","description":"ICD-KBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKB0","description":"ICD-GAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB52","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAA1","description":"ICD-GIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIB0","description":"ICD-EGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECME1","description":"ICD-ECME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ear microscopy examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92504","description":"Ear microscopy examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc thigh/knee les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27337","description":"Exc thigh/knee les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJF0","description":"ICD-BDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABC1","description":"ICD-BABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDA0","description":"ICD-IGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone replce graft each add","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4264","description":"Bone replce graft each add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDE1","description":"ICD-FCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1116","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKC0","description":"ICD-OJKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGC1","description":"ICD-BCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHD0","description":"ICD-JGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCA1","description":"ICD-GHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHD1","description":"ICD-JGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHED1","description":"ICD-MHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak/ft power asst incl motors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5969","description":"Ak/ft power asst incl motors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin substitute_ FDA-cleared as a device_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4100","description":"Skin substitute_ FDA-cleared as a device_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group therapeutic procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97150","description":"Group therapeutic procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Integra matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4108","description":"Integra matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVC1","description":"ICD-CAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skn sub grft t/a/l child add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15274","description":"Skn sub grft t/a/l child add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26433","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMA1","description":"ICD-NKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lengthen metacarpal/finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26568","description":"Lengthen metacarpal/finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMC0","description":"ICD-ECMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of arm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23931","description":"Drainage of arm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARA0","description":"ICD-DARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40530","description":"Partial removal of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0488U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","description":"CPT-0488U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWA1","description":"ICD-OIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC21","description":"ICD-1LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for reconstructive procedures of eyelid (eg_ blepharoplasty_ pto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0114U","description":"Anesthesia for reconstructive procedures of eyelid (eg_ blepharoplasty_ pto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAF1","description":"ICD-EDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDA0","description":"ICD-MCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing warfarin or another FDA-approved anticoagulant (e.g._ atrial appendage device in place)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8968","description":"Documentation of medical reason(s) for not prescribing warfarin or another FDA-approved anticoagulant (e.g._ atrial appendage device in place)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUF1","description":"ICD-NFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE111","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81416","description":"Exome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJA0","description":"ICD-NCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRC0","description":"ICD-HFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct hrt w/3d image congen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75573","description":"Ct hrt w/3d image congen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-rays bone survey infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77076","description":"X-rays bone survey infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOF1","description":"ICD-HFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUB0","description":"ICD-MGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27497","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBD1","description":"ICD-BCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthoptic training; under supervision of a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92066","description":"Orthoptic training; under supervision of a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLB0","description":"ICD-IDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13A","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAED0","description":"ICD-JAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert w lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5673","description":"Socket insert w lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSC1","description":"ICD-PGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rsv mab im 50mg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90378","description":"Rsv mab im 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWF1","description":"ICD-HBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of mercury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83825","description":"Assay of mercury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTE1","description":"ICD-MFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBF1","description":"ICD-IFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMC1","description":"ICD-FBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped home apnea rec downld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94776","description":"Ped home apnea rec downld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOA0","description":"ICD-LCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDA0","description":"ICD-NJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRC0","description":"ICD-OIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCD1","description":"ICD-BBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28X","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gluco mngmnt plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0540F","description":"Gluco mngmnt plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMB1","description":"ICD-FHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDC1","description":"ICD-NFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Locm 200-299mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9966","description":"Locm 200-299mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABF0","description":"ICD-KABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXD0","description":"ICD-BDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0266T","description":"Implt/rpl crtd sns dev total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No hist cd4+ cell count <350","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3493F","description":"No hist cd4+ cell count <350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40801","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSB1","description":"ICD-KHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc pretreatment serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86978","description":"Rbc pretreatment serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01952","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","description":"CPT-01952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSF0","description":"ICD-PHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp axillary-axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35650","description":"Art byp axillary-axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB25","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOE0","description":"ICD-PLOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWD1","description":"ICD-OHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCND0","description":"ICD-OCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC236","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQA0","description":"ICD-PEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOC1","description":"ICD-OAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQA1","description":"ICD-DBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIE1","description":"ICD-JHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","description":"HCPCS-M1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5941","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5941","description":"CDT-D5941","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHB1","description":"ICD-IAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEE1","description":"ICD-MHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHE0","description":"ICD-FCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOE1","description":"ICD-KCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUE0","description":"ICD-OCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES110","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKD1","description":"ICD-BEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJC0","description":"ICD-CFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral - occlusal radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0706","description":"Intraoral - occlusal radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove thyroid duct lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60280","description":"Remove thyroid duct lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUF1","description":"ICD-NKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYE1","description":"ICD-LGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4046F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE256","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compres burn garment_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6512","description":"Compres burn garment_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWF0","description":"ICD-DBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Npo (nothing-mouth) ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6020F","description":"Npo (nothing-mouth) ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYB1","description":"ICD-PIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQA1","description":"ICD-OLQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluzone vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2038","description":"Fluzone vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEE0","description":"ICD-KFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQB1","description":"ICD-KIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQC0","description":"ICD-LIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSF1","description":"ICD-KFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC160","description":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGD0","description":"ICD-JGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rx cntact lens aphakia 1 eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92315","description":"Rx cntact lens aphakia 1 eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v auto redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88152","description":"Cytopath c/v auto redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYB1","description":"ICD-CGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD251","description":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCC0","description":"ICD-AGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEB0","description":"ICD-EDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANE1","description":"ICD-BANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVB0","description":"ICD-NDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBC0","description":"ICD-EBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPE0","description":"ICD-ODPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iodine I-131 iobenguane_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9407","description":"Iodine I-131 iobenguane_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYD0","description":"ICD-GEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADD1","description":"ICD-EADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC11","description":"ICD-1EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPB0","description":"ICD-OKPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIE0","description":"ICD-JDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28H","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lanreotide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1930","description":"Lanreotide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFME1","description":"ICD-BFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAB0","description":"ICD-EIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1C","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKF0","description":"ICD-FHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHD0","description":"ICD-BBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFE0","description":"ICD-OEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home health aide or certifie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9122","description":"Home health aide or certifie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ikbkap gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81260","description":"Ikbkap gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA14","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDC1","description":"ICD-MJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJE1","description":"ICD-OLJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXF0","description":"ICD-NGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAED1","description":"ICD-IAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00834","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","description":"CPT-00834","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTB0","description":"ICD-EBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHC0","description":"ICD-BAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients Received Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurrence A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2157","description":"Patients Received Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurrence A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth correct heart rhythm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41051","description":"Anesth correct heart rhythm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38380","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx cml chronic phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9123","description":"Onc dx cml chronic phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjust elbow ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1800","description":"Adjust elbow ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUE1","description":"ICD-NIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pet image w/ct lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78814","description":"Pet image w/ct lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFB1","description":"ICD-NIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"teledentistry synchronous real time encounter","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9995","description":"teledentistry synchronous real time encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2639","description":"Brachytx_ non-stranded_i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth sitting procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60451","description":"Anesth sitting procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0743","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","description":"HCPCS-E0743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1499","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","description":"HCPCS-M1499","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/o fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21195","description":"Reconst lwr jaw w/o fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIB1","description":"ICD-AFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ benralizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0517","description":"Injection_ benralizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSA0","description":"ICD-ODSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBC1","description":"ICD-JBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUC0","description":"ICD-JFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cyp2d6 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81226","description":"Cyp2d6 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIC0","description":"ICD-GGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWA1","description":"ICD-GBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVE0","description":"ICD-FBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUA1","description":"ICD-GEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIC1","description":"ICD-ICIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0672U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672U","description":"CPT-0672U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIB0","description":"ICD-MIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iliac bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20956","description":"Iliac bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCF0","description":"ICD-KFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX16","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUD1","description":"ICD-MKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHC0","description":"ICD-OHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLB0","description":"ICD-FCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC254","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer dome & mouthpiece","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7016","description":"Nebulizer dome & mouthpiece","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSD0","description":"ICD-CCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35180","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBA1","description":"ICD-GCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDD1","description":"ICD-JCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQF1","description":"ICD-PDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cap bacterial assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012F","description":"Cap bacterial assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/dye_ upper extremity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8934","description":"Mra_ w/dye_ upper extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUE0","description":"ICD-ABUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGB1","description":"ICD-OKGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compres burngarment chinstrp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6502","description":"Compres burngarment chinstrp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFA1","description":"ICD-GIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of spleen partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38101","description":"Removal of spleen partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vedolizumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3380","description":"Injection_ vedolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7525","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESF0","description":"ICD-HESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHB1","description":"ICD-CFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA46","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXF0","description":"ICD-OFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50620","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJB0","description":"ICD-FGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUE0","description":"ICD-ADUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No bp measure doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8756","description":"No bp measure doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of total replacement heart system (artificial heart)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33928","description":"Removal and replacement of total replacement heart system (artificial heart)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE121","description":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQF0","description":"ICD-OBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4105","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIB0","description":"ICD-JHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQC1","description":"ICD-HFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUE1","description":"ICD-CBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAF0","description":"ICD-FEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47142","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","description":"CPT-90635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXF0","description":"ICD-JGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral function therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92526","description":"Oral function therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHC1","description":"ICD-OHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerv sr 2pc thor ext pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0174","description":"Cerv sr 2pc thor ext pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUD0","description":"ICD-FDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVE0","description":"ICD-NKVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDF1","description":"ICD-KGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained Without Diagnostic Ultrasound Examination Of The Same Anatom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0689T","description":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained Without Diagnostic Ultrasound Examination Of The Same Anatom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA31","description":"Very High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2212","description":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYB0","description":"ICD-CBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conform band n/s w>=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6443","description":"Conform band n/s w>=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGD0","description":"ICD-CDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion mr imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19085","description":"Bx breast 1st lesion mr imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXF1","description":"ICD-BIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML44","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prol intubation req","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8569","description":"Prol intubation req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJE1","description":"ICD-CGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITC0","description":"ICD-FITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQA0","description":"ICD-KGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNE0","description":"ICD-FHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epidural lysis on single day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62264","description":"Epidural lysis on single day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCA0","description":"ICD-FHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDE1","description":"ICD-MJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27780","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0560U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","description":"CPT-0560U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRE1","description":"ICD-ODRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUE1","description":"ICD-GHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCC1","description":"ICD-JHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9802","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHA0","description":"ICD-AEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (inherited thrombocytopenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Inherited Thrombocytopenia Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0276U","description":"Hematology (inherited thrombocytopenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Inherited Thrombocytopenia Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levoleucovorin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0641","description":"Levoleucovorin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBD0","description":"ICD-GGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD110","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSE1","description":"ICD-LBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow socket ins use w/o lck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6695","description":"Elbow socket ins use w/o lck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray male genital tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74440","description":"X-ray male genital tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy arm/elbow soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24065","description":"Biopsy arm/elbow soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRC0","description":"ICD-HCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKB1","description":"ICD-FAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBD1","description":"ICD-NKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ levoleucovorin (khapzory)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0642","description":"Injection_ levoleucovorin (khapzory)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69637","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWD0","description":"ICD-PFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE115","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKA0","description":"ICD-KGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCB1","description":"ICD-OJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTD1","description":"ICD-KBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIED1","description":"ICD-OIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQD0","description":"ICD-DGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Megestrol 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0179","description":"Megestrol 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB35","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHND0","description":"ICD-KHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSE1","description":"ICD-ODSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asparaginase_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9020","description":"Asparaginase_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQF1","description":"ICD-ODQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko single upright pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0901","description":"Ko single upright pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUD0","description":"ICD-MHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parathyrd planar w/spect&ct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78072","description":"Parathyrd planar w/spect&ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAE1","description":"ICD-MJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIC1","description":"ICD-GIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWE1","description":"ICD-LBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSC1","description":"ICD-LFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure ureter/skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50920","description":"Closure ureter/skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29860","description":"Hip arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDD0","description":"ICD-GHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQB0","description":"ICD-KGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQA1","description":"ICD-PFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECA1","description":"ICD-KECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOB0","description":"ICD-OJOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visc & infraren abd 2 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34846","description":"Visc & infraren abd 2 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEF0","description":"ICD-OJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair heavy duty fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1285","description":"Wheelchair heavy duty fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA31","description":"ICD-1HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8C","description":"Very High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artificial cornea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8609","description":"Artificial cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMC1","description":"ICD-CIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJA1","description":"ICD-KDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECB0","description":"ICD-JECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1803","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1803","description":"CDT-D1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX40","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUA1","description":"ICD-OHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVC1","description":"ICD-BDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYF0","description":"ICD-LFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOF0","description":"ICD-OHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0006","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHA1","description":"ICD-BCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB40","description":"High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOC1","description":"ICD-LGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML41","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJC0","description":"ICD-CCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXC0","description":"ICD-GAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEED0","description":"ICD-MEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 3RD DOSE MODERNA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 3RD DOSE MODERNA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin sub grft t/arm/lg child","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15273","description":"Skin sub grft t/arm/lg child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKB0","description":"ICD-JCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETF0","description":"ICD-AETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAC1","description":"ICD-OGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42960","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUA0","description":"ICD-KGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFD1","description":"ICD-FAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red Cell Antigen (Mns Blood Group) Genotyping (Gypa)_ Gene Analysis_ Gypa (Glycophorin A [Mns Blood Group]) Introns 1_ 5_ Exon 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1089U","description":"Red Cell Antigen (Mns Blood Group) Genotyping (Gypa)_ Gene Analysis_ Gypa (Glycophorin A [Mns Blood Group]) Introns 1_ 5_ Exon 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25680","description":"Treat wrist fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUE0","description":"ICD-JEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRD1","description":"ICD-HGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOA0","description":"ICD-DIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glass/plastic slab off prism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2710","description":"Glass/plastic slab off prism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUB1","description":"ICD-CDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69631","description":"Repair eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient is undergoing palliative dialysis with a catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9747","description":"Patient is undergoing palliative dialysis with a catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical stent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5982","description":"Surgical stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA21","description":"ICD-3BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGB1","description":"ICD-FEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJC0","description":"ICD-GDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGF0","description":"ICD-OFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Male external catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4326","description":"Male external catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE101","description":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEC1","description":"ICD-NKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention_ under skin or into muscle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0012","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention_ under skin or into muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87812","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","description":"CPT-87812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDE1","description":"ICD-AIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDE0","description":"ICD-JHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNB0","description":"ICD-OFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Morcellator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1782","description":"Morcellator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDD0","description":"ICD-IIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESA0","description":"ICD-OESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVE0","description":"ICD-OJVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interest escort in non er","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0090","description":"Interest escort in non er","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPD0","description":"ICD-OLPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap revision perm ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49325","description":"Lap revision perm ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23B","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHB0","description":"ICD-IGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5275","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE244","description":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNE0","description":"ICD-OFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCE1","description":"ICD-JDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVA0","description":"ICD-BAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFD1","description":"ICD-JGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFD0","description":"ICD-JEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEED1","description":"ICD-JEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc death after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9256","description":"Doc death after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic prop tire tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2212","description":"Pneumatic prop tire tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERA0","description":"ICD-LERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor_ ear level_ replacement_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8624","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor_ ear level_ replacement_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRA1","description":"ICD-KGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0303","description":"HCPCS-C0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVF0","description":"ICD-NKVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66940","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0346T","description":"Ultrasound_ elastography (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQB1","description":"ICD-KDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Establish access to aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36160","description":"Establish access to aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX55","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOF0","description":"ICD-OEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDA1","description":"ICD-IFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01744","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","description":"CPT-01744","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADF1","description":"ICD-KADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis access system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1881","description":"Dialysis access system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHA0","description":"ICD-GGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB126","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTE1","description":"ICD-ABTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUD0","description":"ICD-OIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKE1","description":"ICD-KEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRD1","description":"ICD-DHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFA1","description":"ICD-BHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01432","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","description":"CPT-01432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fem/popl revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37226","description":"Fem/popl revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC21","description":"ICD-4EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQB1","description":"ICD-OCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDE1","description":"ICD-EEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90612","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","description":"CPT-90612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cathepsin-d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82387","description":"Assay of cathepsin-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1451","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","description":"HCPCS-M1451","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHA1","description":"ICD-ADHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNB1","description":"ICD-KDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX45","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOF1","description":"ICD-PBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxy suppl heater for nebuliz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1372","description":"Oxy suppl heater for nebuliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJC1","description":"ICD-KHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE211","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 4/5 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72083","description":"X-ray exam entire spi 4/5 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mental health service_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0046","description":"Mental health service_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAC0","description":"ICD-FDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl of subq defibrillator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33272","description":"Rmvl of subq defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adhesive bandage_ first-aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6413","description":"Adhesive bandage_ first-aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFF0","description":"ICD-NEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOA0","description":"ICD-CGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIB1","description":"ICD-BDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cerclage suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59871","description":"Remove cerclage suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSB0","description":"ICD-KCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNC0","description":"ICD-KFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mdd mild","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3088F","description":"Mdd mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0704","description":"HCPCS-B0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tob non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9459","description":"Tob non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLA0","description":"ICD-KHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPB0","description":"ICD-JAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compres burngarment bodysuit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6501","description":"Compres burngarment bodysuit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDB0","description":"ICD-ABDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUA1","description":"ICD-NHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLC1","description":"ICD-NBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj secretin synthetic human","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2850","description":"Inj secretin synthetic human","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJE1","description":"ICD-ODJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAB0","description":"ICD-FDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Path rprt w/ pt pn cat et al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3267F","description":"Path rprt w/ pt pn cat et al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSB0","description":"ICD-KHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBC0","description":"ICD-CIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thyrotropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3240","description":"Thyrotropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGB1","description":"ICD-BHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQC0","description":"ICD-HEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0D","description":"High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVE1","description":"ICD-JDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85461","description":"Hemoglobin fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXE1","description":"ICD-JIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATE0","description":"ICD-MATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1444","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","description":"HCPCS-M1444","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGD0","description":"ICD-GGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lice treatment_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9180","description":"Lice treatment_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interstitial radioelement application; simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77776","description":"Interstitial radioelement application; simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLE0","description":"ICD-FFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen supplies stand/rack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1355","description":"Oxygen supplies stand/rack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEB1","description":"ICD-GCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAB1","description":"ICD-JHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBF1","description":"ICD-BHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBC1","description":"ICD-MLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUE1","description":"ICD-FAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRC1","description":"ICD-HGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0927T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","description":"CPT-0927T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place breast cath for rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19297","description":"Place breast cath for rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interphalangeal joint repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8659","description":"Interphalangeal joint repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBC0","description":"ICD-NDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCE0","description":"ICD-ABCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWE0","description":"ICD-PBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHA1","description":"ICD-EGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDB1","description":"ICD-CBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0838","description":"Pwc gp 2 hd sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIA1","description":"ICD-GBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUC1","description":"ICD-NDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sewho cap design w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3961","description":"Sewho cap design w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ 10 mcg (Sinuva)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9122","description":"Mometasone furoate sinus implant_ 10 mcg (Sinuva)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVD1","description":"ICD-NLVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHB1","description":"ICD-GCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUA1","description":"ICD-AAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leflunomide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80193","description":"Leflunomide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain open lung lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32200","description":"Drain open lung lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL40","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC55","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Soft interface above knee se","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2830","description":"Soft interface above knee se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auricular replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5927","description":"Auricular replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUF1","description":"ICD-MAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0452T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQC0","description":"ICD-KGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB21","description":"ICD-2IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDC1","description":"ICD-JCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPD0","description":"ICD-NKPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJC0","description":"ICD-GFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKB0","description":"ICD-BBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASB0","description":"ICD-GASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKE1","description":"ICD-FGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD131","description":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt no dchg home postop day 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9602","description":"Pt no dchg home postop day 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9811","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9811","description":"HCPCS-C9811","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure_ for example patient bilateral amputee; patient has condition tha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2178","description":"Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure_ for example patient bilateral amputee; patient has condition tha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMC1","description":"ICD-NCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd us fine needle bx/aspir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43242","description":"Egd us fine needle bx/aspir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Habil res waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2016","description":"Habil res waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGD1","description":"ICD-JEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCA1","description":"ICD-JGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTB1","description":"ICD-CHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFA1","description":"ICD-GAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj pantoprazole sodium_ via","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9113","description":"Inj pantoprazole sodium_ via","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIF0","description":"ICD-BDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVF1","description":"ICD-JHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUA0","description":"ICD-JCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPD1","description":"ICD-FDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tissue expander(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11960","description":"Insert tissue expander(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00864","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","description":"CPT-00864","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogen m array copy no&snp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81229","description":"Cytogen m array copy no&snp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast exam thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75600","description":"Contrast exam thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHD1","description":"ICD-EHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9936","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9936","description":"CDT-D9936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASB1","description":"ICD-GASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJE0","description":"ICD-KGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCC0","description":"ICD-CBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PIGF Preeclampsia Screen_ PerkinElmer Genetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0243U","description":"PIGF Preeclampsia Screen_ PerkinElmer Genetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Administration of caregiver-focused health risk assessment instrument (eg_ depression inventory) for the benefit of the patient_ with scoring and documentation_ per standardiz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96161","description":"Administration of caregiver-focused health risk assessment instrument (eg_ depression inventory) for the benefit of the patient_ with scoring and documentation_ per standardiz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHD1","description":"ICD-MDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB31","description":"ICD-2CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"JR GNOTYP ABCG2 EXONS 2-26","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0193U","description":"JR GNOTYP ABCG2 EXONS 2-26","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKE0","description":"ICD-KFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFC1","description":"ICD-FEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap resect s/intestine addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44203","description":"Lap resect s/intestine addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of glutathione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82978","description":"Assay of glutathione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXB0","description":"ICD-FDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28113","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDB1","description":"ICD-CGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ above knee_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6585","description":"Gradient pressure wrap with adjustable straps_ above knee_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIF0","description":"ICD-AEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Space maintainer_ removable bilateral_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1526","description":"Space maintainer_ removable bilateral_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUB0","description":"ICD-OHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAA1","description":"ICD-BEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDC1","description":"ICD-KDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open bowel to skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44300","description":"Open bowel to skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oct breast surg cavity i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0354T","description":"Oct breast surg cavity i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl & rplcmt dfb gen mlt ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33264","description":"Rmvl & rplcmt dfb gen mlt ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SkinTE_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4200","description":"SkinTE_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Uvl sys panel 6 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0693","description":"Uvl sys panel 6 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ra disease activity high","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3472F","description":"Ra disease activity high","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB52","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJE0","description":"ICD-OJJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01941","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","description":"CPT-01941","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft subclav-brchial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35512","description":"Art byp grft subclav-brchial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00950","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","description":"CPT-00950","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTB0","description":"ICD-MKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVB0","description":"ICD-OGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTC1","description":"ICD-FFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gel-one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7326","description":"Gel-one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHD1","description":"ICD-KDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone graft repair perimplant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6103","description":"Bone graft repair perimplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERE0","description":"ICD-CERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"P2y inhib not presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9440","description":"P2y inhib not presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53660","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","description":"HCPCS-A2032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHA0","description":"ICD-OIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMD1","description":"ICD-BCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD113","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASB0","description":"ICD-DASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCME1","description":"ICD-OCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28D","description":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUB1","description":"ICD-MCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCC0","description":"ICD-NLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36563","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat penis lesion graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54111","description":"Treat penis lesion graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth 60 min/> as docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4255F","description":"Anesth 60 min/> as docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk fork strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5684","description":"Bk fork strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDC0","description":"ICD-NLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert ant drainage device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66183","description":"Insert ant drainage device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFE0","description":"ICD-BDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEC0","description":"ICD-JBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator_ dual lead system_ with insertion of pacing electrode_ cardiac venous system_ for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7540","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator_ dual lead system_ with insertion of pacing electrode_ cardiac venous system_ for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTE1","description":"ICD-KFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLE1","description":"ICD-MFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20C","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLB1","description":"ICD-MCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICA0","description":"ICD-EICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOE0","description":"ICD-KHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intra-vaginal motion sensor system_ provides biofeedback for pelvic floor muscle rehabilitation device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9002","description":"Intra-vaginal motion sensor system_ provides biofeedback for pelvic floor muscle rehabilitation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apically positioned flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4245","description":"Apically positioned flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDC1","description":"ICD-MHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tb scrng done-interpd 6mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3455F","description":"Tb scrng done-interpd 6mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA116","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBF1","description":"ICD-NDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAF0","description":"ICD-KCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0B","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Abnormal Nat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93597","description":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Abnormal Nat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFB1","description":"ICD-KHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYC0","description":"ICD-GGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEE1","description":"ICD-EFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQB1","description":"ICD-OHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKE0","description":"ICD-GAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAF0","description":"ICD-FAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Buprenorphine (Oral); Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2079","description":"Take-Home Supply Of Buprenorphine (Oral); Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC146","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKF0","description":"ICD-OHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBC0","description":"ICD-OFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSD0","description":"ICD-KHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma provocative tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92140","description":"Glaucoma provocative tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monoclonal antibodies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7505","description":"Monoclonal antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Image not std nomenclature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9319","description":"Image not std nomenclature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWC0","description":"ICD-DIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLE1","description":"ICD-BHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocollator unit portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0239","description":"Hydrocollator unit portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTA0","description":"ICD-GDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59856","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69745","description":"Repair facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAD1","description":"ICD-OGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSA0","description":"ICD-KGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGC0","description":"ICD-BEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4B","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWD1","description":"ICD-OJWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23B","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral supply kit premix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4220","description":"Parenteral supply kit premix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETB1","description":"ICD-FETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJA1","description":"ICD-NEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAE1","description":"ICD-BFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQB1","description":"ICD-CAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heinz bodies induced","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85445","description":"Heinz bodies induced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWD1","description":"ICD-KBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCF1","description":"ICD-IHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBB0","description":"ICD-KEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4A","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physician standby services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99360","description":"Physician standby services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNE1","description":"ICD-ODNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVE1","description":"ICD-OJVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0478U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","description":"CPT-0478U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQF1","description":"ICD-CGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMD0","description":"ICD-BIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of metatarsals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28322","description":"Repair of metatarsals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALD0","description":"ICD-IALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder universal joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6650","description":"Shoulder universal joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special radiation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77470","description":"Special radiation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA11","description":"Default_ /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDC0","description":"ICD-MKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKA0","description":"ICD-BAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJA0","description":"ICD-OBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone intra implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7312","description":"Dexamethasone intra implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0571","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","description":"HCPCS-G0571","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLB1","description":"ICD-OBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Norsn incomp inf antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9302","description":"Norsn incomp inf antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital outpt clinic visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0463","description":"Hospital outpt clinic visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ de","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81164","description":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMF0","description":"ICD-AIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSF1","description":"ICD-DBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUA0","description":"ICD-FHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICA0","description":"ICD-NICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper ext fx orthosis wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3984","description":"Upper ext fx orthosis wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stationary o2 contents_ gas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0441","description":"Stationary o2 contents_ gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of bladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51960","description":"Revision of bladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEB1","description":"ICD-KIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78609","description":"Brain imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC117","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAD1","description":"ICD-NIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37271","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","description":"CPT-37271","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKC1","description":"ICD-GIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bed cradle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0280","description":"Bed cradle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper limb orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3999","description":"Upper limb orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESC0","description":"ICD-GESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIC1","description":"ICD-BIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEA1","description":"ICD-ADEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sewhfo airplane w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3976","description":"Sewhfo airplane w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGD0","description":"ICD-CFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGF1","description":"ICD-ODGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77334","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBA0","description":"ICD-MGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFE1","description":"ICD-FBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8I","description":"High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETB1","description":"ICD-IETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLA0","description":"ICD-OGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28415","description":"Treat heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exoskeletal bk ultralt mater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5785","description":"Exoskeletal bk ultralt mater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTE0","description":"ICD-AGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGA0","description":"ICD-BHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB235","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC50","description":"Medium Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA21","description":"ICD-3GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspir/inj thyroid cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60300","description":"Aspir/inj thyroid cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUB0","description":"ICD-OKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIF1","description":"ICD-FIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLE1","description":"ICD-FDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPA1","description":"ICD-CIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWF1","description":"ICD-OAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis g dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87525","description":"Hepatitis g dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB13","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ DNA and RNA by next-generation sequencing_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_ 437 genes_ interpretive report for single nucleoti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0391U","description":"Oncology (solid tumor)_ DNA and RNA by next-generation sequencing_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_ 437 genes_ interpretive report for single nucleoti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSA0","description":"ICD-HCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSC1","description":"ICD-GFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evacuate mole of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59870","description":"Evacuate mole of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0A","description":"High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc shoulder tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23073","description":"Exc shoulder tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGE1","description":"ICD-JEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB10","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvef not performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8396","description":"Lvef not performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome count additional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88285","description":"Chromosome count additional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAB0","description":"ICD-EHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUF0","description":"ICD-GHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behind ear binaur hearing ai","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5140","description":"Behind ear binaur hearing ai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMD1","description":"ICD-OBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRD0","description":"ICD-PDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWD0","description":"ICD-PAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Salmonella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86768","description":"Salmonella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIC0","description":"ICD-CHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brow wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15826","description":"Removal of brow wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Voice current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9171","description":"Voice current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAE1","description":"ICD-GBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18C","description":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Puncture drainage of lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10160","description":"Puncture drainage of lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 10 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91319","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 10 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHF1","description":"ICD-JBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL01","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTB1","description":"ICD-KHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ hexaminolevulinate HCl_ 100 mg_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9275","description":"Injection_ hexaminolevulinate HCl_ 100 mg_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0693U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693U","description":"CPT-0693U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open treatment of rib fracture without fixation_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21805","description":"Open treatment of rib fracture without fixation_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (eg_ Parkinson disease_ dementia with Lewy bodies)_ cerebrospinal fluid (CSF)_ detection of misfolded a-synuclein protein by seed amplification assay_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0393U","description":"Neurology (eg_ Parkinson disease_ dementia with Lewy bodies)_ cerebrospinal fluid (CSF)_ detection of misfolded a-synuclein protein by seed amplification assay_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALE1","description":"ICD-JALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL50","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days_ or SNF notified untimely of MSP denial_ or SNF notified untimely of revocation of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA00","description":"Default_ /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days_ or SNF notified untimely of MSP denial_ or SNF notified untimely of revocation of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOA0","description":"ICD-DHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPD0","description":"ICD-FHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ileostomy/jejunostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44310","description":"Ileostomy/jejunostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine & cord thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63195","description":"Incise spine & cord thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSB1","description":"ICD-OJSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAD1","description":"ICD-FBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSA0","description":"ICD-CGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBB0","description":"ICD-FDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWD1","description":"ICD-HCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluorescent antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86255","description":"Fluorescent antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEE1","description":"ICD-BGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHE1","description":"ICD-OEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFA1","description":"ICD-OKFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPC0","description":"ICD-KCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9767","description":"Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1206","description":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALE1","description":"ICD-AALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDME1","description":"ICD-GDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQA1","description":"ICD-CFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJA1","description":"ICD-BBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWC1","description":"ICD-PKWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB24","description":"Very High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKD1","description":"ICD-JGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYF1","description":"ICD-OFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34707","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCF1","description":"ICD-KHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTE1","description":"ICD-NBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCE0","description":"ICD-ADCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFB0","description":"ICD-CAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGID0","description":"ICD-GGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMA0","description":"ICD-NDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscope procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58579","description":"Hysteroscope procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear canal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69140","description":"Remove ear canal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYE1","description":"ICD-CIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWD0","description":"ICD-CIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMA0","description":"ICD-EFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Full Gene Sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81307","description":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Full Gene Sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11B","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of prealbumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84134","description":"Assay of prealbumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (heparin-induced thrombocytopenia)_ platelet antibody reactivity by flow cytometry_ serum (Versiti™ Heparin-Induced Thrombocytopenia Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0275U","description":"Hematology (heparin-induced thrombocytopenia)_ platelet antibody reactivity by flow cytometry_ serum (Versiti™ Heparin-Induced Thrombocytopenia Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICE1","description":"ICD-BICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOA0","description":"ICD-GGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPB0","description":"ICD-BCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00870","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","description":"CPT-00870","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carboplatin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9045","description":"Carboplatin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES346","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTB1","description":"ICD-NGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQD1","description":"ICD-OFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSA0","description":"ICD-OKSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct abd & pelvis w/o contrast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74176","description":"Ct abd & pelvis w/o contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWD1","description":"ICD-KIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBD1","description":"ICD-AIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIE0","description":"ICD-FHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYB1","description":"ICD-ODYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAE1","description":"ICD-NIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDF0","description":"ICD-MKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX11","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB211","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDE1","description":"ICD-MCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart septum defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33647","description":"Repair heart septum defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFF0","description":"ICD-FFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18G","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIC1","description":"ICD-JBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIE1","description":"ICD-MBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNB1","description":"ICD-JDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTD1","description":"ICD-OKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUF1","description":"ICD-OEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42220","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILE1","description":"ICD-BILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEE1","description":"ICD-IGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX54","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYC0","description":"ICD-CIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLC1","description":"ICD-JBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX54","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMC1","description":"ICD-JIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQA1","description":"ICD-LAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ guiding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1887","description":"Catheter_ guiding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Palliative Care Services Given To Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0031","description":"Palliative Care Services Given To Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult disp brief/diap abv xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4543","description":"Adult disp brief/diap abv xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81284","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEF0","description":"ICD-OBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYC0","description":"ICD-PDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFC1","description":"ICD-NIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPA0","description":"ICD-JEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mental status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2014F","description":"Mental status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5A","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHB0","description":"ICD-CDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLC1","description":"ICD-OBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVC1","description":"ICD-NDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFC0","description":"ICD-NHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Delivery comp imrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6016","description":"Delivery comp imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUE1","description":"ICD-EBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41120","description":"Partial removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWF0","description":"ICD-LIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eosinophil blood count","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3630","description":"Eosinophil blood count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37282","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","description":"CPT-37282","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBF0","description":"ICD-KFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc neck tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21554","description":"Exc neck tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDB0","description":"ICD-AHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0721","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0721","description":"HCPCS-E0721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAD0","description":"ICD-KDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription digital visual therapy_ software-only_ FDA cleared_ per course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9292","description":"Prescription digital visual therapy_ software-only_ FDA cleared_ per course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emr pwr cbl combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0493","description":"Emr pwr cbl combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAE0","description":"ICD-FEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair mouth laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40831","description":"Repair mouth laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMD0","description":"ICD-CCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUC0","description":"ICD-GGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUF0","description":"ICD-ABUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJB0","description":"ICD-FFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFA0","description":"ICD-GFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGD0","description":"ICD-KFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Packing strips_ non-impreg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6407","description":"Packing strips_ non-impreg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEF0","description":"ICD-CEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surg redct fibrous tuberosit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7972","description":"Surg redct fibrous tuberosit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVB0","description":"ICD-FEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estrone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82679","description":"Assay of estrone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc lack perm&cont&parox fib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1061F","description":"Doc lack perm&cont&parox fib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQE0","description":"ICD-HCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIC1","description":"ICD-CCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain breast lesion add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19001","description":"Drain breast lesion add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33903","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0512U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","description":"CPT-0512U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26478","description":"Lengthening of hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA241","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOF0","description":"ICD-KFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (high-grade prostate cancer)_ biochemical assay of four proteins (Total PSA_ Free PSA_ Intact PSA_ and human kallikrein-2 [hK2])_ utilizing plasma or serum_ prognosti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81539","description":"Oncology (high-grade prostate cancer)_ biochemical assay of four proteins (Total PSA_ Free PSA_ Intact PSA_ and human kallikrein-2 [hK2])_ utilizing plasma or serum_ prognosti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIE1","description":"ICD-BEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair stern/nuss w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21742","description":"Repair stern/nuss w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9613","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9613","description":"HCPCS-A9613","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLF0","description":"ICD-OHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18C","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28290","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAED1","description":"ICD-BAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLD1","description":"ICD-CGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHA0","description":"ICD-JIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHD1","description":"ICD-BBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artacent AC_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4189","description":"Artacent AC_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATB0","description":"ICD-BATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69727","description":"Removal_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDB1","description":"ICD-IDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Simult panc kidn trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2065","description":"Simult panc kidn trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAB1","description":"ICD-AGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25C","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPA0","description":"ICD-KBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SLCO1B1 (solute carrier organic anion transporter family_ member 1B1) (eg_ adverse drug reaction)_ gene analysis_ common variant(s) (eg_ *5)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81328","description":"SLCO1B1 (solute carrier organic anion transporter family_ member 1B1) (eg_ adverse drug reaction)_ gene analysis_ common variant(s) (eg_ *5)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHC0","description":"ICD-FFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRF1","description":"ICD-KHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nk cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86357","description":"Nk cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTD0","description":"ICD-NLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual wc hand rim w project","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0967","description":"Manual wc hand rim w project","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert uteri tandem/ovoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57155","description":"Insert uteri tandem/ovoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAF0","description":"ICD-EEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXB0","description":"ICD-KEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Voice goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9172","description":"Voice goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTF0","description":"ICD-NHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFC1","description":"ICD-KBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate biliary duct/ampulla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47542","description":"Dilate biliary duct/ampulla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg strap h style each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0039","description":"Leg strap h style each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1065T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1065T","description":"CPT-1065T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gold sodium thiomaleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1600","description":"Gold sodium thiomaleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADF1","description":"ICD-EADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi (Lyme disease)_ OspA protein evaluation_ urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0316U","description":"Borrelia burgdorferi (Lyme disease)_ OspA protein evaluation_ urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Md home visit outside cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0273","description":"Md home visit outside cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKE0","description":"ICD-KCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81249","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8B","description":"High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQC0","description":"ICD-PHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSB1","description":"ICD-CGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXB1","description":"ICD-CFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost a/e acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7404","description":"Add ue prost a/e acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKB0","description":"ICD-KDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28C","description":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg ped plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4031","description":"Cast sup lng leg ped plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWF1","description":"ICD-OIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMC0","description":"ICD-CEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ adalimumab-aacf (idacio)_ biosimilar_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5131","description":"Injection_ adalimumab-aacf (idacio)_ biosimilar_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Needle Insertion(S) Without Injection(S); 1 Or 2 Muscle(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20560","description":"Needle Insertion(S) Without Injection(S); 1 Or 2 Muscle(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNB1","description":"ICD-CBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBC1","description":"ICD-AEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCA1","description":"ICD-FFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5B","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTA0","description":"ICD-GGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYD0","description":"ICD-PIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNF0","description":"ICD-CFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC55","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWE1","description":"ICD-CHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81174","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture tiss condtin mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5851","description":"Denture tiss condtin mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEE1","description":"ICD-BEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINB0","description":"ICD-KINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEF0","description":"ICD-GCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0B","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTC1","description":"ICD-JDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12C","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4427","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","description":"HCPCS-Q4427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCF1","description":"ICD-EFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ suprachoroidal (Xipere)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9092","description":"Injection_ triamcinolone acetonide_ suprachoroidal (Xipere)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPD0","description":"ICD-OHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFC1","description":"ICD-BIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery_ including any type of measur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9741","description":"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery_ including any type of measur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFA0","description":"ICD-CAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJD1","description":"ICD-JIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWB0","description":"ICD-HDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33405","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE130","description":"Special Care High _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAD0","description":"ICD-MAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36470","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj tst 3-4 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95908","description":"Nrv cndj tst 3-4 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4D","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1341","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1446","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","description":"HCPCS-M1446","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOF1","description":"ICD-KHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETE1","description":"ICD-AETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERA0","description":"ICD-HERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part remove hip bone super","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27070","description":"Part remove hip bone super","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELC1","description":"ICD-EELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAB0","description":"ICD-NCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection and post administration monitoring_ subsequent repeat doses","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0240","description":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection and post administration monitoring_ subsequent repeat doses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNE0","description":"ICD-CDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKF1","description":"ICD-JIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUC1","description":"ICD-AIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Received At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After The Pat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2160","description":"Patient Received At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After The Pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28E","description":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ONC MRNA 5 genes ur alg rish urothelial cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012M","description":"ONC MRNA 5 genes ur alg rish urothelial cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPA1","description":"ICD-FHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97552","description":"Group caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJD0","description":"ICD-NKJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVF1","description":"ICD-FBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Filter gone aft 3mos placmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9541","description":"Filter gone aft 3mos placmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTE0","description":"ICD-NJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolong service w/o contact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99358","description":"Prolong service w/o contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJB0","description":"ICD-GGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPC1","description":"ICD-GAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLA1","description":"ICD-CFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKC1","description":"ICD-JGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of upper eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15823","description":"Revision of upper eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBE1","description":"ICD-JDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87468","description":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explr/decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67445","description":"Explr/decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1077","description":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUC0","description":"ICD-FBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSB0","description":"ICD-HFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEED1","description":"ICD-EEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARF1","description":"ICD-OARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMD0","description":"ICD-OCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHD0","description":"ICD-EFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXC1","description":"ICD-OCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Belatacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0485","description":"Belatacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSA1","description":"ICD-OKSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAA1","description":"ICD-AEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBF0","description":"ICD-ABBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE134","description":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1041","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA205","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC256","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSD1","description":"ICD-CDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBF1","description":"ICD-KIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQC0","description":"ICD-HCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCD1","description":"ICD-FFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD224","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHD1","description":"ICD-EIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPE0","description":"ICD-GDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peg interferon alfa-2b/10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0148","description":"Peg interferon alfa-2b/10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRB1","description":"ICD-GFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHD1","description":"ICD-OBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBB0","description":"ICD-KCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHC0","description":"ICD-NLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic deluxe shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5508","description":"Diabetic deluxe shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEE1","description":"ICD-IEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatic elastase fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82656","description":"Pancreatic elastase fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDF1","description":"ICD-JIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGA0","description":"ICD-BEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psysoc rehab svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2018","description":"Psysoc rehab svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIA1","description":"ICD-EDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOE0","description":"ICD-LCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWE0","description":"ICD-KIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYF1","description":"ICD-LHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWB0","description":"ICD-CHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Swallow d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8998","description":"Swallow d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55865","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74470","description":"X-ray exam of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQC0","description":"ICD-KCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mech hip extension assist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5855","description":"Mech hip extension assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB117","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10C","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lngleg cylndr ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4035","description":"Cast sup lngleg cylndr ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAC1","description":"ICD-JFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE106","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath w/drainage 2-way latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4314","description":"Cath w/drainage 2-way latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGD1","description":"ICD-NFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYF1","description":"ICD-GHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FMRI brain by phys/psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70555","description":"FMRI brain by phys/psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUE1","description":"ICD-BHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTC1","description":"ICD-GCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHC1","description":"ICD-IBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_ without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_ without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDF0","description":"ICD-FGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKE0","description":"ICD-JBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYD1","description":"ICD-KAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAE1","description":"ICD-GCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Co-morbid condition assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1026F","description":"Co-morbid condition assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker folding wheeled w/o s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0143","description":"Walker folding wheeled w/o s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36576","description":"Repair tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHC0","description":"ICD-OIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8E","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSD0","description":"ICD-HBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUD1","description":"ICD-EFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB125","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33745","description":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX12","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPC0","description":"ICD-BDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ oritavancin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2407","description":"Injection_ oritavancin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In111 capromab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9507","description":"In111 capromab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77299","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prostate saturation sampling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55706","description":"Prostate saturation sampling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carbamazepine; -10_11-Epoxide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80161","description":"Carbamazepine; -10_11-Epoxide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAF1","description":"ICD-FFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No rx ace/arb therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8937","description":"No rx ace/arb therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVD1","description":"ICD-NHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFB0","description":"ICD-NIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUD0","description":"ICD-ECUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of glycated protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82985","description":"Assay of glycated protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA44","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTB0","description":"ICD-NDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bowel bulge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57268","description":"Repair of bowel bulge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSE1","description":"ICD-CHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suture large intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44604","description":"Suture large intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bladder wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51865","description":"Repair of bladder wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWB1","description":"ICD-OIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJF0","description":"ICD-NCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01390","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","description":"CPT-01390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBB0","description":"ICD-ECBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGC0","description":"ICD-OEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOF1","description":"ICD-CHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNF1","description":"ICD-BGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"C-reactive protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86140","description":"C-reactive protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEA0","description":"ICD-GCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUF1","description":"ICD-BHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical supplies and equipme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9061","description":"Medical supplies and equipme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TBP (TATA box binding protein) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81344","description":"TBP (TATA box binding protein) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diab manage trn ind/group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0109","description":"Diab manage trn ind/group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-49186","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","description":"CPT-49186","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47540","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVC0","description":"ICD-OBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKE1","description":"ICD-JGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCB1","description":"ICD-MBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAB0","description":"ICD-JCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVE0","description":"ICD-NBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGF0","description":"ICD-JEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meals when receive services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1010","description":"Meals when receive services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75825","description":"Vein x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00215","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","description":"CPT-00215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADA0","description":"ICD-FADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCF0","description":"ICD-IHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xe133 xenon 10mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9558","description":"Xe133 xenon 10mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARE0","description":"ICD-GARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJD1","description":"ICD-FDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKB1","description":"ICD-OLKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair elevating leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0990","description":"Wheelchair elevating leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62256","description":"Remove brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBF1","description":"ICD-FBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8H","description":"Very High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHB1","description":"ICD-NDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEID0","description":"ICD-NEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2121","description":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXD1","description":"ICD-JGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0105","description":"HCPCS-C0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOE1","description":"ICD-PFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMB1","description":"ICD-IDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDF0","description":"ICD-BEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIA1","description":"ICD-MIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imp/abut fixed dent part man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6117","description":"Imp/abut fixed dent part man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subs eval for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1121F","description":"Subs eval for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Molecular testing for a public health related pathogen_ including coronavirus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0606","description":"Molecular testing for a public health related pathogen_ including coronavirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX51","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX60","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrical stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97032","description":"Electrical stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMD1","description":"ICD-MGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tendon lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26476","description":"Tendon lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01360","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","description":"CPT-01360","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTC0","description":"ICD-NCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg awake and asleep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95819","description":"Eeg awake and asleep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Molecular Fluorescent Imaging Of Suspicious Nevus; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0701T","description":"Molecular Fluorescent Imaging Of Suspicious Nevus; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cover eye w/membrane suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65779","description":"Cover eye w/membrane suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGA0","description":"ICD-NAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81184","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"S&i stent/chest vert art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0076T","description":"S&i stent/chest vert art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35121","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCF1","description":"ICD-KDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61600","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cases in which an inhalational anesthetic is used only for induction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9955","description":"Cases in which an inhalational anesthetic is used only for induction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complex body section x-rays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76102","description":"Complex body section x-rays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC20","description":"Ultra High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther/proph/diag iv inf addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96366","description":"Ther/proph/diag iv inf addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx bronchoscope/wash","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31622","description":"Dx bronchoscope/wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIC0","description":"ICD-CAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27675","description":"Repair lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25C","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWF1","description":"ICD-KDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway press prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8845","description":"Pos airway press prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICA0","description":"ICD-BICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMD1","description":"ICD-MDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prefab stnlss steel crown pe","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2931","description":"Prefab stnlss steel crown pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUF1","description":"ICD-JDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPB1","description":"ICD-KFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng ace/arb blker <3mos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4481F","description":"Pt rcvng ace/arb blker <3mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1120","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATC1","description":"ICD-AATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Persist asthma medicine ctrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4015F","description":"Persist asthma medicine ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYE0","description":"ICD-KAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHC0","description":"ICD-ECHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATD0","description":"ICD-NATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0982T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","description":"CPT-0982T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMC0","description":"ICD-BGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVF1","description":"ICD-CIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUE1","description":"ICD-BGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMD0","description":"ICD-KHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES354","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLC0","description":"ICD-BCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; each additional 20 sq cm_ or part thereof (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0492T","description":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; each additional 20 sq cm_ or part thereof (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQB1","description":"ICD-PIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHE0","description":"ICD-ICHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMC0","description":"ICD-MLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65426","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHF1","description":"ICD-JAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMA1","description":"ICD-JCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"B-amyloid (Abeta42) and total tau (tTau)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0459U","description":"B-amyloid (Abeta42) and total tau (tTau)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJC0","description":"ICD-GAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKD0","description":"ICD-BFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemophilus influenza antibdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86684","description":"Hemophilus influenza antibdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXD1","description":"ICD-JBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLC1","description":"ICD-OGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vascular endoscopy procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37501","description":"Vascular endoscopy procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJE1","description":"ICD-OEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ emapalumab-lzsg_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9050","description":"Injection_ emapalumab-lzsg_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No bone scn b/4 txmnt/aftrdx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3270F","description":"No bone scn b/4 txmnt/aftrdx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIE1","description":"ICD-BHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ sculptra_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2028","description":"Inj_ sculptra_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33542","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ingest challenge ini 120 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95076","description":"Ingest challenge ini 120 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHF1","description":"ICD-OJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSD1","description":"ICD-CHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score shdl < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8664","description":"Fun stat score shdl < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA144","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHA0","description":"ICD-NJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate t3b-t4noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9079","description":"Onc dx prostate t3b-t4noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUF0","description":"ICD-FIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSF1","description":"ICD-GCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing serologic rh(d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86901","description":"Blood typing serologic rh(d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0882T","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1124","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTE0","description":"ICD-KHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITE1","description":"ICD-BITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art pancreas inv disp sensor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1035","description":"Art pancreas inv disp sensor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBD0","description":"ICD-OJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periph field stimul analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0285T","description":"Periph field stimul analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA10","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath insertion tray w/bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4354","description":"Cath insertion tray w/bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Atropine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7636","description":"Atropine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGD1","description":"ICD-JDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB60","description":"Very High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1425","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","description":"HCPCS-M1425","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam abdo back wall comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76770","description":"Us exam abdo back wall comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko swedish type pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1850","description":"Ko swedish type pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEF1","description":"ICD-GFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMB0","description":"ICD-CEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLC1","description":"ICD-BBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLA1","description":"ICD-IFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPE1","description":"ICD-JBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQC0","description":"ICD-LHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYA0","description":"ICD-CIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB131","description":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFB1","description":"ICD-CBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMA0","description":"ICD-OKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJC1","description":"ICD-BDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES331","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBF0","description":"ICD-OJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33361","description":"Replace aortic valve perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat skull fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62000","description":"Treat skull fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monit store cryo embryo 30 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4040","description":"Monit store cryo embryo 30 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHC1","description":"ICD-OAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHE0","description":"ICD-GIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia)_ gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ short tandem repeat (STR) expa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0233U","description":"FXN (frataxin) (eg_ Friedreich ataxia)_ gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ short tandem repeat (STR) expa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXB0","description":"ICD-KDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXA1","description":"ICD-CFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWF0","description":"ICD-HDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLC0","description":"ICD-CGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIE0","description":"ICD-GIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD254","description":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0682","description":"Non-pneumatic sequential compression garment_ full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFE1","description":"ICD-GGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aortoiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35637","description":"Art byp aortoiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28445","description":"Treat ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0956T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","description":"CPT-0956T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1078T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1078T","description":"CPT-1078T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (xellia) not therapeutically equivalent to j0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0873","description":"Injection_ daptomycin (xellia) not therapeutically equivalent to j0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILC1","description":"ICD-JILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25444","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNE0","description":"ICD-KDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEME1","description":"ICD-GEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of bile duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47420","description":"Incision of bile duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBD0","description":"ICD-MIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echosclerotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2202","description":"Echosclerotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary cath leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4334","description":"Urinary cath leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEA0","description":"ICD-FIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUE1","description":"ICD-ACUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0426","description":"Inpt/ed teleconsult50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj codeine phosphate /30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0745","description":"Inj codeine phosphate /30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00148","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","description":"CPT-00148","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML01","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trans-abdominal or trans-vaginal ultrasound not performed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8808","description":"Trans-abdominal or trans-vaginal ultrasound not performed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXD0","description":"ICD-FIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1504","description":"HCPCS-A1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC205","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1163","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","description":"HCPCS-J1163","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVA1","description":"ICD-NHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHC1","description":"ICD-MGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Etoposide oral 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8560","description":"Etoposide oral 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELC0","description":"ICD-BELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 10 MCG TRS-SUCR (pediatric vaccine)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91307","description":"SARSCOV2 VAC 10 MCG TRS-SUCR (pediatric vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXC1","description":"ICD-KAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYA1","description":"ICD-DBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCD1","description":"ICD-MJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco use txmnt pharmacol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4001F","description":"Tobacco use txmnt pharmacol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Variable asphericity lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2499","description":"Variable asphericity lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dm meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8494","description":"Dm meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNA1","description":"ICD-CDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGE1","description":"ICD-ODGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCA1","description":"ICD-NFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMC0","description":"ICD-GGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27303","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of serum sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84295","description":"Assay of serum sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percut allergy skin tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95004","description":"Percut allergy skin tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNB0","description":"ICD-KGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each multiplex antibody stain procedure (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0762T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each multiplex antibody stain procedure (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNF0","description":"ICD-NGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj paracervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64435","description":"N block inj paracervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHD1","description":"ICD-JCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No prol intub req","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8570","description":"No prol intub req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastro/jejuno tube_ std","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4087","description":"Gastro/jejuno tube_ std","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen supplies regulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1353","description":"Oxygen supplies regulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; simple (ie_ valvotomy_ debridement_ debulking_ and/or simple commissural resuspension)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33390","description":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; simple (ie_ valvotomy_ debridement_ debulking_ and/or simple commissural resuspension)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJA1","description":"ICD-GIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJF0","description":"ICD-OGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAD0","description":"ICD-NLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCD0","description":"ICD-JHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAC0","description":"ICD-OBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clonidine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0735","description":"Clonidine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYF1","description":"ICD-OEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27001","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31085","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADD1","description":"ICD-OADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; With Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0637T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; With Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJE1","description":"ICD-KCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50060","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWA0","description":"ICD-GDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHF0","description":"ICD-NBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWB0","description":"ICD-ODWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27607","description":"Treat lower leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTA1","description":"ICD-MJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth bladder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91051","description":"Anesth bladder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPD0","description":"ICD-OCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TGFBI (transforming growth factor beta-induced) (eg_ corneal dystrophy) gene analysis_ common variants (eg_ R124H_ R124C_ R124L_ R555W_ R555Q)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81333","description":"TGFBI (transforming growth factor beta-induced) (eg_ corneal dystrophy) gene analysis_ common variants (eg_ R124H_ R124C_ R124L_ R555W_ R555Q)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAB0","description":"ICD-NGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26080","description":"Explore/treat finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2083","description":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAF1","description":"ICD-CCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43121","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAD0","description":"ICD-MHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBA1","description":"ICD-OCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGB0","description":"ICD-BHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVA1","description":"ICD-BAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography with right heart catheterization with endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7521","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography with right heart catheterization with endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5253","description":"Hearing aid_ prog_ bin_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cranial cervical orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0112","description":"Cranial cervical orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp ext fixate strut change","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20697","description":"Comp ext fixate strut change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCA0","description":"ICD-OBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAD0","description":"ICD-JAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41821","description":"Excision of gum flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHB0","description":"ICD-JCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGC0","description":"ICD-OGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBE1","description":"ICD-OBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUA0","description":"ICD-KEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYD0","description":"ICD-HCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGID0","description":"ICD-EGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERD1","description":"ICD-KERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc no comp or mort w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9269","description":"Doc no comp or mort w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frozen ivf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4016","description":"Frozen ivf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSF1","description":"ICD-CCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom grad glove med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8425","description":"Custom grad glove med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nose polyp(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30110","description":"Removal of nose polyp(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDA1","description":"ICD-CHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOB0","description":"ICD-CEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETB1","description":"ICD-JETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosphate_ 300 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0736","description":"Injection_ clindamycin phosphate_ 300 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8H","description":"Very High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had one or less emergency department visits in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9851","description":"Patient had one or less emergency department visits in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJF0","description":"ICD-GCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWC1","description":"ICD-OFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0049","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXD1","description":"ICD-OCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHF1","description":"ICD-FHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHD0","description":"ICD-JFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAF1","description":"ICD-EHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening methadone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80358","description":"Drug screening methadone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLD0","description":"ICD-JGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX46","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBA0","description":"ICD-NFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSF1","description":"ICD-LGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJC1","description":"ICD-OAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHC1","description":"ICD-MLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmptr ophth dx img ant segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92132","description":"Cmptr ophth dx img ant segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEE1","description":"ICD-MBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1080T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1080T","description":"CPT-1080T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1197","description":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1087","description":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAC1","description":"ICD-KBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eculizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1300","description":"Eculizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAA1","description":"ICD-KDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTC0","description":"ICD-JGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29821","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEC1","description":"ICD-JIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low-level laser therapy_ dynamic photonic and dynamic thermokinetic energies_ provided by a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0552T","description":"Low-level laser therapy_ dynamic photonic and dynamic thermokinetic energies_ provided by a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med reas pt_ pn_ not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8722","description":"Med reas pt_ pn_ not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1026","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDD0","description":"ICD-KDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAB0","description":"ICD-NHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSE1","description":"ICD-OBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18H","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ enfortumab vedotin-ejfv_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9177","description":"Injection_ enfortumab vedotin-ejfv_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pemetrexed injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9305","description":"Pemetrexed injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Internal root repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3333","description":"Internal root repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAB1","description":"ICD-BFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUE1","description":"ICD-OEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRF1","description":"ICD-CFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBF0","description":"ICD-NLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSC1","description":"ICD-LHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBB1","description":"ICD-KHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open red simpl mandible fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7630","description":"Open red simpl mandible fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pressure pneum appl full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0671","description":"Pressure pneum appl full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53600","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney imaging with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78701","description":"Kidney imaging with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apheresis wbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36511","description":"Apheresis wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNC0","description":"ICD-CGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIA0","description":"ICD-FHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQB0","description":"ICD-OBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUB1","description":"ICD-MAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep cadaver renal allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50323","description":"Prep cadaver renal allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC156","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis nonauto w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81002","description":"Urinalysis nonauto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDD0","description":"ICD-IEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJB0","description":"ICD-BGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKF0","description":"ICD-KIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMC0","description":"ICD-EAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACC0","description":"ICD-EACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Saliva test_ hormone level;","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3652","description":"Saliva test_ hormone level;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFME1","description":"ICD-OFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft ipsilat carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35501","description":"Art byp grft ipsilat carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVB1","description":"ICD-FDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct abdomen w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74170","description":"Ct abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Omnicardiogram/cardiointegra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9025","description":"Omnicardiogram/cardiointegra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA41","description":"High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWF0","description":"ICD-KIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9839","description":"Anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHE0","description":"ICD-OIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy for foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44390","description":"Colonoscopy for foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNA0","description":"ICD-OCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA220","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracorp shockwv tx hi enrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0101T","description":"Extracorp shockwv tx hi enrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUA0","description":"ICD-MEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE213","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOA0","description":"ICD-KFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACC0","description":"ICD-GACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTC1","description":"ICD-CCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTF0","description":"ICD-MFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2B","description":"Default_ /PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nivolumab and relatlimab-rmbw_ 3 mg/1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9298","description":"Injection_ nivolumab and relatlimab-rmbw_ 3 mg/1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg_ cryopreservation_ storage)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0538T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg_ cryopreservation_ storage)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0878T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDC1","description":"ICD-FDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0875T","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove anal fist subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46270","description":"Remove anal fist subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"H pylori (c-13) breath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83013","description":"H pylori (c-13) breath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPF0","description":"ICD-OLPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRE0","description":"ICD-CDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6561","description":"Gradient compression stocking_ full length/chap style_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAE1","description":"ICD-OHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNE1","description":"ICD-FHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOE0","description":"ICD-OEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC210","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL23","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemical peel face epiderm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15788","description":"Chemical peel face epiderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB21","description":"Medium Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVE1","description":"ICD-FDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGD0","description":"ICD-NGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSD1","description":"ICD-HCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj theophylline per 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2810","description":"Inj theophylline per 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gabapentin non-blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80355","description":"Gabapentin non-blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHD0","description":"ICD-NFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVE0","description":"ICD-KCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDA0","description":"ICD-FBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXF0","description":"ICD-KHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCD1","description":"ICD-BDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01652","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","description":"CPT-01652","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"A/d tx program_ per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2035","description":"A/d tx program_ per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKE1","description":"ICD-OGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQA1","description":"ICD-DGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSB0","description":"ICD-HGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Neisseria gonorrhoeae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87850","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Neisseria gonorrhoeae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDC0","description":"ICD-IHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy stent add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31637","description":"Bronchoscopy stent add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDE0","description":"ICD-FHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation patient unable to communicate and informant not available","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2183","description":"Documentation patient unable to communicate and informant not available","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHF1","description":"ICD-CDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Io rad tx delivery by x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77424","description":"Io rad tx delivery by x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close chest after drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32810","description":"Close chest after drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61863","description":"Implant neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRD0","description":"ICD-PFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMC1","description":"ICD-FIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNC1","description":"ICD-OKNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMA0","description":"ICD-KIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDD1","description":"ICD-AHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18G","description":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESA0","description":"ICD-KESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKE0","description":"ICD-OKKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ccnd1/Igh (T(11;14)) (Eg_ Mantle Cell Lymphoma) Translocation Analysis_ Major Breakpoint_ Qualitative And Quantitative_ If Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81168","description":"Ccnd1/Igh (T(11;14)) (Eg_ Mantle Cell Lymphoma) Translocation Analysis_ Major Breakpoint_ Qualitative And Quantitative_ If Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rad exp time w/fluor doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9500","description":"Rad exp time w/fluor doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXE1","description":"ICD-KAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acesso_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4311","description":"Acesso_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31297","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUA0","description":"ICD-JEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28X","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O shoe add instep velcro clo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3580","description":"O shoe add instep velcro clo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgimend_ neonatal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9360","description":"Surgimend_ neonatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBE1","description":"ICD-NHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEB0","description":"ICD-KEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEC1","description":"ICD-NFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB134","description":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","description":"HCPCS-Q4386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECF1","description":"ICD-FECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHC1","description":"ICD-KHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKB0","description":"ICD-BDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTC1","description":"ICD-AFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTE1","description":"ICD-MBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAF0","description":"ICD-FDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAA0","description":"ICD-MAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospitalist visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0310","description":"Hospitalist visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYF0","description":"ICD-DEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foscarnet sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1455","description":"Foscarnet sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHC0","description":"ICD-KDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB255","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infect disease (bact)_ DNA_ 27 resistance genes_ PCR amplification and probe hybridization in microarray format (molecular detection and identification of AmpC_ carbapenemas)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004U","description":"Infect disease (bact)_ DNA_ 27 resistance genes_ PCR amplification and probe hybridization in microarray format (molecular detection and identification of AmpC_ carbapenemas)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites_ liquid chromatography with tandem mass spectrom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0322U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites_ liquid chromatography with tandem mass spectrom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Private duty/independent nsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1000","description":"Private duty/independent nsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31233","description":"Nasal/sinus endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDC1","description":"ICD-MEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANE1","description":"ICD-OANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85421","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVA0","description":"ICD-KDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap paraesophag hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43281","description":"Lap paraesophag hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISD0","description":"ICD-OISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEC0","description":"ICD-ADEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKF0","description":"ICD-FEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78306","description":"Bone imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy & duct catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52010","description":"Cystoscopy & duct catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam k transpl w/doppler","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76776","description":"Us exam k transpl w/doppler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Trichomonas vaginalis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87808","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Trichomonas vaginalis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQD1","description":"ICD-CGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Actigraphy testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95803","description":"Actigraphy testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast exam thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75605","description":"Contrast exam thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFME0","description":"ICD-EFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meropenem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2185","description":"Meropenem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETA1","description":"ICD-IETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69635","description":"Repair eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Modification diabetic shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5507","description":"Modification diabetic shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fx rad intra-articul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25608","description":"Treat fx rad intra-articul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE260","description":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGA0","description":"ICD-CAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla i & ii typing lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81370","description":"Hla i & ii typing lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETE0","description":"ICD-CETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair pul venous stenosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33726","description":"Repair pul venous stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJB1","description":"ICD-GCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of more than","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1034","description":"Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of more than","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther xcl hrvst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0264T","description":"Im b1 mrw cel ther xcl hrvst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRA0","description":"ICD-GBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHB0","description":"ICD-NBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8B","description":"Very High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0302","description":"HCPCS-B0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUC0","description":"ICD-OFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair maxillofacial defects","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7955","description":"Repair maxillofacial defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMA1","description":"ICD-KCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNC1","description":"ICD-OCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA22","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagosc dilate balloon 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43214","description":"Esophagosc dilate balloon 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGA1","description":"ICD-NDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise reconst elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24370","description":"Revise reconst elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9896","description":"Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colpopexy extraperitoneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57282","description":"Colpopexy extraperitoneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBD0","description":"ICD-GIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEB1","description":"ICD-AGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of jaw <4views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70100","description":"X-ray exam of jaw <4views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBD0","description":"ICD-EFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair double ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33612","description":"Repair double ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNE0","description":"ICD-FFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEC0","description":"ICD-IIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASE1","description":"ICD-KASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYC0","description":"ICD-KBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implnt_bon void filler-strip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9362","description":"Implnt_bon void filler-strip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supported housing_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0044","description":"Supported housing_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSC1","description":"ICD-OJSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPC0","description":"ICD-FCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOA0","description":"ICD-HGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAF0","description":"ICD-OKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDB0","description":"ICD-BEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of ureters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50760","description":"Fusion of ureters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYF0","description":"ICD-DFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINA1","description":"ICD-GINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - comprehensive series of radiographic images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0372","description":"intraoral tomosynthesis - comprehensive series of radiographic images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Color cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0514","description":"Color cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLF0","description":"ICD-BHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYA1","description":"ICD-CBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5948","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5948","description":"CDT-D5948","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xylose tolerance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84620","description":"Xylose tolerance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen sng non","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8686","description":"Implt nrostm pls gen sng non","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXA1","description":"ICD-FCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93312","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc plan hybrid/stage proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9640","description":"Doc plan hybrid/stage proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRA1","description":"ICD-HDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultraviolet light therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96900","description":"Ultraviolet light therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICD0","description":"ICD-GICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thumb tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26510","description":"Thumb tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNB1","description":"ICD-BGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91315","description":"SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLF0","description":"ICD-OFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAD1","description":"ICD-CHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJE0","description":"ICD-NBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinsert spinal fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22849","description":"Reinsert spinal fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUD1","description":"ICD-BAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Admin pneumococcal vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0009","description":"Admin pneumococcal vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55715","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","description":"CPT-55715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVA1","description":"ICD-KCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVA0","description":"ICD-CEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPB1","description":"ICD-KEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELD1","description":"ICD-MELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTE0","description":"ICD-GDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA16","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFD1","description":"ICD-NCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPB0","description":"ICD-OHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1010T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","description":"CPT-1010T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53454","description":"Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correct rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45540","description":"Correct rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corneal tissue transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65767","description":"Corneal tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81413","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood smear interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85060","description":"Blood smear interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wc planar back cush wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2620","description":"Wc planar back cush wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0903","description":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval cardiac modulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0417T","description":"Prgrmg eval cardiac modulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBB1","description":"ICD-ECBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGD0","description":"ICD-CEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31588","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6073","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELB0","description":"ICD-JELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDC0","description":"ICD-IGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDB1","description":"ICD-CDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69632","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOA1","description":"ICD-CDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDC0","description":"ICD-NEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOD1","description":"ICD-DAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imp/abut rem dent part mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6113","description":"Imp/abut rem dent part mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54530","description":"Removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVC0","description":"ICD-JEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEB1","description":"ICD-BGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCF0","description":"ICD-IDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXA0","description":"ICD-NEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHB0","description":"ICD-AIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC206","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATA0","description":"ICD-OATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYE0","description":"ICD-HHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXD0","description":"ICD-BIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prostate biopsy_ any mthd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0416","description":"Prostate biopsy_ any mthd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28I","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had history of immunocompromising conditions prior to or during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1158","description":"Patient had history of immunocompromising conditions prior to or during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; fu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81175","description":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEB1","description":"ICD-MHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96132","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of a subcutaneously implanted peritoneal ascites pump system_ any component (ascites pump_ associated peritoneal catheter_ associated bladder catheter)_ including ima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0873T","description":"Revision of a subcutaneously implanted peritoneal ascites pump system_ any component (ascites pump_ associated peritoneal catheter_ associated bladder catheter)_ including ima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHC1","description":"ICD-IFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQD0","description":"ICD-GHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical opening of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43510","description":"Surgical opening of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg cylinder pl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4033","description":"Cast sup lng leg cylinder pl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAE1","description":"ICD-BBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXE0","description":"ICD-FEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low back disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63030","description":"Low back disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploratory shoulder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23040","description":"Exploratory shoulder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIF0","description":"ICD-OJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMD0","description":"ICD-OFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYE1","description":"ICD-KCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWB1","description":"ICD-DFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult electric hook","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7009","description":"Adult electric hook","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJD0","description":"ICD-OGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDED0","description":"ICD-BDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBD0","description":"ICD-NJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALB1","description":"ICD-AALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTC1","description":"ICD-CBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEF0","description":"ICD-FAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMD1","description":"ICD-AIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESD0","description":"ICD-GESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18E","description":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenting class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9444","description":"Parenting class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Color vision examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92283","description":"Color vision examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQF1","description":"ICD-LIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWE0","description":"ICD-PDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravasc us heart add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92978","description":"Intravasc us heart add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAF1","description":"ICD-MKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Standard wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0001","description":"Standard wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIC1","description":"ICD-GEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUF0","description":"ICD-NKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIF1","description":"ICD-MEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSD0","description":"ICD-CBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETF0","description":"ICD-BETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"So hard plas stabili pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3678","description":"So hard plas stabili pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Atropine sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0461","description":"Atropine sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWB0","description":"ICD-CIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCD1","description":"ICD-EDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAC1","description":"ICD-EBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDE0","description":"ICD-OBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAD0","description":"ICD-FBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC144","description":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of csf protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83873","description":"Assay of csf protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKB0","description":"ICD-FGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFME0","description":"ICD-IFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETC1","description":"ICD-EETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3D","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGF0","description":"ICD-FBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFC1","description":"ICD-OGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10B","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD206","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAED0","description":"ICD-OAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-pvc intravenous administ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1016","description":"Non-pvc intravenous administ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0026","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTF1","description":"ICD-JGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAB1","description":"ICD-GBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILE1","description":"ICD-CILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Uv lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2755","description":"Uv lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCC0","description":"ICD-BHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice refer visit nonmd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0255","description":"Hospice refer visit nonmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTE0","description":"ICD-KFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOA0","description":"ICD-KIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNA1","description":"ICD-NBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATE0","description":"ICD-CATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCE1","description":"ICD-NCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ per hour of the psychologist_s or physicia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96118","description":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ per hour of the psychologist_s or physicia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microsurgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69990","description":"Microsurgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBB0","description":"ICD-JFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEF0","description":"ICD-GEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXD0","description":"ICD-FHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKE0","description":"ICD-FFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXF1","description":"ICD-CAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures complete mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5120","description":"Dentures complete mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay for phencyclidine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83992","description":"Assay for phencyclidine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50135","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","description":"CPT-01470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIA0","description":"ICD-OAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJB0","description":"ICD-NCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJC0","description":"ICD-JCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLE1","description":"ICD-CDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRD0","description":"ICD-OJRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMA0","description":"ICD-CEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPC1","description":"ICD-CGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYE1","description":"ICD-PLYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bp scrn no perf at interval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8785","description":"Bp scrn no perf at interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lsh w/t/o uterus above 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58544","description":"Lsh w/t/o uterus above 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOE0","description":"ICD-GBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNB1","description":"ICD-OFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVB0","description":"ICD-FCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLC0","description":"ICD-FGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31800","description":"Repair of windpipe injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERB0","description":"ICD-DERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAD1","description":"ICD-KCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metal frame recipro hip & ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2628","description":"Metal frame recipro hip & ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSC1","description":"ICD-PLSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAF0","description":"ICD-BBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open aortofemor prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34832","description":"Open aortofemor prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1305","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPB1","description":"ICD-BGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEB0","description":"ICD-ABEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC11","description":"ICD-4CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGC0","description":"ICD-FEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 12.6-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12035","description":"Intmd rpr s/a/t/ext 12.6-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRD1","description":"ICD-OFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTF1","description":"ICD-CHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPC0","description":"ICD-OBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNA0","description":"ICD-ODNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYD0","description":"ICD-DAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair rectum-vagina fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57300","description":"Repair rectum-vagina fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWF0","description":"ICD-DIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTD1","description":"ICD-FBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQE0","description":"ICD-CAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB234","description":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBD0","description":"ICD-FEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXD1","description":"ICD-KFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37262","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","description":"CPT-37262","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA140","description":"Clinically Complex _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interim abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6051","description":"Interim abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOB1","description":"ICD-PFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPC0","description":"ICD-CFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPD0","description":"ICD-CCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blinded procedure for New York Heart Association (NYHA) Class II or III heart failure_ or Canadian Cardiovascular Society (CCS) Class III or IV chronic refractory angina; tran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9782","description":"Blinded procedure for New York Heart Association (NYHA) Class II or III heart failure_ or Canadian Cardiovascular Society (CCS) Class III or IV chronic refractory angina; tran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDC1","description":"ICD-GGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWA0","description":"ICD-DDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0B","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg <=16 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6234","description":"Hydrocolld drg <=16 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFE0","description":"ICD-KDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDD0","description":"ICD-OLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAF0","description":"ICD-AIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor liver 3-segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47144","description":"Prep donor liver 3-segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18H","description":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ occlusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2628","description":"Catheter_ occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBF1","description":"ICD-NKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq card angio/athrect 1 art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92924","description":"Prq card angio/athrect 1 art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Technetium tc-99m aerosol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9567","description":"Technetium tc-99m aerosol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42305","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leuprolide Injectable_ Camcevi_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1952","description":"Leuprolide Injectable_ Camcevi_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUB1","description":"ICD-JBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJD1","description":"ICD-OLJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWB0","description":"ICD-DIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA255","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXB0","description":"ICD-BHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQD1","description":"ICD-HEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBA0","description":"ICD-CCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIB1","description":"ICD-IDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Fixed Bilateral Space Maintainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1557","description":"Removal Of Fixed Bilateral Space Maintainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIB0","description":"ICD-JAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGA1","description":"ICD-BDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFB1","description":"ICD-OIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Procalcitonin (pct)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84145","description":"Procalcitonin (pct)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACD0","description":"ICD-KACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHC1","description":"ICD-NEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKA0","description":"ICD-JIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLC0","description":"ICD-NLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATE1","description":"ICD-BATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKF1","description":"ICD-BDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92081","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYC1","description":"ICD-GBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWF0","description":"ICD-HIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound pouch each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6154","description":"Wound pouch each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1432","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","description":"HCPCS-M1432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWC1","description":"ICD-PAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXE1","description":"ICD-GBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acesso dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4293","description":"Acesso dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICE1","description":"ICD-OICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer care checklist used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0583F","description":"Transfer care checklist used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXE1","description":"ICD-CBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect prox finger tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26260","description":"Resect prox finger tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOA1","description":"ICD-PKOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEA1","description":"ICD-BDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methyl aminolevulinate_ top","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7309","description":"Methyl aminolevulinate_ top","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 100 mcg/0.5mL dosage_ for in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91301","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 100 mcg/0.5mL dosage_ for in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"G-esoph reflx tst w/electrod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91035","description":"G-esoph reflx tst w/electrod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67346","description":"Biopsy eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ DNA_ targeted sequencing of protein-coding exons of 468 cancer-associated genes_ including interrogation for somatic mutations and microsatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0048U","description":"Oncology (solid organ neoplasia)_ DNA_ targeted sequencing of protein-coding exons of 468 cancer-associated genes_ including interrogation for somatic mutations and microsatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOA1","description":"ICD-KAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKE1","description":"ICD-CDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXC1","description":"ICD-NLXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKF1","description":"ICD-JAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOB0","description":"ICD-LDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/in 2yr dxa not order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9471","description":"W/in 2yr dxa not order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pharm thx for op rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4005F","description":"Pharm thx for op rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQE0","description":"ICD-LGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJF1","description":"ICD-NKJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLF0","description":"ICD-EGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sincalide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2805","description":"Sincalide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early ind/delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9356","description":"Early ind/delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA31","description":"ICD-1IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB31","description":"ICD-2FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBD0","description":"ICD-KGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTB1","description":"ICD-MBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bifoc prscp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0506","description":"Bifoc prscp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0A","description":"Very High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUA0","description":"ICD-AGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iliac revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37221","description":"Iliac revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos microalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3060F","description":"Pos microalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ArdeoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4333","description":"ArdeoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUF0","description":"ICD-AFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOC1","description":"ICD-HBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUE0","description":"ICD-AAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYA1","description":"ICD-LGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA33","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABF1","description":"ICD-IABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBF0","description":"ICD-JCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUF0","description":"ICD-GIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQD1","description":"ICD-OJQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCME1","description":"ICD-FCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBE1","description":"ICD-KIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVC1","description":"ICD-OAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA21","description":"ICD-1BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stem cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86367","description":"Stem cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYA0","description":"ICD-DHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76978","description":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blooc clot factor v test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85220","description":"Blooc clot factor v test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bypass graft/av fist patency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35686","description":"Bypass graft/av fist patency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEE1","description":"ICD-FBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELD1","description":"ICD-BELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA04","description":"Default_ /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWA1","description":"ICD-OGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hfo nontorsion jnts pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3929","description":"Hfo nontorsion jnts pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQE0","description":"ICD-LEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGA1","description":"ICD-GFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary pan-cancer (eg_ hereditary sarcomas_ hereditary endocrine tumors_ hereditary neuroendocrine tumors_ hereditary cutaneous melanoma)_ genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0474U","description":"Hereditary pan-cancer (eg_ hereditary sarcomas_ hereditary endocrine tumors_ hereditary neuroendocrine tumors_ hereditary cutaneous melanoma)_ genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYF1","description":"ICD-DIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLA1","description":"ICD-CDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLD1","description":"ICD-JFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFD0","description":"ICD-FAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHD1","description":"ICD-BFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECB1","description":"ICD-KECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0019","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAB0","description":"ICD-MLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAA1","description":"ICD-EBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBA0","description":"ICD-KDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Device Supply With Initial Set-Up And Patient Education On Use Of Equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0704T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Device Supply With Initial Set-Up And Patient Education On Use Of Equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPD0","description":"ICD-BHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAB0","description":"ICD-KFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRF0","description":"ICD-DHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUD1","description":"ICD-NGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALC1","description":"ICD-IALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22A","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27052","description":"Biopsy of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGB0","description":"ICD-KGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQC1","description":"ICD-CGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28F","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dxa bone density/peripheral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77081","description":"Dxa bone density/peripheral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXD0","description":"ICD-GEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0766T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCB1","description":"ICD-EFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRB0","description":"ICD-HFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transdermal gfr measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0602T","description":"Transdermal gfr measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7526","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7526","description":"HCPCS-J7526","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQD1","description":"ICD-KHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental skin graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7920","description":"Dental skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40451","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIB0","description":"ICD-BDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0561","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","description":"HCPCS-G0561","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBF0","description":"ICD-JEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEC1","description":"ICD-KHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUE1","description":"ICD-IBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBF0","description":"ICD-KGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3751","description":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trim nail(s) any number","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11719","description":"Trim nail(s) any number","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUC1","description":"ICD-IFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Case presentation_ subsequent to detailed and extensive treatment planning","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9450","description":"Case presentation_ subsequent to detailed and extensive treatment planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGA1","description":"ICD-BFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYA1","description":"ICD-GCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMA1","description":"ICD-AAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFC0","description":"ICD-KEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTA0","description":"ICD-FDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXD0","description":"ICD-BHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraop kinetic balnce sensr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0396T","description":"Intraop kinetic balnce sensr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLB1","description":"ICD-IBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA41","description":"Default_ /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharm dx agent noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4641","description":"Radiopharm dx agent noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computerized Dynamic Posturography Sensory Organization Test (Cdp-Sot)_ 6 Conditions (Ie_ Eyes Open_ Eyes Closed_ Visual Sway_ Platform Sway_ Eyes Closed Platform Sway_ Platfo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92549","description":"Computerized Dynamic Posturography Sensory Organization Test (Cdp-Sot)_ 6 Conditions (Ie_ Eyes Open_ Eyes Closed_ Visual Sway_ Platform Sway_ Eyes Closed Platform Sway_ Platfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21193","description":"Reconst lwr jaw w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWC0","description":"ICD-KFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of skull seams","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61550","description":"Release of skull seams","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0675U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675U","description":"CPT-0675U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWE0","description":"ICD-OFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCE1","description":"ICD-CCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRA0","description":"ICD-DHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOF0","description":"ICD-OFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYB0","description":"ICD-OFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAB0","description":"ICD-GAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSE1","description":"ICD-CBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Next gen aco model<10min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9868","description":"Next gen aco model<10min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOD0","description":"ICD-KCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFB1","description":"ICD-KEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEC0","description":"ICD-BGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTA1","description":"ICD-KGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYE1","description":"ICD-OGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMC0","description":"ICD-KAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLC1","description":"ICD-MLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAE0","description":"ICD-GFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEA1","description":"ICD-NKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27477","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay technique_ (eg_ enzyme immunoassay [EIA]_ enzyme-linked immunosorbent assay [ELISA]_ fluorescence immunoassay [FIA]_ immunoch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87467","description":"Infectious agent antigen detection by immunoassay technique_ (eg_ enzyme immunoassay [EIA]_ enzyme-linked immunosorbent assay [ELISA]_ fluorescence immunoassay [FIA]_ immunoch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDF1","description":"ICD-OLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0402","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0402","description":"CDT-D0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27178","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add clasp to partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5660","description":"Add clasp to partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Routine footcare pt w lops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0247","description":"Routine footcare pt w lops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biphos thxpy vein ord/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4100F","description":"Biphos thxpy vein ord/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26686","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDE1","description":"ICD-MLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0403","description":"HCPCS-C0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In-hospital on call service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99026","description":"In-hospital on call service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITA0","description":"ICD-AITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJB0","description":"ICD-JGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD260","description":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUB0","description":"ICD-FDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEB0","description":"ICD-OCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVA1","description":"ICD-FHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBD0","description":"ICD-ICBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVB1","description":"ICD-GIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1098","description":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDD1","description":"ICD-GEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct urethra/penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54352","description":"Reconstruct urethra/penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDA1","description":"ICD-ABDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIF1","description":"ICD-MFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSA1","description":"ICD-LDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJF1","description":"ICD-BHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUA0","description":"ICD-OEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Facility/Er/Emergency Room","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"450U5","description":"Facility/Er/Emergency Room","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBB0","description":"ICD-CCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13A","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Who nontorsion jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3916","description":"Who nontorsion jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Outside state ambulance serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0021","description":"Outside state ambulance serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suspension sleeve lower ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2397","description":"Suspension sleeve lower ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Methadone; Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Addition To Code F","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2078","description":"Take-Home Supply Of Methadone; Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Addition To Code F","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWA1","description":"ICD-DBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCD1","description":"ICD-FBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFD1","description":"ICD-JEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture interm cmplt maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5810","description":"Denture interm cmplt maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25280","description":"Revise wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disp wound suct_ drsg/access","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9272","description":"Disp wound suct_ drsg/access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFC1","description":"ICD-BEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBC1","description":"ICD-AGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMB1","description":"ICD-FGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAA0","description":"ICD-AAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQB0","description":"ICD-CIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24C","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUC1","description":"ICD-NCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFB1","description":"ICD-FIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDD1","description":"ICD-ABDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDE0","description":"ICD-GEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQE1","description":"ICD-ODQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEC1","description":"ICD-OEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCB1","description":"ICD-OBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMB1","description":"ICD-MIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBE0","description":"ICD-NKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genotype dna hiv reverse t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87901","description":"Genotype dna hiv reverse t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERA1","description":"ICD-PERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33261","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo assay seven anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81506","description":"Endo assay seven anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyalomatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4117","description":"Hyalomatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES251","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVD1","description":"ICD-NAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23155","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXC0","description":"ICD-CEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMB0","description":"ICD-JBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEB0","description":"ICD-JBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1402","description":"HCPCS-C1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYE1","description":"ICD-LEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imaging study ordered (bkp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3330F","description":"Imaging study ordered (bkp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACC1","description":"ICD-AACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKB1","description":"ICD-BBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCF1","description":"ICD-ECCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHA0","description":"ICD-CHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted to palliative care services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1017","description":"Patient admitted to palliative care services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens hydrophilic toric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2521","description":"Cntct lens hydrophilic toric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLB1","description":"ICD-MBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67110","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPA0","description":"ICD-BFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSC0","description":"ICD-KDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAF1","description":"ICD-MIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYF0","description":"ICD-OLYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corrugated tubing_ non-disposable_ used with large volume nebulizer_ 10 feet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7011","description":"Corrugated tubing_ non-disposable_ used with large volume nebulizer_ 10 feet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX35","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKB0","description":"ICD-KBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9814","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9814","description":"HCPCS-C9814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSA1","description":"ICD-GBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00147","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","description":"CPT-00147","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0705","description":"Transfer device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUD1","description":"ICD-JIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit12.6-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12045","description":"Intmd rpr n-hf/genit12.6-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Igh@/Bcl2 (T(14;18)) (Eg_ Follicular Lymphoma) Translocation Analysis_ Major Breakpoint Region (Mbr) And Minor Cluster Region (Mcr) Breakpoints_ Qualitative Or Quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81278","description":"Igh@/Bcl2 (T(14;18)) (Eg_ Follicular Lymphoma) Translocation Analysis_ Major Breakpoint Region (Mbr) And Minor Cluster Region (Mcr) Breakpoints_ Qualitative Or Quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGE1","description":"ICD-BIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44626","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 4.12-7.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2301","description":"Lens sphere trifocal 4.12-7.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSE1","description":"ICD-OCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMB1","description":"ICD-MJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSD1","description":"ICD-GGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3503","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor xiii anti-hem factor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7180","description":"Factor xiii anti-hem factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10C","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelets_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9019","description":"Platelets_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation_ upper extremity_ single access of both the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_ tra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36836","description":"Percutaneous arteriovenous fistula creation_ upper extremity_ single access of both the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_ tra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnt pain noted pain prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1125F","description":"Amnt pain noted pain prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-91124","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","description":"CPT-91124","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTA1","description":"ICD-FDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0648T","description":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27618","description":"Exc leg/ankle tum < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLF1","description":"ICD-NLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFF0","description":"ICD-JDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2091","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid fitting/checking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5011","description":"Hearing aid fitting/checking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLF0","description":"ICD-FCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKD1","description":"ICD-BIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 4 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0868","description":"Pwc gp 4 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUF0","description":"ICD-EDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54328","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14A","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVB1","description":"ICD-CGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJE1","description":"ICD-FIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNF0","description":"ICD-JGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL13","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ready gradient sleev/glov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8421","description":"Ready gradient sleev/glov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDA1","description":"ICD-NGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHF1","description":"ICD-KFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg/ankle surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27899","description":"Leg/ankle surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23145","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ calaspargase pegol-mknl_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9118","description":"Injection_ calaspargase pegol-mknl_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ inelastic short stretch_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6599","description":"Gradient compression bandage roll_ inelastic short stretch_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93247","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDD0","description":"ICD-IGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic Positional Obstructive Sleep Apnea Treatment_ With Sensor_ Includes All Components And Accessories_ Any Type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1001","description":"Electronic Positional Obstructive Sleep Apnea Treatment_ With Sensor_ Includes All Components And Accessories_ Any Type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKA0","description":"ICD-JHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDC1","description":"ICD-IHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDND1","description":"ICD-NDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemiluminescent assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82397","description":"Chemiluminescent assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amphetamines 5 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80326","description":"Amphetamines 5 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTE1","description":"ICD-OHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWC0","description":"ICD-PAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEA1","description":"ICD-ACEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAF0","description":"ICD-OLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPA0","description":"ICD-FFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSD0","description":"ICD-HDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2101","description":"HCPCS-B2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC206","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam drg >16<=48 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6210","description":"Foam drg >16<=48 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDND0","description":"ICD-KDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETE1","description":"ICD-EETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00922","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","description":"CPT-00922","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1426","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","description":"HCPCS-M1426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA54","description":"Low Rehab_ ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of pelvis brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20662","description":"Application of pelvis brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIA0","description":"ICD-BHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clearance of airways","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31720","description":"Clearance of airways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt asked re symp auto dysfxn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4326F","description":"Pt asked re symp auto dysfxn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAC0","description":"ICD-BHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLB1","description":"ICD-MHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of apolipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82172","description":"Assay of apolipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove intra-aortic balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33974","description":"Remove intra-aortic balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABB1","description":"ICD-GABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBA1","description":"ICD-EEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMB0","description":"ICD-ADMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKF1","description":"ICD-NAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC231","description":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye image valid to dx rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2026F","description":"Eye image valid to dx rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of diaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39545","description":"Revision of diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAA1","description":"ICD-MGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plastazote sandal each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3265","description":"Plastazote sandal each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGD1","description":"ICD-OAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67505","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Res care_ nos waiver/month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2032","description":"Res care_ nos waiver/month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUE1","description":"ICD-IDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAA0","description":"ICD-MCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHC0","description":"ICD-MJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0115U","description":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLE0","description":"ICD-OLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXA1","description":"ICD-FAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCE0","description":"ICD-MCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDC1","description":"ICD-OFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEA0","description":"ICD-MEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBE0","description":"ICD-ODBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSF1","description":"ICD-OJSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6035","description":"Gold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOC0","description":"ICD-CHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHA1","description":"ICD-OKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHA0","description":"ICD-OFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26670","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; including placement and manipulation of transducer_ image acquisi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76987","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; including placement and manipulation of transducer_ image acquisi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOC0","description":"ICD-OEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNA1","description":"ICD-GCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDME1","description":"ICD-BDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABD0","description":"ICD-AABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKA0","description":"ICD-NFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDE0","description":"ICD-OEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5B","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"B cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86355","description":"B cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLD0","description":"ICD-FGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEB0","description":"ICD-KCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8X","description":"Medium Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTB0","description":"ICD-GHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMF1","description":"ICD-CBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMD0","description":"ICD-BDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long leg fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4030","description":"Cast sup long leg fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWB1","description":"ICD-PBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRB1","description":"ICD-HFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITA0","description":"ICD-GITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE155","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMB0","description":"ICD-NLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKC1","description":"ICD-FIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMC1","description":"ICD-KCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral prescription drug chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8999","description":"Oral prescription drug chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0566U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","description":"CPT-0566U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","description":"CPT-00472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA03","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHE0","description":"ICD-MGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXB1","description":"ICD-NGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9612","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","description":"HCPCS-A9612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rad resect hand tumor 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26118","description":"Rad resect hand tumor 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","description":"HCPCS-J9028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sp bone agrft local add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20936","description":"Sp bone agrft local add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFD0","description":"ICD-FIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove electrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43882","description":"Revise/remove electrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBE0","description":"ICD-IEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYE0","description":"ICD-PEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFA0","description":"ICD-CBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKME0","description":"ICD-MKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18G","description":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61870","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nudge control elbow lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6637","description":"Nudge control elbow lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIF1","description":"ICD-ACIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADD1","description":"ICD-AADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart rhythm pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93618","description":"Heart rhythm pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc share dec prior proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9296","description":"Doc share dec prior proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSF1","description":"ICD-CBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Single transfer toe-hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26553","description":"Single transfer toe-hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWA1","description":"ICD-CBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABE0","description":"ICD-CABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ranibizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2778","description":"Ranibizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMF1","description":"ICD-CEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No impr vis acuit w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9517","description":"No impr vis acuit w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIE1","description":"ICD-ICIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of pyruvate kinase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84220","description":"Assay of pyruvate kinase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77620","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther behav svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2019","description":"Ther behav svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAC1","description":"ICD-BIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28C","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJF0","description":"ICD-KAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQF1","description":"ICD-PEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIE1","description":"ICD-NDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFF1","description":"ICD-NLFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBD1","description":"ICD-OKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0678T","description":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKB0","description":"ICD-ODKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N-et; stretcher van","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2005","description":"N-et; stretcher van","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANC0","description":"ICD-GANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECE0","description":"ICD-MECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXF1","description":"ICD-JDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAE0","description":"ICD-BFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBB1","description":"ICD-OKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1003","description":"HCPCS-B1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGE0","description":"ICD-BAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKB0","description":"ICD-CBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKA1","description":"ICD-CFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adenoma(s) or colorectal cancer detected during screening colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9933","description":"Adenoma(s) or colorectal cancer detected during screening colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31579","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ metronidazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0030","description":"Injection_ metronidazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEC1","description":"ICD-MCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAND0","description":"ICD-BAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB104","description":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sup fee antiem_antica_immuno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0511","description":"Sup fee antiem_antica_immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCE1","description":"ICD-EDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4C","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ natalizumab-sztn (tyruko)_ biosimilar_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5134","description":"Injection_ natalizumab-sztn (tyruko)_ biosimilar_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBC1","description":"ICD-NDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB11","description":"ICD-2DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHF0","description":"ICD-MCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOE0","description":"ICD-HDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUD0","description":"ICD-JHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEED1","description":"ICD-FEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAB1","description":"ICD-MDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker platform attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0154","description":"Walker platform attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXD1","description":"ICD-CAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILF0","description":"ICD-BILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKA0","description":"ICD-OHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGD1","description":"ICD-JHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIA0","description":"ICD-NCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD116","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHF1","description":"ICD-IFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1204","description":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8500","description":"Hiv meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGF0","description":"ICD-BCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20D","description":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB31","description":"ICD-2AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial Plmt Drug Eluting Ocular Insert Uni/Bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0444T","description":"Initial Plmt Drug Eluting Ocular Insert Uni/Bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYE0","description":"ICD-HIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"C diff amplified probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87493","description":"C diff amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPC0","description":"ICD-GBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tube_ pneum wheel drive tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2382","description":"Tube_ pneum wheel drive tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELC0","description":"ICD-KELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"General health panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80050","description":"General health panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSA0","description":"ICD-LCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUE1","description":"ICD-MDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQA0","description":"ICD-GCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAA1","description":"ICD-OCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWD1","description":"ICD-LBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo guidance radiotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76965","description":"Echo guidance radiotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEE1","description":"ICD-AGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKD0","description":"ICD-NJKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKA0","description":"ICD-KAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dysphag test done b/4 eating","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6010F","description":"Dysphag test done b/4 eating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt recvd aspirin w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4563F","description":"Pt recvd aspirin w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOC1","description":"ICD-HDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ready gradient gauntlet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8428","description":"Ready gradient gauntlet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQF0","description":"ICD-DIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJD1","description":"ICD-BAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quant nonher2 ihc brst cx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3395F","description":"Quant nonher2 ihc brst cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVC0","description":"ICD-KAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aud brainstem implt programg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92640","description":"Aud brainstem implt programg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMD1","description":"ICD-MAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monosuspension arm/hand supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2630","description":"Monosuspension arm/hand supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cult epiderm grft f/n/hfg +%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15157","description":"Cult epiderm grft f/n/hfg +%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJC0","description":"ICD-OGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES301","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telecare equipment installation and removal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W2024","description":"Telecare equipment installation and removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gen_ neuro_ hf_ rechg bat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1822","description":"Gen_ neuro_ hf_ rechg bat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRC0","description":"ICD-PKRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald_ tv caption decoder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5271","description":"Ald_ tv caption decoder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB215","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low extemity neur exam docum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8404","description":"Low extemity neur exam docum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pin knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26706","description":"Pin knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUE0","description":"ICD-IGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter therapy_ infusion_ any method (eg_ thrombolysis other than coronary)_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75896","description":"Transcatheter therapy_ infusion_ any method (eg_ thrombolysis other than coronary)_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFC1","description":"ICD-BFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSF0","description":"ICD-PKSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHC1","description":"ICD-MDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEF1","description":"ICD-FBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSA1","description":"ICD-PGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUD1","description":"ICD-EAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHA0","description":"ICD-MAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOD0","description":"ICD-CEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDB0","description":"ICD-CCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHC1","description":"ICD-KAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJB1","description":"ICD-GFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0233T","description":"Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXF1","description":"ICD-JFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5C","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRA0","description":"ICD-DCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX26","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLE0","description":"ICD-IDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0536U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","description":"CPT-0536U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluid flow or fluid GF_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4206","description":"Fluid flow or fluid GF_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJF0","description":"ICD-NAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUD1","description":"ICD-IHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0649T","description":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone graft peri per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3428","description":"Bone graft peri per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess bengn docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3342F","description":"Mammo assess bengn docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRD1","description":"ICD-LDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACD1","description":"ICD-BACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heredtry nurondcrn tum dsrdr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81437","description":"Heredtry nurondcrn tum dsrdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No dxa no med hx no rv sx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9472","description":"No dxa no med hx no rv sx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLB1","description":"ICD-OJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGF1","description":"ICD-NEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45315","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYB0","description":"ICD-KAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTC0","description":"ICD-CHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9715","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFA1","description":"ICD-FFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1298","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQB0","description":"ICD-PBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5362","description":"Speech screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat pleurodesis w/agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32560","description":"Treat pleurodesis w/agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27720","description":"Repair of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBE0","description":"ICD-GBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUD0","description":"ICD-FBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29902","description":"Mcp joint arthroscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDA1","description":"ICD-CIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HISTOPLASM CAPSULATUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87385","description":"IAAD IA HISTOPLASM CAPSULATUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech audiometry threshold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0210T","description":"Speech audiometry threshold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18F","description":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAF0","description":"ICD-KEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTC1","description":"ICD-NLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMD0","description":"ICD-JFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC11","description":"ICD-2AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radical resection of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24149","description":"Radical resection of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCE0","description":"ICD-MFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPF0","description":"ICD-OBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50365","description":"Transplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Including Data Preparation And Transmission_ Quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0710T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Including Data Preparation And Transmission_ Quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMA0","description":"ICD-CIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXB0","description":"ICD-GGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERF0","description":"ICD-DERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOF0","description":"ICD-HCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78258","description":"Esophageal motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove esophagus obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74235","description":"Remove esophagus obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETB1","description":"ICD-NETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0D","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTF0","description":"ICD-CCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC11","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal biophys profil w/o nst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76819","description":"Fetal biophys profil w/o nst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBF1","description":"ICD-MJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nocardia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86744","description":"Nocardia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES304","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXC0","description":"ICD-BFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammogram both breasts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77056","description":"Mammogram both breasts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy tubal cautery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58670","description":"Laparoscopy tubal cautery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRF1","description":"ICD-HGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4D","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALC0","description":"ICD-NALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFE1","description":"ICD-NGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTA1","description":"ICD-FGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88366","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RUNX1 (runt related transcription factor 1) (eg_ acute myeloid leukemia_ familial platelet disorder with associated myeloid malignancy)_ gene analysis_ targeted sequence analy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81334","description":"RUNX1 (runt related transcription factor 1) (eg_ acute myeloid leukemia_ familial platelet disorder with associated myeloid malignancy)_ gene analysis_ targeted sequence analy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attach bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51841","description":"Attach bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Teriparatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3110","description":"Teriparatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDC1","description":"ICD-GDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Omeza Collagen Matrix_ per 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2014","description":"Omeza Collagen Matrix_ per 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWE1","description":"ICD-CDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracic vertebral body tethering_ including thoracoscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22838","description":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracic vertebral body tethering_ including thoracoscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBB1","description":"ICD-EBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGA1","description":"ICD-JHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEB0","description":"ICD-FCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam&tx estab pt 1/>vst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92014","description":"Eye exam&tx estab pt 1/>vst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMC0","description":"ICD-EHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRF0","description":"ICD-CGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRD0","description":"ICD-HDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinician documented that patient had medical reason for not performing lower extremity neurological exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2179","description":"Clinician documented that patient had medical reason for not performing lower extremity neurological exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRD0","description":"ICD-KDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70481","description":"Ct orbit/ear/fossa w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAB0","description":"ICD-IAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) PEGylated_ 1 I.U.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9137","description":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) PEGylated_ 1 I.U.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18H","description":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venous thrombosis imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78457","description":"Venous thrombosis imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUD1","description":"ICD-FCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray guide for gi tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74340","description":"X-ray guide for gi tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEB0","description":"ICD-FIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cord blood harvesting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2140","description":"Cord blood harvesting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Root amputation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3450","description":"Root amputation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Each addtnl prefab post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2957","description":"Each addtnl prefab post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pvb thoracic single inj site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64461","description":"Pvb thoracic single inj site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tooth reimplantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7270","description":"Tooth reimplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMD0","description":"ICD-GDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pad water circulating heat u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0249","description":"Pad water circulating heat u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assess vol mgmt not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8958","description":"Assess vol mgmt not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-prxd rsk et al docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3018F","description":"Pre-prxd rsk et al docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed_ arterial approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0643T","description":"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed_ arterial approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAF0","description":"ICD-ODAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIB0","description":"ICD-ICIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHB0","description":"ICD-EBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0603","description":"HCPCS-A0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHE1","description":"ICD-FAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAD1","description":"ICD-CFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23A","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHF0","description":"ICD-CGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14C","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01968","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","description":"CPT-01968","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKE0","description":"ICD-FAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41140","description":"Removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9276","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","description":"HCPCS-J9276","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPF0","description":"ICD-BBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYC1","description":"ICD-DGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHE0","description":"ICD-GFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETC0","description":"ICD-AETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixation of shoulder blade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23400","description":"Fixation of shoulder blade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMB0","description":"ICD-GBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (list separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37250","description":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (list separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUE1","description":"ICD-KCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXD1","description":"ICD-JAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGB1","description":"ICD-FIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHB1","description":"ICD-KEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRB1","description":"ICD-HHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug Assay_ Presumptive_ 30 Or More Drugs Or Metabolites_ Urine_ Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms) Using Multiple Reaction Monitoring (Mrm)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0227U","description":"Drug Assay_ Presumptive_ 30 Or More Drugs Or Metabolites_ Urine_ Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms) Using Multiple Reaction Monitoring (Mrm)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLD0","description":"ICD-NJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28F","description":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37700","description":"Revise leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Symes met fr leath socket ar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5060","description":"Symes met fr leath socket ar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy w/fb & op scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31531","description":"Laryngoscopy w/fb & op scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDD0","description":"ICD-OEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation (In-Person) With Analysis_ Review And Report By A Physician Or Other Qualified Health Care Professional_ Including Connection_ Recording And Di","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0685T","description":"Interrogation Device Evaluation (In-Person) With Analysis_ Review And Report By A Physician Or Other Qualified Health Care Professional_ Including Connection_ Recording And Di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABD1","description":"ICD-JABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19081","description":"Bx breast 1st lesion strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSA1","description":"ICD-OGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYE0","description":"ICD-ODYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antihemophilic viii/vwf comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7186","description":"Antihemophilic viii/vwf comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75251","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bile acids cholylglycine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82240","description":"Bile acids cholylglycine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCME1","description":"ICD-KCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep ak ischial laminated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5590","description":"Prep ak ischial laminated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLE0","description":"ICD-EHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENC1","description":"ICD-GENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDB0","description":"ICD-FDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of long arm cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29065","description":"Application of long arm cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26040","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hgb <10g/dl_ med rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8975","description":"Hgb <10g/dl_ med rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTB0","description":"ICD-KHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fld ped wc tltnspc w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1234","description":"Fld ped wc tltnspc w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolloid drg filler dry","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6241","description":"Hydrocolloid drg filler dry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ls >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8659","description":"Fun stat score ls >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBB0","description":"ICD-MJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75803","description":"Lymph vessel x-ray arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOA0","description":"ICD-OCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFF1","description":"ICD-GDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove impacted ear wax uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69209","description":"Remove impacted ear wax uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2124","description":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYC0","description":"ICD-GDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair urethrovaginal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57310","description":"Repair urethrovaginal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAA0","description":"ICD-AFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0996T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","description":"CPT-0996T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWD0","description":"ICD-LAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKA1","description":"ICD-KDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMB1","description":"ICD-BFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA46","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINB1","description":"ICD-CINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUC0","description":"ICD-EDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTD1","description":"ICD-NDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsyin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9785","description":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsyin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ faricimab-svoa_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9097","description":"Injection_ faricimab-svoa_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft axill-brachial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35522","description":"Art byp grft axill-brachial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJED0","description":"ICD-OJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGE0","description":"ICD-NFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCA0","description":"ICD-NFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNE1","description":"ICD-GFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63278","description":"Bx/exc xdrl spine lesn scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXC0","description":"ICD-FCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electron beam computed tomog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8092","description":"Electron beam computed tomog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLE1","description":"ICD-EBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIA1","description":"ICD-MDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGED0","description":"ICD-EGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal Vaccine Was Not Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9990","description":"Pneumococcal Vaccine Was Not Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth special head surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21851","description":"Anesth special head surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj intercost sng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64420","description":"N block inj intercost sng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMA1","description":"ICD-OFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBD1","description":"ICD-MIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMC1","description":"ICD-AGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62322","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10A","description":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLD1","description":"ICD-MKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"School-based iep ser bundled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1018","description":"School-based iep ser bundled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44382","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBE0","description":"ICD-KDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEC1","description":"ICD-FAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEC0","description":"ICD-CBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infrared heating pad system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0221","description":"Infrared heating pad system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAF0","description":"ICD-BGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intend rpt card prev msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9673","description":"Intend rpt card prev msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFC0","description":"ICD-NGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPB0","description":"ICD-KCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTB1","description":"ICD-EGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29010","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen prsmptv 1 class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80302","description":"Drug screen prsmptv 1 class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIB1","description":"ICD-AGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBD0","description":"ICD-NEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWC1","description":"ICD-HFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High inten beh couns std 30m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0445","description":"High inten beh couns std 30m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65222","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel thomas with wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3465","description":"Shoe heel thomas with wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASB1","description":"ICD-KASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAB1","description":"ICD-MGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl & rpl car modulj pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0414T","description":"Rmvl & rpl car modulj pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB02","description":"High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Helicobacter pylori antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86677","description":"Helicobacter pylori antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACE1","description":"ICD-IACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNF1","description":"ICD-NKNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDD1","description":"ICD-FGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine nrv >2 segmnts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63190","description":"Incise spine nrv >2 segmnts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIC1","description":"ICD-IEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Taking statin or recd order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9664","description":"Taking statin or recd order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIB1","description":"ICD-NHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0826","description":"Pwc gp 2 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/repair chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32110","description":"Explore/repair chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNE1","description":"ICD-OLNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20A","description":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 45 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90836","description":"Psytx pt&/fam w/e&m 45 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srs spinal lesion addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63621","description":"Srs spinal lesion addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00222","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","description":"CPT-00222","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEED0","description":"ICD-KEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ex hd hosp bed > 600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0302","description":"Ex hd hosp bed > 600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGE0","description":"ICD-BFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11424","description":"Exc h-f-nk-sp b9+marg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of quinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84228","description":"Assay of quinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBD0","description":"ICD-BFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove abdominal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38747","description":"Remove abdominal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUC1","description":"ICD-BAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAB0","description":"ICD-MBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical repair of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43501","description":"Surgical repair of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGME0","description":"ICD-BGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWD0","description":"ICD-CGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBE0","description":"ICD-OFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWF0","description":"ICD-HEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8G","description":"Low Rehab_ ADL Index 0-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEB1","description":"ICD-BHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heterophile antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86308","description":"Heterophile antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28A","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01940","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","description":"CPT-01940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQC0","description":"ICD-LFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWE1","description":"ICD-ODWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVC0","description":"ICD-BBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHD1","description":"ICD-IFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58976","description":"Transfer of embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEC1","description":"ICD-IFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thawing cryopresrved oocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89356","description":"Thawing cryopresrved oocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3272F","description":"Med risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGB1","description":"ICD-CDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collect & appl blood product","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7921","description":"Collect & appl blood product","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKF1","description":"ICD-FHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCE0","description":"ICD-OFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYF0","description":"ICD-HHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJA1","description":"ICD-GFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHB0","description":"ICD-OGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALE1","description":"ICD-OALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB11","description":"ICD-3JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8H","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Community health integration services_ each additional 30 minutes per calendar month (list separately in addition to g0019)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0022","description":"Community health integration services_ each additional 30 minutes per calendar month (list separately in addition to g0019)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/o hemodyn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75887","description":"Vein x-ray liver w/o hemodyn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKF1","description":"ICD-GDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove by ligat int hem grp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46945","description":"Remove by ligat int hem grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLB1","description":"ICD-NJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICC0","description":"ICD-GICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9948","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOB0","description":"ICD-CGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDA0","description":"ICD-GGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBE1","description":"ICD-JEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 21_ 18_ and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff_ algorithm reported as a risk score for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0168U","description":"Fetal aneuploidy (trisomy 21_ 18_ and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff_ algorithm reported as a risk score for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYB0","description":"ICD-HDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETB1","description":"ICD-BETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urofollitropin_ 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3355","description":"Urofollitropin_ 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray upper gi&small intest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74245","description":"X-ray upper gi&small intest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCE0","description":"ICD-JHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23605","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC24","description":"High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPD0","description":"ICD-OJPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMF1","description":"ICD-NFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWD0","description":"ICD-CBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trans care mgmt 14 day disch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99495","description":"Trans care mgmt 14 day disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFF1","description":"ICD-CFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAD0","description":"ICD-NEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVE1","description":"ICD-OIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound warming wound cover","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6000","description":"Wound warming wound cover","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEB0","description":"ICD-BHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Romiplostim injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2796","description":"Romiplostim injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE145","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFD0","description":"ICD-OIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXD1","description":"ICD-JCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nash fibrosure(tm)_ labcorp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003M","description":"Nash fibrosure(tm)_ labcorp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l addl 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13122","description":"Cmplx rpr s/a/l addl 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOA0","description":"ICD-DBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLB0","description":"ICD-BHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repos prev impltbl subq dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33273","description":"Repos prev impltbl subq dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Solid Organ Neoplasm)_ Targeted Genomic Sequence Dna Analysis Of 505 Genes_ Interrogation For Somatic Alterations (Snvs [Single Nucleotide Variant]_ Small Insertions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0250U","description":"Oncology (Solid Organ Neoplasm)_ Targeted Genomic Sequence Dna Analysis Of 505 Genes_ Interrogation For Somatic Alterations (Snvs [Single Nucleotide Variant]_ Small Insertions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87513","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","description":"CPT-87513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOB1","description":"ICD-PDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25924","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray guide intestinal tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74355","description":"X-ray guide intestinal tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIND0","description":"ICD-CIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of iron","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83540","description":"Assay of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGA1","description":"ICD-OIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNF1","description":"ICD-NHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEA0","description":"ICD-KBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ mRNA_ gene expression profiling by massively parallel sequencing for analysis of 51 genes_ utilizing formalin-fixed paraffin-embedded tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0057U","description":"Oncology (solid organ neoplasia)_ mRNA_ gene expression profiling by massively parallel sequencing for analysis of 51 genes_ utilizing formalin-fixed paraffin-embedded tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLB0","description":"ICD-ACLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEE0","description":"ICD-MJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ c-131","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2642","description":"Brachytx_ stranded_ c-131","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPC0","description":"ICD-OAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNC0","description":"ICD-OLNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEF0","description":"ICD-FHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJD1","description":"ICD-NCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECME0","description":"ICD-ECME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54055","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABB0","description":"ICD-FABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRC1","description":"ICD-OLRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLC0","description":"ICD-OFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBE0","description":"ICD-KBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System_ Remote Data Acquisition(S)_ Receipt Of Transmissions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0579T","description":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System_ Remote Data Acquisition(S)_ Receipt Of Transmissions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray bile duct dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74363","description":"X-ray bile duct dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQF1","description":"ICD-KBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8E","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASF0","description":"ICD-LASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB204","description":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJF1","description":"ICD-KAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLF1","description":"ICD-EDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAB1","description":"ICD-MEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDA0","description":"ICD-ABDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGF1","description":"ICD-CAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTA1","description":"ICD-BFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","description":"HCPCS-M1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supra SDRM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2011","description":"Supra SDRM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCD0","description":"ICD-IDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bl push transfuse 2 yr/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36440","description":"Bl push transfuse 2 yr/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYD0","description":"ICD-GGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBE0","description":"ICD-ICBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABB1","description":"ICD-EABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRC0","description":"ICD-CCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLC0","description":"ICD-BFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise sublingual gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42450","description":"Excise sublingual gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNA1","description":"ICD-CBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg <= 16 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6245","description":"Hydrogel drg <= 16 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10051","description":"Anesth salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNC1","description":"ICD-JGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTD0","description":"ICD-BHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8H","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rezafungin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0349","description":"Injection_ rezafungin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVC0","description":"ICD-GCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGD1","description":"ICD-NEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inherited bone marrow failure syndromes (IBMFS) (eg_ Fanconi anemia_ dyskeratosis congenita_ Diamond-Blackfan anemia_ Shwachman-Diamond syndrome_ GATA2 deficiency syndrome_ co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81441","description":"Inherited bone marrow failure syndromes (IBMFS) (eg_ Fanconi anemia_ dyskeratosis congenita_ Diamond-Blackfan anemia_ Shwachman-Diamond syndrome_ GATA2 deficiency syndrome_ co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixed wing air transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0430","description":"Fixed wing air transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurosurgical Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4016","description":"Neurosurgical Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anes spine transthor w/vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62651","description":"Anes spine transthor w/vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUC0","description":"ICD-GEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Written discharge instr prvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4014F","description":"Written discharge instr prvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00126","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","description":"CPT-00126","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLD0","description":"ICD-EFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1467","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","description":"HCPCS-M1467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8014","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8014","description":"HCPCS-C8014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXB0","description":"ICD-FBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA11","description":"ICD-1LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGF0","description":"ICD-BGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plasma_ cryoprecipitate reduced_ pathogen reduced_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9025","description":"Plasma_ cryoprecipitate reduced_ pathogen reduced_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90851","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair ruptd popliteal art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35152","description":"Repair ruptd popliteal art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision graft thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35905","description":"Excision graft thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLE1","description":"ICD-AFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIB0","description":"ICD-MFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXB0","description":"ICD-BEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental inlay metallic 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2520","description":"Dental inlay metallic 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft trunk add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15201","description":"Skin full graft trunk add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWF0","description":"ICD-PBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYB0","description":"ICD-HAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-83884","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","description":"CPT-83884","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18X","description":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHF0","description":"ICD-EDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transverse aortic arch graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33870","description":"Transverse aortic arch graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNC0","description":"ICD-FGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Int therapeutic restoration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2941","description":"Int therapeutic restoration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung transplant double","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32853","description":"Lung transplant double","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQF0","description":"ICD-OAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQD0","description":"ICD-LBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75756","description":"Artery x-rays chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAB1","description":"ICD-EIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10D","description":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nesiritide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2325","description":"Nesiritide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLD1","description":"ICD-AFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67923","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0609","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","description":"HCPCS-J0609","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8006","description":"HCPCS-C8006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYE0","description":"ICD-HDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGE1","description":"ICD-FDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLE1","description":"ICD-ADLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1552","description":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWC1","description":"ICD-OBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3C","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRE1","description":"ICD-GCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGF1","description":"ICD-CCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDD0","description":"ICD-GDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPD0","description":"ICD-GIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plnning pt spec fenest graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34839","description":"Plnning pt spec fenest graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mild-mod dep symp by deptool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3353F","description":"Mild-mod dep symp by deptool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEA1","description":"ICD-GIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTD0","description":"ICD-IDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC21","description":"ICD-2CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGC0","description":"ICD-KIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGF0","description":"ICD-KAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOD0","description":"ICD-GGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARE1","description":"ICD-KARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTA0","description":"ICD-OBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC30","description":"High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Jak2 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81270","description":"Jak2 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUF1","description":"ICD-MIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIF1","description":"ICD-OFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1160","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28A","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTC1","description":"ICD-MFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical home_ initial plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0280","description":"Medical home_ initial plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment Of Amblyopia Using An Online Digital Program; Device Supply_ Educational Set-Up_ And Initial Session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0687T","description":"Treatment Of Amblyopia Using An Online Digital Program; Device Supply_ Educational Set-Up_ And Initial Session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26350","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQC0","description":"ICD-DGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies)_ with intravascular lithotripsy_ includes angioplasty within the same vessel (s)_ when perfo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9772","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies)_ with intravascular lithotripsy_ includes angioplasty within the same vessel (s)_ when perfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIF1","description":"ICD-IGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNF1","description":"ICD-GBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9301","description":"HCPCS-C9301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLE0","description":"ICD-FBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMB1","description":"ICD-KGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJF0","description":"ICD-FDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52260","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80435","description":"Insulin tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj cladribine per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9065","description":"Inj cladribine per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCE0","description":"ICD-JBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAED1","description":"ICD-NAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Each Additional 15 Minutes Of One-On-One Physician Or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90913","description":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Each Additional 15 Minutes Of One-On-One Physician Or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tkr composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9233","description":"Tkr composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRE0","description":"ICD-PJRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56630","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRC0","description":"ICD-HHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRA0","description":"ICD-PCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIF1","description":"ICD-NAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp femoral-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35656","description":"Art byp femoral-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln cmplt mand lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5751","description":"Denture reln cmplt mand lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJE1","description":"ICD-JHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-speech device service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92606","description":"Non-speech device service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEA0","description":"ICD-OGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVB1","description":"ICD-OCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/o pseudobulbaffect/als","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3757F","description":"Pt w/o pseudobulbaffect/als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct neck spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72126","description":"Ct neck spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNF1","description":"ICD-NGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ spheroid cell culture_ 4-drug panel (carboplatin_ doxorubicin_ gemcitabine_ paclitaxel)_ tumor chemotherapy response prediction for each drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0324U","description":"Oncology (ovarian)_ spheroid cell culture_ 4-drug panel (carboplatin_ doxorubicin_ gemcitabine_ paclitaxel)_ tumor chemotherapy response prediction for each drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27403","description":"Repair of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMA0","description":"ICD-KDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOC0","description":"ICD-PDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIB0","description":"ICD-KAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ldct for lung ca screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0297","description":"Ldct for lung ca screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External ambulatory infus pu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0781","description":"External ambulatory infus pu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPE0","description":"ICD-GCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22610","description":"Thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKA1","description":"ICD-BIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Norsn pt cath >=90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9266","description":"Norsn pt cath >=90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQE0","description":"ICD-PLQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYD0","description":"ICD-DBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27033","description":"Exploration of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe molded to pt silicone s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3251","description":"Shoe molded to pt silicone s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXE0","description":"ICD-GCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGA1","description":"ICD-JFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMC0","description":"ICD-KFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Melatonin levels test_ sleep study_ 7 or 9 sample melatonin profile (cortisol optional)_ enzyme-linked immunosorbent assay (ELISA)_ saliva_ screening/preliminary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0462U","description":"Melatonin levels test_ sleep study_ 7 or 9 sample melatonin profile (cortisol optional)_ enzyme-linked immunosorbent assay (ELISA)_ saliva_ screening/preliminary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML12","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCB1","description":"ICD-GDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBD1","description":"ICD-FEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec osteogen stim spinal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0748","description":"Elec osteogen stim spinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogate subq defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93261","description":"Interrogate subq defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot and ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28262","description":"Revision of foot and ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glofitamab-gxbm_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9286","description":"Injection_ glofitamab-gxbm_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Signature APatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4260","description":"Signature APatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCB0","description":"ICD-CGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51845","description":"Repair bladder neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEB0","description":"ICD-BFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIC1","description":"ICD-OLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implanted vestibular device_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0726T","description":"Removal of implanted vestibular device_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2D","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC35","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQB0","description":"ICD-DFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEB0","description":"ICD-JIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient with transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9929","description":"Patient with transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary ovarian cancer (eg_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing a combination of NGS_ Sanger_ MLPA_ and arr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0103U","description":"Hereditary ovarian cancer (eg_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing a combination of NGS_ Sanger_ MLPA_ and arr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNF1","description":"ICD-KDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAB1","description":"ICD-OFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRF1","description":"ICD-OLRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METE0","description":"ICD-METE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Portable home suction pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0743","description":"Portable home suction pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQB0","description":"ICD-LCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMF0","description":"ICD-ICMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD201","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67208","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHND1","description":"ICD-CHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLC1","description":"ICD-MCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRC1","description":"ICD-CGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo tib fx cast plaster mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2106","description":"Afo tib fx cast plaster mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20701","description":"Removal Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC31","description":"Medium Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXA0","description":"ICD-NDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB11","description":"ICD-2HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJB1","description":"ICD-CIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNF0","description":"ICD-OLNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACF0","description":"ICD-FACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSB0","description":"ICD-PHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m disofenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9510","description":"Tc99m disofenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIF1","description":"ICD-GGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16070","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16070","description":"CPT-16070","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCF1","description":"ICD-JFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1046","description":"Functional status measurement with score was not obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJE1","description":"ICD-GAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trabeculotomy by laser_ including optical coherence tomography (OCT) guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0730T","description":"Trabeculotomy by laser_ including optical coherence tomography (OCT) guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syme typ expandabl wall sckt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5630","description":"Syme typ expandabl wall sckt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compatibility test antiglob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86922","description":"Compatibility test antiglob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLC1","description":"ICD-JGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC112","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOD1","description":"ICD-KFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neostim tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4265","description":"Neostim tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mumps virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90704","description":"Mumps virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24655","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITA1","description":"ICD-CITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXA0","description":"ICD-BEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clear outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69205","description":"Clear outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhc pt assistant ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0157","description":"Hhc pt assistant ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8A","description":"Very High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUB0","description":"ICD-NBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQB1","description":"ICD-ODQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":">=50% of total number of a patient_s outpatient RA encounters assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1007","description":">=50% of total number of a patient_s outpatient RA encounters assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWD1","description":"ICD-GGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJC1","description":"ICD-KCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVD1","description":"ICD-GHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53010","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIF0","description":"ICD-AAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB206","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPC1","description":"ICD-FGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA21","description":"ICD-3FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIB1","description":"ICD-IGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein_ open or percutaneous_ including all vascular access_ catheter manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0524T","description":"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein_ open or percutaneous_ including all vascular access_ catheter manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIB1","description":"ICD-MKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levetiracetam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1953","description":"Levetiracetam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML15","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB150","description":"Clinically Complex _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMA0","description":"ICD-OAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDF1","description":"ICD-GIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAF1","description":"ICD-EEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Expandable controller_ initl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2377","description":"Expandable controller_ initl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Silicone gel sheet_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6025","description":"Silicone gel sheet_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOE1","description":"ICD-PGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ace/arb therapy rxd/taken","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4010F","description":"Ace/arb therapy rxd/taken","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTB0","description":"ICD-NHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"teledentistry - asynchronous; information stored and forwarded to dentist for subse","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9996","description":"teledentistry - asynchronous; information stored and forwarded to dentist for subse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDD0","description":"ICD-OBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHF0","description":"ICD-FDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIA1","description":"ICD-FBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEB1","description":"ICD-IBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPF1","description":"ICD-NHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKD1","description":"ICD-FDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFND0","description":"ICD-KFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECC1","description":"ICD-KECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHB0","description":"ICD-KCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVA1","description":"ICD-CBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYC1","description":"ICD-HGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31760","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRB0","description":"ICD-OKRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental connector bar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6920","description":"Dental connector bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOD1","description":"ICD-OAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHC1","description":"ICD-ECHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCED0","description":"ICD-FCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTF1","description":"ICD-KFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct vena cava","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34502","description":"Reconstruct vena cava","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair sciatic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64858","description":"Repair sciatic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71047","description":"Radiologic examination_ chest; 3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (urothelial carcinoma)_ DNA_ quantitative methylation-specific PCR of 2 genes (ONECUT2_ VIM)_ algorithmic analysis reported as positive or negative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0465U","description":"Oncology (urothelial carcinoma)_ DNA_ quantitative methylation-specific PCR of 2 genes (ONECUT2_ VIM)_ algorithmic analysis reported as positive or negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOF0","description":"ICD-PGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA240","description":"Reduced Physical Function _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRD0","description":"ICD-DIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUC1","description":"ICD-MKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA21","description":"ICD-2LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited dental tx adolescent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8030","description":"Limited dental tx adolescent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGID1","description":"ICD-KGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWE0","description":"ICD-KFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9978","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEB0","description":"ICD-KFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKF0","description":"ICD-NGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ inf_ per/cent/midline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1751","description":"Cath_ inf_ per/cent/midline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laps rmvl vgl arry&pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0314T","description":"Laps rmvl vgl arry&pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA23","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLC1","description":"ICD-KDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52290","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67516","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electric heat pad moist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0215","description":"Electric heat pad moist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMD0","description":"ICD-NCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUD0","description":"ICD-GGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIF0","description":"ICD-IBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enverse_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4258","description":"Enverse_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Narcosynthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90865","description":"Narcosynthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99222","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2C","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5943","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5943","description":"CDT-D5943","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspirate/inj ganglion cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20612","description":"Aspirate/inj ganglion cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of tyrosine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84510","description":"Assay of tyrosine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27134","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2351","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","description":"HCPCS-J2351","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLE1","description":"ICD-CGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calculus assay quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82360","description":"Calculus assay quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB53","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAA0","description":"ICD-ODAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIB1","description":"ICD-CDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63283","description":"Bx/exc idrl spine lesn scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIC1","description":"ICD-FEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLB0","description":"ICD-OCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIE0","description":"ICD-KBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extended culture of oocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89272","description":"Extended culture of oocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Habil ed waiver per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2013","description":"Habil ed waiver per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPC0","description":"ICD-GAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAD0","description":"ICD-IHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hfo flexion glove pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3912","description":"Hfo flexion glove pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX41","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSA0","description":"ICD-CHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vis inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9628","description":"Vis inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1334","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunotherapy one injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95120","description":"Immunotherapy one injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC210","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIA1","description":"ICD-EBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42300","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/o preop order iv ab pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8918","description":"Pt w/o preop order iv ab pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLF1","description":"ICD-KFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental house call","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9410","description":"Dental house call","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBB0","description":"ICD-CBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIF0","description":"ICD-IHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCB0","description":"ICD-BFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trans shoe calip plate exist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3600","description":"Trans shoe calip plate exist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIE0","description":"ICD-JCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMA1","description":"ICD-KBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPB0","description":"ICD-FIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinsert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65155","description":"Reinsert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUF0","description":"ICD-MGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tkr intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9234","description":"Tkr intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36500","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50553","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28B","description":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDF1","description":"ICD-CGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTD1","description":"ICD-GGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture typing glc/hplc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87143","description":"Culture typing glc/hplc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC31","description":"ICD-2BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFID0","description":"ICD-KFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relocation pocket pacemaker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33222","description":"Relocation pocket pacemaker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDF0","description":"ICD-KBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Micafungin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2248","description":"Micafungin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUD1","description":"ICD-JDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9775","description":"Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ionm remote/>1 pt or per hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95941","description":"Ionm remote/>1 pt or per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1401","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1401","description":"CDT-D1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below knee leather socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5638","description":"Below knee leather socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54520","description":"Removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGD0","description":"ICD-BEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADA0","description":"ICD-BADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9761","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9707","description":"Patient received hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOF0","description":"ICD-GHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mpsv4 vaccine subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90733","description":"Mpsv4 vaccine subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKC0","description":"ICD-NCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC20","description":"High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam ribs/chest4/> vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71111","description":"X-ray exam ribs/chest4/> vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIE1","description":"ICD-GEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMF0","description":"ICD-AGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0603","description":"HCPCS-C0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive ear canal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69150","description":"Extensive ear canal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFD1","description":"ICD-BHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calc bmi abv up param f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8417","description":"Calc bmi abv up param f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXE0","description":"ICD-CEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGE1","description":"ICD-FGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted misc prosthetic ser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8499","description":"Unlisted misc prosthetic ser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPD1","description":"ICD-KIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITA1","description":"ICD-KITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLA0","description":"ICD-OKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYE1","description":"ICD-GCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMC0","description":"ICD-MFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARA0","description":"ICD-KARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMA1","description":"ICD-GIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXA1","description":"ICD-NKXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRE1","description":"ICD-CCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKA1","description":"ICD-FEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVA1","description":"ICD-GFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grp b strep screening docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3294F","description":"Grp b strep screening docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absolute quantitation of myocardial blood flow (AQMBF)_ single-photon emission computed tomography (SPECT)_ with exercise or pharmacologic stress_ and at rest_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0742T","description":"Absolute quantitation of myocardial blood flow (AQMBF)_ single-photon emission computed tomography (SPECT)_ with exercise or pharmacologic stress_ and at rest_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal smear for eosinophils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89190","description":"Nasal smear for eosinophils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXC1","description":"ICD-GDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPC0","description":"ICD-OIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl bifocal over 12.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2214","description":"Lens sphcyl bifocal over 12.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-49189","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","description":"CPT-49189","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of bone cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20615","description":"Treatment of bone cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILF1","description":"ICD-MILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87336","description":"IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing_ Including Repacking_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49014","description":"Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing_ Including Repacking_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILD1","description":"ICD-BILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIF1","description":"ICD-FHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy flex biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43202","description":"Esophagoscopy flex biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enter feed supkit syr by day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4034","description":"Enter feed supkit syr by day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBID1","description":"ICD-CBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0502T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ vincristine sul lip 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9371","description":"Inj_ vincristine sul lip 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEB1","description":"ICD-NIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9068","description":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA25","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harness figure of 8 dual con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6676","description":"Harness figure of 8 dual con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGB0","description":"ICD-NEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytotoxic antibody screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86807","description":"Cytotoxic antibody screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADB0","description":"ICD-NADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruct b9 lesion 1-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17110","description":"Destruct b9 lesion 1-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temp fml iu vlv-pmp 1st insj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0596T","description":"Temp fml iu vlv-pmp 1st insj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate (Jylamvo)_ oral_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8611","description":"Methotrexate (Jylamvo)_ oral_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWF0","description":"ICD-DAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0901","description":"HCPCS-A0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFA0","description":"ICD-CDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gr 34 nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2358","description":"Gr 34 nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC52","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBC1","description":"ICD-OCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ivf canc a aspir case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4020","description":"Ivf canc a aspir case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDB1","description":"ICD-BEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1390","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","description":"HCPCS-M1390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMC1","description":"ICD-OBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEA1","description":"ICD-CFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSD0","description":"ICD-CHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carry goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8985","description":"Carry goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITA1","description":"ICD-NITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDD0","description":"ICD-JBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTF0","description":"ICD-EDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carpal tunnel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64721","description":"Carpal tunnel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ivf canc p aspir case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4021","description":"Ivf canc p aspir case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAE0","description":"ICD-MDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACB0","description":"ICD-CACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of neck wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15825","description":"Removal of neck wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No reas_ no ret or w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9515","description":"No reas_ no ret or w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oprelvekin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2355","description":"Oprelvekin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray head for orthodontia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70350","description":"X-ray head for orthodontia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43192","description":"Esophagoscp rig trnso inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUA1","description":"ICD-BBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDB0","description":"ICD-MBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAE0","description":"ICD-EDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHE1","description":"ICD-ODHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSC1","description":"ICD-OFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUB0","description":"ICD-NCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBB1","description":"ICD-NFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Av fuse uppr arm basilic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36819","description":"Av fuse uppr arm basilic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIC0","description":"ICD-EDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKB0","description":"ICD-CCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIA1","description":"ICD-NIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVD0","description":"ICD-KBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQF1","description":"ICD-DHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEF1","description":"ICD-AEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vasopressin (american regent) not therapeutically equivalent to j2598_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2599","description":"Injection_ vasopressin (american regent) not therapeutically equivalent to j2598_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVA0","description":"ICD-FDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFE1","description":"ICD-KAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENA0","description":"ICD-BENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVE0","description":"ICD-JAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24565","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Root surgery ea add root","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3426","description":"Root surgery ea add root","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICF0","description":"ICD-EICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revsc opn/prq tib/pero stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37234","description":"Revsc opn/prq tib/pero stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse esophagus & stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43320","description":"Fuse esophagus & stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOA0","description":"ICD-HHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0903","description":"HCPCS-A0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (coronary artery disease [CAD])_ DNA_ genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs]_ targeted variant genotyping)_ patient lifestyl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0466U","description":"Cardiology (coronary artery disease [CAD])_ DNA_ genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs]_ targeted variant genotyping)_ patient lifestyl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tr retinal les preterm inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67229","description":"Tr retinal les preterm inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB145","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMC0","description":"ICD-AIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACD0","description":"ICD-GACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rn home care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1030","description":"Rn home care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special radiation dosimetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77331","description":"Special radiation dosimetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft head/neck >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64886","description":"Nerve graft head/neck >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLD0","description":"ICD-NCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 3 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP03","description":"Auto.test pane pricing code_ 3 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC13","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Financial mgt waiver/15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2040","description":"Financial mgt waiver/15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCF1","description":"ICD-ICCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27391","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation tray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4320","description":"Irrigation tray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1030","description":"Patients with clinical indications for imaging of the head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14B","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTC1","description":"ICD-BHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cran surg hemotoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21152","description":"Anesth cran surg hemotoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKA1","description":"ICD-BBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1119","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct pelvis w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72193","description":"Ct pelvis w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivitive_ genvisc 850_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7320","description":"Hyaluronan or derivitive_ genvisc 850_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMD0","description":"ICD-MCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBF1","description":"ICD-KGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55605","description":"Incise sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJD1","description":"ICD-GCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement breastpump tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4281","description":"Replacement breastpump tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSA1","description":"ICD-LCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEF1","description":"ICD-FGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWB0","description":"ICD-GCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEE1","description":"ICD-CDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 9","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA56","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFD0","description":"ICD-CHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFD1","description":"ICD-ODFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVF0","description":"ICD-BHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA31","description":"ICD-4LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBC0","description":"ICD-GIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect fibula tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27646","description":"Resect fibula tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ftrst lower extension tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0043","description":"Ftrst lower extension tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAE0","description":"ICD-NDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMF0","description":"ICD-GBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Isoetharine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7649","description":"Isoetharine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0909T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","description":"CPT-0909T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay synovial fluid mucin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83872","description":"Assay synovial fluid mucin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLF0","description":"ICD-AHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1095","description":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGF0","description":"ICD-OBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mirikizumab-mrkz_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9168","description":"Injection_ mirikizumab-mrkz_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAB1","description":"ICD-IGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICD1","description":"ICD-IICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYE1","description":"ICD-PEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUF0","description":"ICD-AAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB116","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABB1","description":"ICD-IABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand-held pefr meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4614","description":"Hand-held pefr meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFD0","description":"ICD-GCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0796T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth hrt surg w/pmp age 1+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56251","description":"Anesth hrt surg w/pmp age 1+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ovary/tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58720","description":"Removal of ovary/tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammogram one breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77055","description":"Mammogram one breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUA0","description":"ICD-IIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFA1","description":"ICD-FAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part hand thumb rem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6000","description":"Part hand thumb rem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematocrit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85014","description":"Hematocrit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMB1","description":"ICD-FFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD244","description":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21B","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug/substance nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80377","description":"Drug/substance nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHE1","description":"ICD-JBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECC1","description":"ICD-NECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13B","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVF0","description":"ICD-CAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1095T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1095T","description":"CPT-1095T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ methylprednisolone sodium succinate_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2919","description":"Injection_ methylprednisolone sodium succinate_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair skull cavity lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62120","description":"Repair skull cavity lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATB1","description":"ICD-CATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inhaled corticosteroids rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4140F","description":"Inhaled corticosteroids rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHF0","description":"ICD-FFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pik3Ca (Phosphatidylinositol-4_ 5-Biphosphate 3-Kinase_ Catalytic Subunit Alpha) (Eg_ Colorectal And Breast Cancer) Gene Analysis_ Targeted Sequence Analysis (Eg_ Exons 7_ 9_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81309","description":"Pik3Ca (Phosphatidylinositol-4_ 5-Biphosphate 3-Kinase_ Catalytic Subunit Alpha) (Eg_ Colorectal And Breast Cancer) Gene Analysis_ Targeted Sequence Analysis (Eg_ Exons 7_ 9_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADF1","description":"ICD-JADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAD0","description":"ICD-IBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVD0","description":"ICD-JFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVD0","description":"ICD-JBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOE0","description":"ICD-DEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEF0","description":"ICD-KGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair tcat mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33419","description":"Repair tcat mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGE0","description":"ICD-FCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDE0","description":"ICD-OFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEF1","description":"ICD-BGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal application device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7034","description":"Nasal application device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVC0","description":"ICD-KCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEF1","description":"ICD-FCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Interpretation And Report By Physician Or Other Qualified Health Care Professional_ Per Calendar Month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0706T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Interpretation And Report By Physician Or Other Qualified Health Care Professional_ Per Calendar Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect mediastinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39200","description":"Resect mediastinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAC0","description":"ICD-JAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATD0","description":"ICD-JATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tinnitus assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92625","description":"Tinnitus assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25931","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5655","description":"Socket insert below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech/hearing therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92508","description":"Speech/hearing therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEF0","description":"ICD-OHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFE0","description":"ICD-JDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCE1","description":"ICD-AFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99253","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27331","description":"Explore/treat knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMA1","description":"ICD-JBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anterior colporrhaphy_ repair of cystocele with or without repair of urethrocele_ including cystourethroscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57240","description":"Anterior colporrhaphy_ repair of cystocele with or without repair of urethrocele_ including cystourethroscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00524","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","description":"CPT-00524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGD1","description":"ICD-GHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUE0","description":"ICD-BAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone biopsy excisional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20240","description":"Bone biopsy excisional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTC1","description":"ICD-OLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCC0","description":"ICD-CDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFA0","description":"ICD-KEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autogenous Av Fistula Received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8530","description":"Autogenous Av Fistula Received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBND1","description":"ICD-NBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVE0","description":"ICD-GCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rib and nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21616","description":"Removal of rib and nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRE0","description":"ICD-DFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resuscitation bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8999","description":"Resuscitation bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ loncastuximab tesirine-lpyl_ 0.075 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9359","description":"Injection_ loncastuximab tesirine-lpyl_ 0.075 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHA1","description":"ICD-CHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4366","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","description":"HCPCS-Q4366","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYB0","description":"ICD-DHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36589","description":"Removal tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext h rate epi sz 14 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0381T","description":"Ext h rate epi sz 14 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrocardiogram report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93010","description":"Electrocardiogram report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPC0","description":"ICD-OLPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bladder wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51860","description":"Repair of bladder wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIB0","description":"ICD-MEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAD0","description":"ICD-BGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKF1","description":"ICD-FEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA11","description":"ICD-4FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg >48 in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6244","description":"Hydrogel drg >48 in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who have an order for or are receiving hospice or palliative care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1186","description":"Patients who have an order for or are receiving hospice or palliative care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg over 1 hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95813","description":"Eeg over 1 hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMD1","description":"ICD-JGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSA0","description":"ICD-LFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace implantable hrt syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053T","description":"Replace implantable hrt syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50070","description":"Incision of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIF0","description":"ICD-GDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEB0","description":"ICD-FFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHED0","description":"ICD-BHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEED0","description":"ICD-IEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medicaid certified community behavioral health clinic services_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1041","description":"Medicaid certified community behavioral health clinic services_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHD0","description":"ICD-EIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay rbc glutathione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82979","description":"Assay rbc glutathione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDF0","description":"ICD-MHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert hepatic shunt (tips)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37182","description":"Insert hepatic shunt (tips)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26236","description":"Partial removal finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trigeminal block anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9212","description":"Trigeminal block anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachy linear_ non-str_p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2636","description":"Brachy linear_ non-str_p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPB1","description":"ICD-NAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC220","description":"Clinically Complex _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIA1","description":"ICD-GIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEE1","description":"ICD-OKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEE0","description":"ICD-JEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCA1","description":"ICD-MGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIB1","description":"ICD-BIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANE0","description":"ICD-OANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIE0","description":"ICD-IAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21240","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX35","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinician Documented That Patient Was Not An Eligible Candidate For Autogenous AV Fistula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8531","description":"Clinician Documented That Patient Was Not An Eligible Candidate For Autogenous AV Fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29450","description":"Application of leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUB0","description":"ICD-CIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHB1","description":"ICD-NJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lower extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93926","description":"Lower extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFF1","description":"ICD-NKFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMD1","description":"ICD-NCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0281","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","description":"HCPCS-J0281","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTD1","description":"ICD-MGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spiro no perf or doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8926","description":"Spiro no perf or doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corticotropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0800","description":"Corticotropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLC1","description":"ICD-FFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUD1","description":"ICD-KFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIF1","description":"ICD-NCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00561","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","description":"CPT-00561","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc cur meds by prov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8427","description":"Doc cur meds by prov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXB1","description":"ICD-BBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 8 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP08","description":"Auto.test pane pricing code_ 8 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limit oral eval problm focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0140","description":"Limit oral eval problm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL41","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCND0","description":"ICD-FCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pmkr_ dual_ non rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2619","description":"Pmkr_ dual_ non rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplant ureter to skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50860","description":"Transplant ureter to skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29425","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARA1","description":"ICD-LARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted procedure colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45399","description":"Unlisted procedure colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17284","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA21","description":"ICD-2BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrin degradation quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85379","description":"Fibrin degradation quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Semen anal vol/count/mot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89320","description":"Semen anal vol/count/mot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUB0","description":"ICD-CCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psa screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0103","description":"Psa screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJC0","description":"ICD-NHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIC1","description":"ICD-EEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - bitewing radiographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0373","description":"intraoral tomosynthesis - bitewing radiographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKB1","description":"ICD-BEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydralazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0360","description":"Hydralazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close kidney-skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50520","description":"Close kidney-skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1502","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1502","description":"CDT-D1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKF0","description":"ICD-GCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQD1","description":"ICD-HHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28660","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPC0","description":"ICD-CEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOB1","description":"ICD-CCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC106","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracolumbar or lumbar vertebral body tethering_ including thoracoscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0790T","description":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracolumbar or lumbar vertebral body tethering_ including thoracoscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFD1","description":"ICD-BBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33305","description":"Repair of heart wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile ele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0335U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile ele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAC0","description":"ICD-BAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35311","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAC1","description":"ICD-JDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","description":"HCPCS-J3375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHE1","description":"ICD-BGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clean & inspect rem dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9932","description":"Clean & inspect rem dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on facial bones or skull; radical surgery (includ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0127U","description":"Anesthesia for procedures on facial bones or skull; radical surgery (includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPB0","description":"ICD-JHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUE0","description":"ICD-GDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVD0","description":"ICD-OFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXD0","description":"ICD-OCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUB0","description":"ICD-AHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOA1","description":"ICD-DHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4048F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEA1","description":"ICD-KDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chiropractic medicine mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0065","description":"Chiropractic medicine mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone scn b/4 txmnt/aftr dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3269F","description":"Bone scn b/4 txmnt/aftr dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADA0","description":"ICD-MADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ etelcalcetide_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0606","description":"Injection_ etelcalcetide_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPA1","description":"ICD-NGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASE0","description":"ICD-GASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWA1","description":"ICD-DCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level IV_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0753T","description":"Digitization of glass microscope slides for level IV_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC45","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL14","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30400","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject epidural patch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62273","description":"Inject epidural patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scope plantar fasciotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29893","description":"Scope plantar fasciotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMA0","description":"ICD-JGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKC0","description":"ICD-FFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDC1","description":"ICD-AFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLE1","description":"ICD-NJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPD0","description":"ICD-JHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair middle ear structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69666","description":"Repair middle ear structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGF0","description":"ICD-GBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVA0","description":"ICD-GEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMA1","description":"ICD-AGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES111","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRD0","description":"ICD-CHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBF0","description":"ICD-CBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAC1","description":"ICD-GGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIF0","description":"ICD-CEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMF0","description":"ICD-JIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOA0","description":"ICD-PHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRF1","description":"ICD-KDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDID1","description":"ICD-IDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB20","description":"Ultra High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMC0","description":"ICD-ABMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB33","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair paravag defect lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57423","description":"Repair paravag defect lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJA0","description":"ICD-KEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIC0","description":"ICD-FAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Straight tip urine catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4351","description":"Straight tip urine catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove tunneled ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49422","description":"Remove tunneled ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37265","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","description":"CPT-37265","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hygienic item or device_ disposable or non-disposable_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9286","description":"Hygienic item or device_ disposable or non-disposable_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sterile needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4215","description":"Sterile needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUF1","description":"ICD-ACUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMF1","description":"ICD-AEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy lumb/sac facet jnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64635","description":"Destroy lumb/sac facet jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADID0","description":"ICD-ADID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJE1","description":"ICD-GBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Angioscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35400","description":"Angioscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of rib fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21812","description":"Treatment of rib fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHA0","description":"ICD-BHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FlowerAmnioPatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4178","description":"FlowerAmnioPatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1216","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shrt leg fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4038","description":"Cast sup shrt leg fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCA1","description":"ICD-CCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLF0","description":"ICD-GCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACD1","description":"ICD-CACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLB0","description":"ICD-GFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sex transformation m to f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55970","description":"Sex transformation m to f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIA0","description":"ICD-AIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJE0","description":"ICD-FIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25360","description":"Revision of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig bmi calculation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8422","description":"Pt inelig bmi calculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXF0","description":"ICD-JIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with dilation of frontal and sphenoid sinus ostia (eg_ balloon dilation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31298","description":"Nasal/sinus endoscopy_ surgical; with dilation of frontal and sphenoid sinus ostia (eg_ balloon dilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBD0","description":"ICD-GFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHE0","description":"ICD-BHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAE1","description":"ICD-IHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair ing hernia blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49521","description":"Rerepair ing hernia blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHE0","description":"ICD-MKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABC0","description":"ICD-CABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preop anes or proxy b/4 surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9497","description":"Preop anes or proxy b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEA1","description":"ICD-BIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occ orthotic device adjust","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7881","description":"Occ orthotic device adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAE0","description":"ICD-EGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Care level rationale doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6005F","description":"Care level rationale doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelet antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86022","description":"Platelet antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDD0","description":"ICD-KBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGD0","description":"ICD-KCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQB0","description":"ICD-HAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRC1","description":"ICD-KBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOD0","description":"ICD-OEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIC1","description":"ICD-EGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manipulation of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27275","description":"Manipulation of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2C","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDF0","description":"ICD-ACDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1251","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrate iv infusion add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96361","description":"Hydrate iv infusion add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl icar ischm mntrng dvce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0307T","description":"Rmvl icar ischm mntrng dvce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYD0","description":"ICD-HDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRA0","description":"ICD-HHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX31","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Birthing class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9442","description":"Birthing class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSB1","description":"ICD-PLSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWB0","description":"ICD-KIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSD0","description":"ICD-DFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of heel spur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28119","description":"Removal of heel spur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albumin; urine (eg_ microalbumin)_ semiquantitative (eg_ reagent strip assay)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82044","description":"Albumin; urine (eg_ microalbumin)_ semiquantitative (eg_ reagent strip assay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0906T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","description":"CPT-0906T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of anal tags","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46230","description":"Removal of anal tags","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch urine w barrier/tapv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4431","description":"Ost pch urine w barrier/tapv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maple syrup urine disease monitoring by patient-collected blood card sample_ quantitative measurement of allo-isoleucine_ leucine_ isoleucine_ and valine_ liquid chromatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0381U","description":"Maple syrup urine disease monitoring by patient-collected blood card sample_ quantitative measurement of allo-isoleucine_ leucine_ isoleucine_ and valine_ liquid chromatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sio panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0624","description":"Sio panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15A","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINB0","description":"ICD-BINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFF1","description":"ICD-JFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home uterine monitor with or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9001","description":"Home uterine monitor with or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHE1","description":"ICD-FFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syst bp ge 130 - 139mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3075F","description":"Syst bp ge 130 - 139mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture tiss conditn maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5850","description":"Denture tiss conditn maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTA1","description":"ICD-FHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDE1","description":"ICD-ADDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWC0","description":"ICD-LBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBE0","description":"ICD-AIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult70","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0427","description":"Inpt/ed teleconsult70","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERD0","description":"ICD-KERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUA0","description":"ICD-AFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69604","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ Cardiac Contractility Modulation (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1824","description":"Generator_ Cardiac Contractility Modulation (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDB0","description":"ICD-IFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOD1","description":"ICD-LCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYA1","description":"ICD-OGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEB0","description":"ICD-NFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth low intestine scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81051","description":"Anesth low intestine scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below knee cushion socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5646","description":"Below knee cushion socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOA1","description":"ICD-HAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYB0","description":"ICD-GIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAID1","description":"ICD-CAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHF0","description":"ICD-KAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab-arrx_ biosimilar_ (riabni)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5123","description":"Injection_ rituximab-arrx_ biosimilar_ (riabni)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCE1","description":"ICD-NDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe molded plastazote cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3252","description":"Shoe molded plastazote cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45331","description":"Sigmoidoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24670","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECE0","description":"ICD-FECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTE1","description":"ICD-CHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for breast x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19030","description":"Injection for breast x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUA1","description":"ICD-CBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVD0","description":"ICD-KGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33976","description":"Implant ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33762","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSC0","description":"ICD-DDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2109","description":"Spherocylinder 4.25d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWD1","description":"ICD-LFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28A","description":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cer post col occ/man sup adj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0180","description":"Cer post col occ/man sup adj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHA1","description":"ICD-JCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKB0","description":"ICD-OCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55707","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","description":"CPT-55707","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4408","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","description":"HCPCS-Q4408","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBF1","description":"ICD-NBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alveoloplasty w/extract 1-3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7311","description":"Alveoloplasty w/extract 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57120","description":"Closure of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJC0","description":"ICD-CBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBF0","description":"ICD-GHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology tx decision-mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9051","description":"Oncology tx decision-mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBD1","description":"ICD-BDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0076","description":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHE1","description":"ICD-MCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glucose monitor platforms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4255","description":"Glucose monitor platforms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreservation ovary tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0058T","description":"Cryopreservation ovary tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visual evoked potential (VEP) checkerboard or flash testing_ central nervous system except glaucoma_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95930","description":"Visual evoked potential (VEP) checkerboard or flash testing_ central nervous system except glaucoma_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMD0","description":"ICD-JBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGA1","description":"ICD-FDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISD0","description":"ICD-GISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0701","description":"HCPCS-C0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Porcelain/ceramic retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6548","description":"Porcelain/ceramic retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22B","description":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0A","description":"Medium Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENA0","description":"ICD-NENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKC0","description":"ICD-GCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chiropract manj 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98941","description":"Chiropract manj 3-4 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC31","description":"ICD-3LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral antral fistula closure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7260","description":"Oral antral fistula closure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of free thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84439","description":"Assay of free thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDC0","description":"ICD-EEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67420","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHB0","description":"ICD-CEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAC1","description":"ICD-AEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aortofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35647","description":"Art byp aortofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUF1","description":"ICD-OLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5098","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","description":"HCPCS-Q5098","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHA0","description":"ICD-CBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCD0","description":"ICD-OBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9809","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9809","description":"HCPCS-C9809","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"B-12 binding capacity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82608","description":"B-12 binding capacity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vancomycin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80202","description":"Assay of vancomycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSA1","description":"ICD-OFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluciclovine f-18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9588","description":"Fluciclovine f-18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKF0","description":"ICD-BEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAE0","description":"ICD-OAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE230","description":"Clinically Complex _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB52","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test socket hip disarticulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5626","description":"Test socket hip disarticulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch w/o barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5052","description":"Clsd ostomy pouch w/o barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Critical care addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99292","description":"Critical care addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLC0","description":"ICD-MGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analyze neurostim no prog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95970","description":"Analyze neurostim no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit hydra 1 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9374","description":"Hit hydra 1 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLF1","description":"ICD-MCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of sialic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84275","description":"Assay of sialic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE115","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLND1","description":"ICD-OLND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBD0","description":"ICD-BGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code  13-16 test","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP16","description":"Auto test panel pricing code  13-16 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEF1","description":"ICD-KGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHF1","description":"ICD-NJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAB0","description":"ICD-EGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens_ >= 1.66 p/>=1.80 g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2783","description":"Lens_ >= 1.66 p/>=1.80 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQE0","description":"ICD-PCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiography head w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70545","description":"Mr angiography head w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOD0","description":"ICD-LEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Isoetharine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7650","description":"Isoetharine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPE0","description":"ICD-NGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMC0","description":"ICD-OAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNB0","description":"ICD-CBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost be/wd_ ultlite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7400","description":"Add ue prost be/wd_ ultlite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53601","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMF1","description":"ICD-CCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAA1","description":"ICD-CCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHND1","description":"ICD-OHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKA1","description":"ICD-BFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16073","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16073","description":"CPT-16073","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0559","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","description":"HCPCS-G0559","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g._ history of gastrointestinal bleed_ intra-cranial bleed_ idiopathic thrombocytopenic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9794","description":"Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g._ history of gastrointestinal bleed_ intra-cranial bleed_ idiopathic thrombocytopenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBE0","description":"ICD-NLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Survey not complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0914","description":"Survey not complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKA1","description":"ICD-CBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Embedded ip cath exit-site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49436","description":"Embedded ip cath exit-site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytarabine hcl 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9100","description":"Cytarabine hcl 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJF1","description":"ICD-NHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB117","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRE1","description":"ICD-OIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place stereo cath brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0169T","description":"Place stereo cath brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMD1","description":"ICD-AGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8711","description":"Pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures adjust part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5422","description":"Dentures adjust part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVD0","description":"ICD-OKVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRA0","description":"ICD-CDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xray place prox ext thor ao","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75958","description":"Xray place prox ext thor ao","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKB1","description":"ICD-GHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0231T","description":"Njx tfrml eprl w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAC1","description":"ICD-JCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5C","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCC1","description":"ICD-OJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGC1","description":"ICD-NKGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHE1","description":"ICD-IEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICA1","description":"ICD-CICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1090T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1090T","description":"CPT-1090T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD225","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILA1","description":"ICD-MILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI low field","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8042","description":"MRI low field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53621","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67121","description":"Remove eye implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vision svcs frames purchases","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2020","description":"Vision svcs frames purchases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBE0","description":"ICD-CDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory eeg monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95950","description":"Ambulatory eeg monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOD1","description":"ICD-GBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENA1","description":"ICD-FENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bio mtrls to aid soft/os reg","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4265","description":"Bio mtrls to aid soft/os reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILF0","description":"ICD-IILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELB1","description":"ICD-JELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1245","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSA1","description":"ICD-PLSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNC0","description":"ICD-NKNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0696U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696U","description":"CPT-0696U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1203","description":"HCPCS-B1203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSF1","description":"ICD-OKSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC11","description":"ICD-3LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"deep sedation/general anesthesia each subsequent 15 minute increment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9223","description":"deep sedation/general anesthesia each subsequent 15 minute increment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27893","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOB0","description":"ICD-DEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cid ext controller repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8628","description":"Cid ext controller repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUA1","description":"ICD-JBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNB1","description":"ICD-KHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKF1","description":"ICD-KEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Discography cerv/thor spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72285","description":"Discography cerv/thor spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ anesthetic agent; carotid sinus (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64508","description":"Injection_ anesthetic agent; carotid sinus (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANE1","description":"ICD-JANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQA0","description":"ICD-DHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"REvenfenacin inhalation solution_ FDA-approved final product_ noncompounded_administered through DME_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7677","description":"REvenfenacin inhalation solution_ FDA-approved final product_ noncompounded_administered through DME_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of stomach nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64755","description":"Incision of stomach nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEC1","description":"ICD-NGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10C","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAA0","description":"ICD-IHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA113","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDD1","description":"ICD-NLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert temp bladder cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51702","description":"Insert temp bladder cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJD0","description":"ICD-CCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast add us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19286","description":"Perq dev breast add us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOB1","description":"ICD-CIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELD1","description":"ICD-GELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene minor bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81207","description":"Bcr/abl1 gene minor bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plasma_ frz between 8-24hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9059","description":"Plasma_ frz between 8-24hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB136","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26590","description":"Repair finger deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDE1","description":"ICD-KGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pertussis ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87265","description":"Pertussis ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath ren art 2nd+ bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36254","description":"Ins cath ren art 2nd+ bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20D","description":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tibial arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29856","description":"Tibial arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXD0","description":"ICD-NHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICD0","description":"ICD-AICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx/pro/dx inj same drug adon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96376","description":"Tx/pro/dx inj same drug adon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIF0","description":"ICD-FHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHF0","description":"ICD-FCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opiates 1 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80361","description":"Opiates 1 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBA0","description":"ICD-JEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with ablation or destruction of lesion(s) with laser_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31572","description":"Laryngoscopy_ flexible; with ablation or destruction of lesion(s) with laser_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95720","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJB1","description":"ICD-BEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJD0","description":"ICD-FEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0D","description":"Default_ /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28B","description":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Celera Dual Layer or Celera Dual Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4259","description":"Celera Dual Layer or Celera Dual Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINC1","description":"ICD-GINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFB0","description":"ICD-CCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTD0","description":"ICD-GBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31087","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28470","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMB0","description":"ICD-GCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJE1","description":"ICD-JDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB54","description":"Medium Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFB0","description":"ICD-OAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Particle agglut antbdy scrn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86403","description":"Particle agglut antbdy scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","description":"HCPCS-M1391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKA1","description":"ICD-NFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHF1","description":"ICD-BCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flu vacc iiv3 no preserv id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90654","description":"Flu vacc iiv3 no preserv id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis B virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9912","description":"Hepatitis B virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOF0","description":"ICD-LDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLB0","description":"ICD-CGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8C","description":"High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Integra flowable wound matri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4114","description":"Integra flowable wound matri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9768","description":"Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBB0","description":"ICD-ICBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQB0","description":"ICD-PAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No reason_ no refer hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9526","description":"No reason_ no refer hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph fundoplasty lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43327","description":"Esoph fundoplasty lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFC1","description":"ICD-FFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-surg eye measures docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3073F","description":"Pre-surg eye measures docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBB0","description":"ICD-CGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urology surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53899","description":"Urology surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMA1","description":"ICD-MHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIC0","description":"ICD-OJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-53866","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","description":"CPT-53866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAB0","description":"ICD-FFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermabind dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4287","description":"Dermabind dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFC0","description":"ICD-NLFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJF0","description":"ICD-KIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0401","description":"HCPCS-B0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRE1","description":"ICD-HDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADF0","description":"ICD-JADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin peel therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17360","description":"Skin peel therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise intraspinl lesion crv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63265","description":"Excise intraspinl lesion crv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLF1","description":"ICD-OBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDE1","description":"ICD-CBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVC1","description":"ICD-OGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12D","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB151","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHE0","description":"ICD-JIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTF0","description":"ICD-JBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKC0","description":"ICD-GEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery to vein shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36835","description":"Artery to vein shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25000","description":"Incision of tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20700","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHA0","description":"ICD-OGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interprof phone/online 5-10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99446","description":"Interprof phone/online 5-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJD1","description":"ICD-KEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computed tomography scan taken for the purpose of biomechanical computed tomography analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0558T","description":"Computed tomography scan taken for the purpose of biomechanical computed tomography analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23675","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKE0","description":"ICD-KGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37264","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","description":"CPT-37264","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBA1","description":"ICD-CDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap proctopexy w/sig resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45402","description":"Lap proctopexy w/sig resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEE0","description":"ICD-CEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPC0","description":"ICD-KHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No sleep apnea assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8841","description":"No sleep apnea assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXC0","description":"ICD-JAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFD0","description":"ICD-OGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1304","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1304","description":"CDT-D1304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAB1","description":"ICD-OLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSC0","description":"ICD-CGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDA1","description":"ICD-BHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJE1","description":"ICD-GCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHA0","description":"ICD-FGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEA0","description":"ICD-GBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABD0","description":"ICD-EABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Child fostercare th per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5145","description":"Child fostercare th per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noncovered ambulance mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0888","description":"Noncovered ambulance mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJE1","description":"ICD-KGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iris support intraoclr lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2631","description":"Iris support intraoclr lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWD0","description":"ICD-OAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB31","description":"ICD-1FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-84393","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","description":"CPT-84393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0304","description":"HCPCS-C0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20A","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Euglobulin lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85360","description":"Euglobulin lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0883T","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gum graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41870","description":"Gum graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGE1","description":"ICD-KDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIID0","description":"ICD-NIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVF0","description":"ICD-JGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove elbow lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24120","description":"Remove elbow lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATB0","description":"ICD-FATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQE1","description":"ICD-PBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Case management_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2022","description":"Case management_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harvest vein for bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35500","description":"Harvest vein for bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ immunohistochemistry_ protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1]_ carcinoembryonic antigen-related cell","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0067U","description":"Oncology (breast)_ immunohistochemistry_ protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1]_ carcinoembryonic antigen-related cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate pulm tumors extnsn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0340T","description":"Ablate pulm tumors extnsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40651","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC05","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01150","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","description":"CPT-01150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogate crtd sns dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0272T","description":"Interrogate crtd sns dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAC0","description":"ICD-EIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic shoe with wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5504","description":"Diabetic shoe with wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOE1","description":"ICD-CDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen class list a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80301","description":"Drug screen class list a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGE0","description":"ICD-KHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67840","description":"Remove eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0A","description":"High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKA1","description":"ICD-JCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete aca_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4302","description":"Complete aca_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proton trmt simple w/o comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77520","description":"Proton trmt simple w/o comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam filled drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2386","description":"Foam filled drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDD0","description":"ICD-NCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult day center_ 8-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0530","description":"Adult day center_ 8-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5276","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lg vol nebulizer disposable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7007","description":"Lg vol nebulizer disposable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NFCT DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0225U","description":"NFCT DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAD1","description":"ICD-EDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ADAMTS13_ recombinant-krhn_ 10 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7171","description":"Injection_ ADAMTS13_ recombinant-krhn_ 10 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMC0","description":"ICD-AGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos air press prescribe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8852","description":"Pos air press prescribe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLB0","description":"ICD-NCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQB1","description":"ICD-KCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUC0","description":"ICD-GHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anaphylaxis due to the vaccine on or before the date of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1311","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acesso tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4300","description":"Acesso tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB56","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4363","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","description":"HCPCS-Q4363","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOE0","description":"ICD-PCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abd paracentesis w/imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49083","description":"Abd paracentesis w/imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDME0","description":"ICD-IDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRC0","description":"ICD-GIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXC1","description":"ICD-GEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDA1","description":"ICD-BDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHC0","description":"ICD-NEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMD1","description":"ICD-MIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0994T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","description":"CPT-0994T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6534","description":"Gc stocking thighlngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not rcvng glucoco thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4192F","description":"Pt not rcvng glucoco thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla class i semiquant panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86834","description":"Hla class i semiquant panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGA1","description":"ICD-BGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22B","description":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPC0","description":"ICD-BHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who utilize hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9768","description":"Patients who utilize hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0501T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSF0","description":"ICD-PCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00450","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","description":"CPT-00450","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA210","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKC0","description":"ICD-OCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sbrt delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77373","description":"Sbrt delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLF0","description":"ICD-GGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRF1","description":"ICD-HFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOF0","description":"ICD-GEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDB0","description":"ICD-GEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA26","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADC1","description":"ICD-OADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replantation digit complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20822","description":"Replantation digit complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of an implantable_ patient-activated cardiac event recorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33284","description":"Removal of an implantable_ patient-activated cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVE0","description":"ICD-BHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHC1","description":"ICD-BDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWF0","description":"ICD-LAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRE1","description":"ICD-CHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transthor diaphrag hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43334","description":"Transthor diaphrag hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVB1","description":"ICD-BBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic control thoracic ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2660","description":"Thoracic control thoracic ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection eye drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67028","description":"Injection eye drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lsh uterus above 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58543","description":"Lsh uterus above 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHE0","description":"ICD-BAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEC1","description":"ICD-FIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of palm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26025","description":"Drainage of palm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJB1","description":"ICD-OHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKD1","description":"ICD-OBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHB0","description":"ICD-NKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLA1","description":"ICD-JCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No impro med time pain med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9427","description":"No impro med time pain med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; interpretation and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0557T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; interpretation and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pain doc pos and plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8730","description":"Pain doc pos and plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCF0","description":"ICD-FBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corplex_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4232","description":"Corplex_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWE0","description":"ICD-LIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28052","description":"Biopsy of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53661","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLA0","description":"ICD-NDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXB0","description":"ICD-OKXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 xtra hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0828","description":"Pwc gp 2 xtra hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25490","description":"Reinforce radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRD1","description":"ICD-LGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allergen specific IgE; qualitative_ multiallergen screen (eg_ disk_ sponge_ card)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86005","description":"Allergen specific IgE; qualitative_ multiallergen screen (eg_ disk_ sponge_ card)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEND1","description":"ICD-FEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYB0","description":"ICD-KGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vagotomy & pylorus repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43641","description":"Vagotomy & pylorus repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGF1","description":"ICD-NIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADB0","description":"ICD-JADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic radiology simulation-aided field setting; complex_ including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy tre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9794","description":"Therapeutic radiology simulation-aided field setting; complex_ including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy tre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup hip spica fiberglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4026","description":"Cast sup hip spica fiberglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of neck/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21550","description":"Biopsy of neck/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBF0","description":"ICD-AHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHD0","description":"ICD-KIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immune admin oral/nasal addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90474","description":"Immune admin oral/nasal addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surfactant admin thru tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94610","description":"Surfactant admin thru tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise urine flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50830","description":"Revise urine flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision graft neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35901","description":"Excision graft neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8X","description":"High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFND1","description":"ICD-FFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBB0","description":"ICD-ACBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening of a patient","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0190","description":"Screening of a patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUC0","description":"ICD-JBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin sub graft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15271","description":"Skin sub graft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES325","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNB0","description":"ICD-FDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWF0","description":"ICD-GCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMF1","description":"ICD-EHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Teflon or equal cable lining","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6665","description":"Teflon or equal cable lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt recvd inhal anesthetic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4554F","description":"Pt recvd inhal anesthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSB1","description":"ICD-PGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECA1","description":"ICD-IECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Counsel prov driving risks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6110F","description":"Counsel prov driving risks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54348","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye strands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67030","description":"Incise inner eye strands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHF0","description":"ICD-BHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBF1","description":"ICD-CFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoplasty_ medialization_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31591","description":"Laryngoplasty_ medialization_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retainer Crown 3/4 - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6784","description":"Retainer Crown 3/4 - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITA1","description":"ICD-FITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit device repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5036","description":"Hit device repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHF1","description":"ICD-FCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDC1","description":"ICD-GFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSA1","description":"ICD-HFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGD1","description":"ICD-CDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWE0","description":"ICD-PIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75962","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUC0","description":"ICD-IEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWE0","description":"ICD-LAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25260","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Embryo hatching","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89253","description":"Embryo hatching","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUE1","description":"ICD-JEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJA1","description":"ICD-OKJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemotaxis assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86155","description":"Chemotaxis assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft subclav-subclav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35511","description":"Art byp grft subclav-subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQB1","description":"ICD-PDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWA0","description":"ICD-CFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of heel bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28118","description":"Removal of heel bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXC0","description":"ICD-BGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVC1","description":"ICD-OKVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Fpd - Porcelain Fused To Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6099","description":"Implant Supported Retainer For Fpd - Porcelain Fused To Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0403","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0403","description":"CDT-D0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hast w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94452","description":"Hast w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBA1","description":"ICD-ODBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sumatriptan succinate / 6 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3030","description":"Sumatriptan succinate / 6 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVB1","description":"ICD-CAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAD0","description":"ICD-FIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Energy storing foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5976","description":"Energy storing foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHC0","description":"ICD-ICHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nicotine patch legend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4990","description":"Nicotine patch legend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVF0","description":"ICD-GHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDA0","description":"ICD-ADDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJF0","description":"ICD-CEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHF0","description":"ICD-ODHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEE1","description":"ICD-NCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQA1","description":"ICD-CCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSA0","description":"ICD-LBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHE1","description":"ICD-FBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGE0","description":"ICD-GFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53430","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVA1","description":"ICD-BGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or both","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1193","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or both","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIB0","description":"ICD-MAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve palsy muscle graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15841","description":"Nerve palsy muscle graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITF1","description":"ICD-MITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Developmental testing_ (includes assessment of motor_ language_ social_ adaptive_ and/or cognitive functioning by standardized developmental instruments) with interpretation a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96111","description":"Developmental testing_ (includes assessment of motor_ language_ social_ adaptive_ and/or cognitive functioning by standardized developmental instruments) with interpretation a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Accession of brush biopsy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0486","description":"Accession of brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQF1","description":"ICD-OAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted procedure_ intestine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6021","description":"Unlisted procedure_ intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ONC PAN-TUM DNA&RNA GNRJ SEQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0211U","description":"ONC PAN-TUM DNA&RNA GNRJ SEQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRA1","description":"ICD-DFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99341","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderna Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 3)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1710","description":"Moderna Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fludeoxyglucose f18 up to 15 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9609","description":"Fludeoxyglucose f18 up to 15 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRD1","description":"ICD-CCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32940","description":"Revision of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHF1","description":"ICD-EFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5D","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPA1","description":"ICD-NBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNA1","description":"ICD-NLNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22D","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test cran nerv unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95867","description":"Muscle test cran nerv unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perp bk ptb thermopls direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5520","description":"Perp bk ptb thermopls direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thromboplastin inhibition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85705","description":"Thromboplastin inhibition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQF1","description":"ICD-KEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imp neurosti pls gn any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8679","description":"Imp neurosti pls gn any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGF0","description":"ICD-GAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22B","description":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services given to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9740","description":"Hospice services given to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise excessive skin arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15836","description":"Excise excessive skin arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRB0","description":"ICD-GDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Furosemide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1940","description":"Furosemide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKD1","description":"ICD-GEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rn telephone calls to dmp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0320","description":"Rn telephone calls to dmp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No xray/ct/ et al ordd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3320F","description":"No xray/ct/ et al ordd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","description":"HCPCS-J2428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHE0","description":"ICD-IEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGF0","description":"ICD-FIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rib cartilage graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21230","description":"Rib cartilage graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tcd vasoreactivity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93890","description":"Tcd vasoreactivity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHC0","description":"ICD-ABHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gi tract capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0355T","description":"Gi tract capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTA0","description":"ICD-MJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWE1","description":"ICD-HHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25A","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHID1","description":"ICD-KHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGD0","description":"ICD-OCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTE0","description":"ICD-CFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDF0","description":"ICD-IEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHD0","description":"ICD-MEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10B","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATB0","description":"ICD-MATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNF1","description":"ICD-FGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALC0","description":"ICD-IALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93978","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVD1","description":"ICD-FBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34490","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enteral infusion pump w/ ala","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9002","description":"Enteral infusion pump w/ ala","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scleral cover shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2627","description":"Scleral cover shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIB1","description":"ICD-ABIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Missed appointment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9986","description":"Missed appointment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear rx oral admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79005","description":"Nuclear rx oral admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trimethobenzamide hcl 250mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0173","description":"Trimethobenzamide hcl 250mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1303","description":"HCPCS-A1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA206","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNA0","description":"ICD-JCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ guselkumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1628","description":"Injection_ guselkumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBC0","description":"ICD-KHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGED1","description":"ICD-KGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSB0","description":"ICD-OHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9901","description":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQC0","description":"ICD-PJQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL32","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastroesophageal reflux test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91034","description":"Gastroesophageal reflux test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTD1","description":"ICD-CGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trauma respons w/hosp criti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0390","description":"Trauma respons w/hosp criti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUF0","description":"ICD-OBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBD1","description":"ICD-JFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit est age 5-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99393","description":"Prev visit est age 5-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUC1","description":"ICD-MCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary retinal disorders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81434","description":"Hereditary retinal disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAC1","description":"ICD-EHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRB0","description":"ICD-DGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove part of neck vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22110","description":"Remove part of neck vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWD1","description":"ICD-HDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBE1","description":"ICD-CFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Thyroid)_ Dna And Mrna_ Next-Generation Sequencing Analysis Of 112 Genes_ Fine Needle Aspirate Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Algorithmic Predict","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0287U","description":"Oncology (Thyroid)_ Dna And Mrna_ Next-Generation Sequencing Analysis Of 112 Genes_ Fine Needle Aspirate Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Algorithmic Predict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQC0","description":"ICD-KAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31380","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9892","description":"Documentation of patient reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24145","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLC1","description":"ICD-OJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of hemorrhoid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46221","description":"Ligation of hemorrhoid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt nephroureteral catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50433","description":"Plmt nephroureteral catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastime-bmez_ biosimilar_ (ziextenzo) 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9058","description":"Injection_ pegfilgrastime-bmez_ biosimilar_ (ziextenzo) 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20702","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc taa repr w/o subcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33881","description":"Endovasc taa repr w/o subcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEE1","description":"ICD-FDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD205","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB10","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYF1","description":"ICD-PFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABA0","description":"ICD-FABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWD0","description":"ICD-DEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC60","description":"High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJA0","description":"ICD-FCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1050T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1050T","description":"CPT-1050T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36216","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay nephelometry not spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83883","description":"Assay nephelometry not spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1244","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47556","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periradicular surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3427","description":"Periradicular surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWF1","description":"ICD-PBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQB0","description":"ICD-PEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWF0","description":"ICD-LHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drnble ostomy pouch w/o barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5062","description":"Drnble ostomy pouch w/o barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle-specific kinase (MuSK) antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86366","description":"Muscle-specific kinase (MuSK) antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFF0","description":"ICD-KBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBB1","description":"ICD-IFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOE1","description":"ICD-HBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOA1","description":"ICD-GIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC42","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Annual gynecological examina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0610","description":"Annual gynecological examina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPD0","description":"ICD-BBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIC0","description":"ICD-MHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXA0","description":"ICD-CGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHE0","description":"ICD-CIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWD1","description":"ICD-OLWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHD0","description":"ICD-FAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKE1","description":"ICD-GFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB11","description":"ICD-1GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinogen activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85384","description":"Fibrinogen activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYA0","description":"ICD-PBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2D","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWF0","description":"ICD-HCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC126","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rig fram pelvic pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0469","description":"Tlso rig fram pelvic pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUB0","description":"ICD-AEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIE1","description":"ICD-ECIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Latex leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5113","description":"Latex leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDB0","description":"ICD-OBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37780","description":"Revision of leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"2d tte w or w/o fol w/con_co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8923","description":"2d tte w or w/o fol w/con_co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; Each Additional 30 Minutes Beyond The First 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2088","description":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; Each Additional 30 Minutes Beyond The First 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ genomic analysis panel_ variant analysis of 25 genes with reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0434U","description":"Drug metabolism (adverse drug reactions and drug response)_ genomic analysis panel_ variant analysis of 25 genes with reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECA0","description":"ICD-FECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPE1","description":"ICD-NFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo ablate liver cryosurg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47371","description":"Laparo ablate liver cryosurg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQD1","description":"ICD-DEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELA0","description":"ICD-EELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt dischg <=2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9255","description":"Doc pt dischg <=2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJE1","description":"ICD-KBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco counseling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1320","description":"Tobacco counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA07","description":"Low Rehab_ ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trabectedin_ 0.1mg (Yondelis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9480","description":"Injection_ trabectedin_ 0.1mg (Yondelis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22556","description":"Thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disk/foam pad +or- adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5126","description":"Disk/foam pad +or- adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61156","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pancreatic duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48148","description":"Removal of pancreatic duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEA1","description":"ICD-GHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ by tissue approximation using thermal resistance e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2170","description":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ by tissue approximation using thermal resistance e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC136","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIC1","description":"ICD-IHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+cell cnt/% docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3500F","description":"Cd4+cell cnt/% docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 30-40 mmhg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6552","description":"Gradient compression stocking_ below knee_ 30-40 mmhg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score shdl not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8666","description":"Fun stat score shdl not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSE1","description":"ICD-PGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJE0","description":"ICD-KFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHA1","description":"ICD-MLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFF0","description":"ICD-GGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFB0","description":"ICD-NDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD210","description":"Special Care High _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAB0","description":"ICD-GEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIF0","description":"ICD-MLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder blade lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23172","description":"Remove shoulder blade lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWC1","description":"ICD-CHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGB0","description":"ICD-CBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRA1","description":"ICD-KDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQF0","description":"ICD-GAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teplizumab-mzwv_ 5 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9381","description":"Injection_ teplizumab-mzwv_ 5 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Gemcitabine Hydrochloride (Infugem)_ 200 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9199","description":"Injection_ Gemcitabine Hydrochloride (Infugem)_ 200 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUE0","description":"ICD-IDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDE0","description":"ICD-BHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epoprostenol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1325","description":"Epoprostenol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBC0","description":"ICD-CFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht irrigation diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9590","description":"Ht irrigation diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQC0","description":"ICD-LCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAE0","description":"ICD-BCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJB1","description":"ICD-FCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTE0","description":"ICD-JFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biological materials","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3431","description":"Biological materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIF0","description":"ICD-EHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWE1","description":"ICD-HAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0595U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","description":"CPT-0595U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak/bk self-aligning unit ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5617","description":"Ak/bk self-aligning unit ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOB1","description":"ICD-LBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGD1","description":"ICD-KEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAE1","description":"ICD-BHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANF1","description":"ICD-FANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVB0","description":"ICD-NFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHF0","description":"ICD-BBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visual acuity screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99173","description":"Visual acuity screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electro-oculography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92270","description":"Electro-oculography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLD0","description":"ICD-BHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAND1","description":"ICD-FAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGC0","description":"ICD-NFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27594","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUD0","description":"ICD-BHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDA1","description":"ICD-MHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug/bio noc part b drug cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4082","description":"Drug/bio noc part b drug cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUB1","description":"ICD-GCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADE0","description":"ICD-EADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abobotulinumtoxina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0586","description":"Abobotulinumtoxina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-disposable underpads_ all sizes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4553","description":"Non-disposable underpads_ all sizes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression glove_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6581","description":"Gradient compression glove_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPE1","description":"ICD-OKPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled air analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94690","description":"Exhaled air analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJC1","description":"ICD-NBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tap block bi injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64488","description":"Tap block bi injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Donor serv ivf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4025","description":"Donor serv ivf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp periodontal evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0180","description":"Comp periodontal evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harness chest/shlder saddle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6672","description":"Harness chest/shlder saddle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Semi-precision abutment - placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6191","description":"Semi-precision abutment - placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD114","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOE0","description":"ICD-OAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEC1","description":"ICD-IEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPB1","description":"ICD-JBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARA1","description":"ICD-CARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFE0","description":"ICD-OIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBE0","description":"ICD-KFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL07","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rabies ig heat treated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90376","description":"Rabies ig heat treated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ GELSYN-3_ for intra-articular injection_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7328","description":"Hyaluronan or derivative_ GELSYN-3_ for intra-articular injection_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81425","description":"Genome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXF1","description":"ICD-FIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOB0","description":"ICD-KHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA146","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLD1","description":"ICD-MJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAD1","description":"ICD-EIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emerge matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4297","description":"Emerge matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKD0","description":"ICD-CBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1 or no ct sinus w/in 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9354","description":"1 or no ct sinus w/in 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bl smear w/o diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85008","description":"Bl smear w/o diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osseous surgery per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4260","description":"Osseous surgery per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVD0","description":"ICD-KHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRB0","description":"ICD-CIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88307","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multi den insert custom mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5513","description":"Multi den insert custom mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant breast silicone/eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8600","description":"Implant breast silicone/eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Care of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59820","description":"Care of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDA0","description":"ICD-OCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87880","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYE1","description":"ICD-KGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYE1","description":"ICD-OHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCB1","description":"ICD-BFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0013","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","description":"HCPCS-J0013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWE0","description":"ICD-CEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD235","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEC1","description":"ICD-KDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27372","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspirin or another antiplatelet therapy not used_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1057","description":"Aspirin or another antiplatelet therapy not used_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYA0","description":"ICD-OAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18D","description":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sympathectomy digital artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64820","description":"Sympathectomy digital artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Encephaltis st louis antbody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86653","description":"Encephaltis st louis antbody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q6h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9503","description":"Hit antibiotic q6h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVC0","description":"ICD-OHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNC0","description":"ICD-KHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQF0","description":"ICD-PCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC135","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCB0","description":"ICD-BGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECF1","description":"ICD-BECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9728","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0138","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","description":"HCPCS-J0138","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCD1","description":"ICD-EGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe lift elev heel/sole cor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3320","description":"Shoe lift elev heel/sole cor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICD0","description":"ICD-CICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln cmplt mand chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5731","description":"Denture reln cmplt mand chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst metastic/ recur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9075","description":"Onc dx brst metastic/ recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (asceniv)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1554","description":"Injection_ immune globulin (asceniv)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs)_ urine and buccal DNA_ for specimen identity verification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0079U","description":"Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs)_ urine and buccal DNA_ for specimen identity verification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKID0","description":"ICD-OKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMF0","description":"ICD-NDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVB0","description":"ICD-GCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRA0","description":"ICD-CHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRA1","description":"ICD-DHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIF1","description":"ICD-OHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28F","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX50","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of percutaneous transhepatic catheter for biliary drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47510","description":"Introduction of percutaneous transhepatic catheter for biliary drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA42","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NFCT AGT HIV GNRJ SEQ ALYS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0219U","description":"NFCT AGT HIV GNRJ SEQ ALYS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subtalar arthro w/fb rmvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29904","description":"Subtalar arthro w/fb rmvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0428T","description":"Rmvl nstim apnea pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB21","description":"ICD-4JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stationary compressed gas 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0424","description":"Stationary compressed gas 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAF1","description":"ICD-OIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAC0","description":"ICD-GFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthotic(s)/prosthetic(s) management and/or training_ upper extremity(ies)_ lower extremity(ies)_ and/or trunk_ subsequent orthotic(s)/prosthetic(s) encounter_ each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97763","description":"Orthotic(s)/prosthetic(s) management and/or training_ upper extremity(ies)_ lower extremity(ies)_ and/or trunk_ subsequent orthotic(s)/prosthetic(s) encounter_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc share dec prior proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9297","description":"No doc share dec prior proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB215","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhc pt maint ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0159","description":"Hhc pt maint ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elosulfase alfa_ injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1322","description":"Elosulfase alfa_ injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPC0","description":"ICD-BAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOC0","description":"ICD-GEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITF0","description":"ICD-GITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUC1","description":"ICD-KHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC235","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bekesy audiometry diagnosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92561","description":"Bekesy audiometry diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC17","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI orbit/face/neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70542","description":"MRI orbit/face/neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJF0","description":"ICD-CCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15011","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","description":"CPT-15011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA17","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHA0","description":"ICD-KEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46606","description":"Anoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOF1","description":"ICD-CEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adults who are deliberately phased out of medication assisted treatment (MAT) prior to 180 days of continuous treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1035","description":"Adults who are deliberately phased out of medication assisted treatment (MAT) prior to 180 days of continuous treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHC1","description":"ICD-MJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-adjunctive_ non-implanted continuous glucose monitor or receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2103","description":"Non-adjunctive_ non-implanted continuous glucose monitor or receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJC1","description":"ICD-NAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWA0","description":"ICD-OKWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 xtra hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0829","description":"Pwc gp 2 xtra hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACA1","description":"ICD-NACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29894","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECC1","description":"ICD-FECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ durvalumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9492","description":"Injection_ durvalumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLE0","description":"ICD-ECLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHD0","description":"ICD-JHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1424","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","description":"HCPCS-M1424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBC1","description":"ICD-ACBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINE1","description":"ICD-FINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thorax spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22327","description":"Treat thorax spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUF0","description":"ICD-GGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopic sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92614","description":"Laryngoscopic sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rheumatoid factor quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86431","description":"Rheumatoid factor quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunofluorescent study_ each antibody; indirect method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88347","description":"Immunofluorescent study_ each antibody; indirect method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq card stent w/angio 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92928","description":"Prq card stent w/angio 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGE0","description":"ICD-BIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15B","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLD1","description":"ICD-MLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0641U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0641U","description":"CPT-0641U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46910","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOF0","description":"ICD-CBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIB0","description":"ICD-IBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10A","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSC1","description":"ICD-HCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep renal graft/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50327","description":"Prep renal graft/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSE1","description":"ICD-HFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fracture frame attachmnts pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0947","description":"Fracture frame attachmnts pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36590","description":"Removal tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA10","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWB1","description":"ICD-DAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33367","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEF1","description":"ICD-MEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj octafluoropropane mic_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9956","description":"Inj octafluoropropane mic_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1106","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRA1","description":"ICD-OJRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAF0","description":"ICD-NGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33963","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscop w/esoph musc exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32665","description":"Thoracoscop w/esoph musc exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vancomycin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3370","description":"Vancomycin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNE1","description":"ICD-KDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smear special stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87207","description":"Smear special stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9037","description":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMB0","description":"ICD-GHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYF0","description":"ICD-DBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHND1","description":"ICD-FHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUC1","description":"ICD-JBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAC1","description":"ICD-MBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sex chromatin identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88140","description":"Sex chromatin identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat sternum fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21825","description":"Treat sternum fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJD0","description":"ICD-NJJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOC1","description":"ICD-PGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61558","description":"Excision of skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFD0","description":"ICD-JGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB23","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/revise wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25320","description":"Repair/revise wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wig any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9282","description":"Wig any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWC0","description":"ICD-LDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icatibant injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1744","description":"Icatibant injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHC0","description":"ICD-MBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCA0","description":"ICD-GHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ewhfo w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3766","description":"Ewhfo w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTF0","description":"ICD-GDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYA1","description":"ICD-PGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13133","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUC1","description":"ICD-OHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelets_ pheresis_ pathogen-reduced_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9073","description":"Platelets_ pheresis_ pathogen-reduced_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVA1","description":"ICD-NEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIC1","description":"ICD-OEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73521","description":"X-ray exam hips bi 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPE1","description":"ICD-JIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOB1","description":"ICD-CGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGF1","description":"ICD-KDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNC1","description":"ICD-GDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ankle implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27704","description":"Removal of ankle implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adhesive remover_ wipes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4456","description":"Adhesive remover_ wipes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo hip ultra-light materia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5960","description":"Endo hip ultra-light materia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDF0","description":"ICD-AGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAB1","description":"ICD-BCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISE1","description":"ICD-GISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYB0","description":"ICD-PAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ neck/head_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6567","description":"Gradient compression garment_ neck/head_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDE1","description":"ICD-NGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOD1","description":"ICD-LBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCA0","description":"ICD-MFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc order given stop antibio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4049F","description":"Doc order given stop antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBC1","description":"ICD-KGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJB0","description":"ICD-FDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSD1","description":"ICD-CFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot_ adductus positioning device_ adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1015","description":"Foot_ adductus positioning device_ adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC210","description":"Special Care High _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroguide for vein device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77001","description":"Fluoroguide for vein device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUC0","description":"ICD-FDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTF0","description":"ICD-OFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cst noble mtl inlay >=3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6607","description":"Cst noble mtl inlay >=3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete cbc w/auto diff wbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85025","description":"Complete cbc w/auto diff wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYE1","description":"ICD-DDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBE0","description":"ICD-NHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGF1","description":"ICD-KIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27550","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQB0","description":"ICD-GGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99345","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAC0","description":"ICD-IFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0615U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","description":"CPT-0615U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXC1","description":"ICD-OEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical procedures that included the use of silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9756","description":"Surgical procedures that included the use of silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot drop splint pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4398","description":"Foot drop splint pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (genetic hyperfibrinolysis_ delayed bleeding)_ genomic sequence analysis of 8 genes (F13A1_ F13B_ FGA_ FGB_ FGG_ SERPINA1_ SERPINE1_ SERPINF2_ PLAU)_ blood_ buccal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0273U","description":"Hematology (genetic hyperfibrinolysis_ delayed bleeding)_ genomic sequence analysis of 8 genes (F13A1_ F13B_ FGA_ FGB_ FGG_ SERPINA1_ SERPINE1_ SERPINF2_ PLAU)_ blood_ buccal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVD1","description":"ICD-CCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWB1","description":"ICD-GEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOC0","description":"ICD-OKOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair biceps tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23430","description":"Repair biceps tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVC0","description":"ICD-BAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVA1","description":"ICD-FCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDE1","description":"ICD-EHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIF0","description":"ICD-NKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pm generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33233","description":"Removal of pm generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Duodenal exclusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48547","description":"Duodenal exclusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFD1","description":"ICD-KHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc elder mal scrn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8536","description":"No doc elder mal scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2116","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQA1","description":"ICD-GAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC125","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHB0","description":"ICD-CHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental sedative filling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2940","description":"Dental sedative filling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDID0","description":"ICD-BDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0303T","description":"Icar ischm mntrng sys eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXD0","description":"ICD-CIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43635","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWC0","description":"ICD-KAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reusable underpad bed size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4537","description":"Reusable underpad bed size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ortho shoe add march bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3595","description":"Ortho shoe add march bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0659U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0659U","description":"CPT-0659U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB112","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hizentra injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1559","description":"Hizentra injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28I","description":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELA0","description":"ICD-FELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMC1","description":"ICD-JGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILB1","description":"ICD-OILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMB1","description":"ICD-NKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tear duct system surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68899","description":"Tear duct system surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35246","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-molded lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2320","description":"Non-molded lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50780","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of leg veins/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37735","description":"Removal of leg veins/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGB1","description":"ICD-GHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVC1","description":"ICD-FAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFC1","description":"ICD-KGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYF1","description":"ICD-PDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC52","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped critical care initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99471","description":"Ped critical care initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES224","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0578U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","description":"CPT-0578U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTD1","description":"ICD-GBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUA0","description":"ICD-FCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECF1","description":"ICD-GECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDD0","description":"ICD-NLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Toe joint transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26556","description":"Toe joint transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-51721","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","description":"CPT-51721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wedge resect of lung add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32506","description":"Wedge resect of lung add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMB1","description":"ICD-OFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 5/> ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64645","description":"Chemodenerv 1 extrem 5/> ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine fusion combined","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22633","description":"Lumbar spine fusion combined","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt & graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33764","description":"Major vessel shunt & graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEF1","description":"ICD-NEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ leuprolide acetate for depot suspension (lutrate)_ 7.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1954","description":"Injection_ leuprolide acetate for depot suspension (lutrate)_ 7.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I&d abscess extraoral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7520","description":"I&d abscess extraoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHC1","description":"ICD-OBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWB1","description":"ICD-KAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRB1","description":"ICD-CCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dxa bone density study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77085","description":"Dxa bone density study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX20","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXD1","description":"ICD-GDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid met imaging/studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78016","description":"Thyroid met imaging/studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report_ unilateral or bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95919","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report_ unilateral or bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWF0","description":"ICD-OJWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDF0","description":"ICD-OKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ diagnostic with cell washing(s) when performed_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7509","description":"Bronchoscopy_ rigid or flexible_ diagnostic with cell washing(s) when performed_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00730","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","description":"CPT-00730","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCB1","description":"ICD-IDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPC0","description":"ICD-KFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPE0","description":"ICD-BAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v thin layer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88142","description":"Cytopath c/v thin layer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytp dx eval fna 1st ea site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88172","description":"Cytp dx eval fna 1st ea site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht hem horm inj diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9537","description":"Ht hem horm inj diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBA1","description":"ICD-EIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0320","description":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28C","description":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXD0","description":"ICD-JHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA32","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELD0","description":"ICD-NELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAF0","description":"ICD-AFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnosticmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0204","description":"Diagnosticmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB11","description":"ICD-3HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC21","description":"ICD-4AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23140","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBB1","description":"ICD-EEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9294","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","description":"HCPCS-A9294","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXD1","description":"ICD-NLXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX50","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAB1","description":"ICD-OBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Musc tst done w/nerv tst lim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95885","description":"Musc tst done w/nerv tst lim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emer response sys instal&tst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5160","description":"Emer response sys instal&tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0166","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","description":"HCPCS-J0166","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Cranberry Peak_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1008","description":"Clinical Decision Support Mechanism Cranberry Peak_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAE0","description":"ICD-MEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-rad contrast materialnoc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9698","description":"Non-rad contrast materialnoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of phenytoin free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80186","description":"Assay of phenytoin free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breath hydrogen/methane test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91065","description":"Breath hydrogen/methane test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDE0","description":"ICD-FGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9842","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aortofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35539","description":"Art byp grft aortofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSE0","description":"ICD-OJSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBE0","description":"ICD-IHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTC0","description":"ICD-EDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB135","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIB1","description":"ICD-KCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis-periapical radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0389","description":"intraoral tomosynthesis-periapical radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWB0","description":"ICD-CAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61540","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHD1","description":"ICD-AEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWE0","description":"ICD-GDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Terbutaline sulf comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7681","description":"Terbutaline sulf comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 std port cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0821","description":"Pwc gp 2 std port cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ pasireotide long acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2502","description":"Inj_ pasireotide long acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEF1","description":"ICD-JHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAC0","description":"ICD-IGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/ stablj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21320","description":"Closed tx nose fx w/ stablj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjustable angle footplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0040","description":"Adjustable angle footplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coronary artery correction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33502","description":"Coronary artery correction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem mntr pulm flu mntr setup","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0607T","description":"Rem mntr pulm flu mntr setup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHD1","description":"ICD-GIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHA1","description":"ICD-MBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mgmt gene methylation anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81287","description":"Mgmt gene methylation anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure dev_ vasc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1760","description":"Closure dev_ vasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXF0","description":"ICD-KAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam abdo back wall lim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76775","description":"Us exam abdo back wall lim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVB0","description":"ICD-CIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACA0","description":"ICD-AACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUE0","description":"ICD-OJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTE0","description":"ICD-JHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCE0","description":"ICD-IBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct midface w/graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7949","description":"Reconstruct midface w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVA1","description":"ICD-ODVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC51","description":"Very High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFND1","description":"ICD-CFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAA0","description":"ICD-FFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBA0","description":"ICD-GDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ initial site (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0843T","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ initial site (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intro windpipe wire/tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31730","description":"Intro windpipe wire/tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: head trauma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2187","description":"Patients with clinical indications for imaging of the head: head trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMD0","description":"ICD-NEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHF0","description":"ICD-MBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Homaker service nos per 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5130","description":"Homaker service nos per 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEC1","description":"ICD-NJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain tumor w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62164","description":"Remove brain tumor w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTF1","description":"ICD-MJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXE0","description":"ICD-OBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20C","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQB1","description":"ICD-OLQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYE0","description":"ICD-LBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANE0","description":"ICD-CANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1553","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","description":"HCPCS-J1553","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare donor heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33933","description":"Prepare donor heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJF1","description":"ICD-KCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOD0","description":"ICD-LCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABB0","description":"ICD-GABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bilirubin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82247","description":"Bilirubin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGC0","description":"ICD-NEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB151","description":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBED1","description":"ICD-GBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPB1","description":"ICD-NBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ inclisiran_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1306","description":"Injection_ inclisiran_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCE0","description":"ICD-JDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision_ benign lesion including margins_ except skin tag (unless listed elsewhere)_ trunk_ arms or legs; excised diameter 2.1 to 3.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11403","description":"Excision_ benign lesion including margins_ except skin tag (unless listed elsewhere)_ trunk_ arms or legs; excised diameter 2.1 to 3.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBA1","description":"ICD-KIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPD0","description":"ICD-CDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPF0","description":"ICD-NHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5142","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","description":"HCPCS-Q5142","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1440","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","description":"HCPCS-M1440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 2 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3376F","description":"Ajcc brstcncr stage 2 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30903","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair fistula w/colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45805","description":"Repair fistula w/colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOB1","description":"ICD-PAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (IIV4)_ split virus_ preservative free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90686","description":"Influenza virus vaccine_ quadrivalent (IIV4)_ split virus_ preservative free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enterectomy cadaver donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44132","description":"Enterectomy cadaver donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEE1","description":"ICD-AFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4423","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","description":"HCPCS-Q4423","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCA1","description":"ICD-OHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spontaneous nystagmus study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92531","description":"Spontaneous nystagmus study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgraft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4209","description":"Surgraft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELF1","description":"ICD-OELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCC0","description":"ICD-MLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBE0","description":"ICD-IFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA44","description":"Default_ /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15953","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Paliperidone palmitate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2426","description":"Paliperidone palmitate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVA1","description":"ICD-NBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27513","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIC1","description":"ICD-CIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXF1","description":"ICD-KDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDD1","description":"ICD-JFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28202","description":"Repair/graft of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERF0","description":"ICD-KERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daratumumab 10 mg and hyaluronidase-fihj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9062","description":"Injection_ daratumumab 10 mg and hyaluronidase-fihj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC160","description":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vertebral body tethering_ anterior; up to 7 vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0656T","description":"Vertebral body tethering_ anterior; up to 7 vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLE0","description":"ICD-OCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAF1","description":"ICD-JHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35306","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLC0","description":"ICD-CBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel)_ radiological supervisio and interpretation; initial vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75945","description":"Intravascular ultrasound (non-coronary vessel)_ radiological supervisio and interpretation; initial vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Most recent hemoglobin a1c level > 9.0%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1211","description":"Most recent hemoglobin a1c level > 9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Helicobacter pylori detection and antibiotic resistance_ DNA_ 16S and 23S rRNA_ gyrA_ pbp1_ rdxA and rpoB_ next generation sequencing_ formalin-fixed paraffin embedded or fres","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0008U","description":"Helicobacter pylori detection and antibiotic resistance_ DNA_ 16S and 23S rRNA_ gyrA_ pbp1_ rdxA and rpoB_ next generation sequencing_ formalin-fixed paraffin embedded or fres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21431","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWC0","description":"ICD-OFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYE1","description":"ICD-ODYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4D","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ventilating tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69424","description":"Remove ventilating tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace g/c tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49450","description":"Replace g/c tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7524","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEC0","description":"ICD-GCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB54","description":"Very High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB10","description":"High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Combination bilateral ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1690","description":"Combination bilateral ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKF1","description":"ICD-FIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1404","description":"HCPCS-C1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test for acetone/ketones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82009","description":"Test for acetone/ketones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACC0","description":"ICD-BACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c manual swingaway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1028","description":"W/c manual swingaway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNE1","description":"ICD-BCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hymenotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56442","description":"Hymenotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACF1","description":"ICD-GACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aldesleukin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9015","description":"Aldesleukin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15B","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ padded textile_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6606","description":"Gradient compression bandaging supply_ padded textile_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACC1","description":"ICD-KACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD141","description":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening buprenorphine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80348","description":"Drug screening buprenorphine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Islet cell antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86341","description":"Islet cell antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEF1","description":"ICD-BFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pituitary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61546","description":"Removal of pituitary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFED0","description":"ICD-GFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with invasive interface (e.g._ tracheostomy tube)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0450","description":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with invasive interface (e.g._ tracheostomy tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETE1","description":"ICD-BETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Front castr compl pneum tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0071","description":"Front castr compl pneum tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAE0","description":"ICD-MBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMA1","description":"ICD-JIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Histoplasmosis skin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86510","description":"Histoplasmosis skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAD0","description":"ICD-BEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove part of neck vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22100","description":"Remove part of neck vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1C","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr angio spine w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72159","description":"Mr angio spine w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0825","description":"Pwc gp 2 hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAF0","description":"ICD-BIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOD0","description":"ICD-DGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFND1","description":"ICD-JFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g._ ulcerative colitis_ crohn_s disease)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1182","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g._ ulcerative colitis_ crohn_s disease)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB21","description":"ICD-1LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDD0","description":"ICD-OCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXB1","description":"ICD-NIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCF0","description":"ICD-OCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC12","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXF1","description":"ICD-OAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUB0","description":"ICD-NDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFD0","description":"ICD-KGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep bk ptb plaster molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5510","description":"Prep bk ptb plaster molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinnervate larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31590","description":"Reinnervate larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA31","description":"ICD-2BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0781T","description":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWC0","description":"ICD-OBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test presump optical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0477","description":"Drug test presump optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMB0","description":"ICD-JEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immune complex assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86332","description":"Immune complex assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLC0","description":"ICD-KFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shingrix vaccine not documented as administered_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1066","description":"Shingrix vaccine not documented as administered_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5152","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","description":"HCPCS-Q5152","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUF1","description":"ICD-OBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDA1","description":"ICD-KHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Dalbavancin_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9443","description":"Injection_ Dalbavancin_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place cath subclavian art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36225","description":"Place cath subclavian art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24D","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJC1","description":"ICD-BFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual adult wc w tiltinspac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1161","description":"Manual adult wc w tiltinspac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEND1","description":"ICD-GEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0552U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","description":"CPT-0552U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFA0","description":"ICD-JFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUC1","description":"ICD-EBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ganciclovir long act implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7310","description":"Ganciclovir long act implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEC0","description":"ICD-EDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA11","description":"ICD-2AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBA0","description":"ICD-CIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of knee cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27345","description":"Removal of knee cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5D","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99350","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq & icut allg test venoms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95017","description":"Perq & icut allg test venoms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAA1","description":"ICD-NGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRE1","description":"ICD-GGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQF1","description":"ICD-GAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0554U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","description":"CPT-0554U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABA0","description":"ICD-EABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANA1","description":"ICD-CANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Declot vascular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36593","description":"Declot vascular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOF0","description":"ICD-ODOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 2.1-3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11443","description":"Exc face-mm b9+marg 2.1-3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX51","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intragastric hypothermia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0100","description":"Intragastric hypothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 20 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP20","description":"Auto test panel pricing code_ 20 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOF0","description":"ICD-KIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIF1","description":"ICD-EIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEA0","description":"ICD-MAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7520","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replantation thumb complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20824","description":"Replantation thumb complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine ost pouch w bltinconv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4429","description":"Urine ost pouch w bltinconv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBB1","description":"ICD-NJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDD0","description":"ICD-BGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX17","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKA1","description":"ICD-CAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA31","description":"ICD-1EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20B","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBF0","description":"ICD-EEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPC0","description":"ICD-JFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNE1","description":"ICD-BFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSC1","description":"ICD-PCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUC0","description":"ICD-JAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orth dev repair/repl minor p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4210","description":"Orth dev repair/repl minor p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML02","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWD0","description":"ICD-HFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCA0","description":"ICD-IDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enterectomy w/o taper cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44126","description":"Enterectomy w/o taper cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYD1","description":"ICD-CAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNA1","description":"ICD-OHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC31","description":"ICD-4HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical boot each infant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3208","description":"Surgical boot each infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid &","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4189","description":"Parenteral sol amino acid &","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O2/water vapor enrich w/o he","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1406","description":"O2/water vapor enrich w/o he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE121","description":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay ass","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX17","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay ass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOA1","description":"ICD-GHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKB1","description":"ICD-KEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHF1","description":"ICD-FGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electromagntic tx for ulcers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0329","description":"Electromagntic tx for ulcers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEB1","description":"ICD-NDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLD0","description":"ICD-IGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC21","description":"ICD-1IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYA1","description":"ICD-PBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy finger joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26110","description":"Biopsy finger joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA120","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXF1","description":"ICD-OEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIF0","description":"ICD-IAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRF0","description":"ICD-HCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRE0","description":"ICD-PCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31580","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJC0","description":"ICD-JHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ givosiran_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9056","description":"Injection_ givosiran_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vacuum drain bottle/tube kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7048","description":"Vacuum drain bottle/tube kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQB1","description":"ICD-DHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrocochleography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92584","description":"Electrocochleography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAED0","description":"ICD-NAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGF1","description":"ICD-BGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJD0","description":"ICD-GIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQD1","description":"ICD-PEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTC1","description":"ICD-NHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emergent Cases","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1142","description":"Emergent Cases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NEURO INH ATAXIA DNA 51 GENE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0217U","description":"NEURO INH ATAXIA DNA 51 GENE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Topical anesthetic_ per gram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4736","description":"Topical anesthetic_ per gram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27880","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKC0","description":"ICD-GHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFB0","description":"ICD-KAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTC1","description":"ICD-MKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYC1","description":"ICD-DEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPF0","description":"ICD-CBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBC1","description":"ICD-JDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0579U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","description":"CPT-0579U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Initial Set-Up And Patient Education On Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98975","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Initial Set-Up And Patient Education On Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Topical prep rx aoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4130F","description":"Topical prep rx aoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCD0","description":"ICD-MHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq card stent/ath/angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92934","description":"Prq card stent/ath/angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLD1","description":"ICD-FBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap radical hyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58548","description":"Lap radical hyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAD1","description":"ICD-KAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUA1","description":"ICD-NGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of natriuretic peptide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83880","description":"Assay of natriuretic peptide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a normal neurological examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9535","description":"Patients with a normal neurological examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB21","description":"ICD-1CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADC1","description":"ICD-BADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27197","description":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gamma globulin 1 cc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1460","description":"Gamma globulin 1 cc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHC1","description":"ICD-OJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of magnesium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83735","description":"Assay of magnesium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0304T","description":"Icar ischm mntrng sys device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA21","description":"ICD-1JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQD1","description":"ICD-LIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL54","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albumin ischemia modified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82045","description":"Albumin ischemia modified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocortisone sodium ph inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1710","description":"Hydrocortisone sodium ph inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWA1","description":"ICD-LGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst base mtl 2 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6612","description":"Onlay cst base mtl 2 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3d photographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0351","description":"3d photographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUF0","description":"ICD-GBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total knee arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27447","description":"Total knee arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25446","description":"Wrist replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caster fork replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2226","description":"Caster fork replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct abdomen w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74160","description":"Ct abdomen w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Humidif extens supple w ippb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0550","description":"Humidif extens supple w ippb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC32","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCE1","description":"ICD-NLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRD1","description":"ICD-CBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mandibular flange prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5934","description":"Mandibular flange prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTB1","description":"ICD-KDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGA0","description":"ICD-FAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66700","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asthma discharge plan presnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5250F","description":"Asthma discharge plan presnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of aldolase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82085","description":"Assay of aldolase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBC1","description":"ICD-NGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2204","description":"Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Breast Ductal Carcinoma In Situ)_ Protein Expression Profiling By Immunohistochemistry Of 7 Proteins (Cox2_ Foxa1_ Her2_ Ki-67_ P16_ Pr_ Siah2)_ With 4 Clinicopathol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0295U","description":"Oncology (Breast Ductal Carcinoma In Situ)_ Protein Expression Profiling By Immunohistochemistry Of 7 Proteins (Cox2_ Foxa1_ Her2_ Ki-67_ P16_ Pr_ Siah2)_ With 4 Clinicopathol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKF0","description":"ICD-OEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKE0","description":"ICD-JAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune (systemic lupus erythematosus)_ IgG and IgM analysis of 80 biomarkers_ utilizing serum_ algorithm reported with a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0062U","description":"Autoimmune (systemic lupus erythematosus)_ IgG and IgM analysis of 80 biomarkers_ utilizing serum_ algorithm reported with a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX06","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg >16<=48 in w/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6246","description":"Hydrogel drg >16<=48 in w/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14A","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Herpes simplex type 1 test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86695","description":"Herpes simplex type 1 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe wedge sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3340","description":"Shoe wedge sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of chloramphenicol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82415","description":"Assay of chloramphenicol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOE0","description":"ICD-DBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHB0","description":"ICD-BIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAD1","description":"ICD-AEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med record copy per page","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9982","description":"Med record copy per page","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMA1","description":"ICD-FCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0632U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0632U","description":"CPT-0632U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove mastoid structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69505","description":"Remove mastoid structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30420","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1345","description":"Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEC0","description":"ICD-GFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWB0","description":"ICD-GDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVF1","description":"ICD-OGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYD0","description":"ICD-OCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24147","description":"Partial removal of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVA1","description":"ICD-FFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1449","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","description":"HCPCS-M1449","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2783","description":"Crown 3/4 porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYC1","description":"ICD-PGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0861T","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITE0","description":"ICD-EITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYD1","description":"ICD-HFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENA1","description":"ICD-BENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sig w/tndsc balloon dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45340","description":"Sig w/tndsc balloon dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mycophenolic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7518","description":"Mycophenolic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHD1","description":"ICD-NLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg2 no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9064","description":"Onc dx nsclc stg2 no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement bulb th lightbox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4634","description":"Replacement bulb th lightbox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9762","description":"Patient had at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27187","description":"Reinforce hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art trnsposj subclav carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35694","description":"Art trnsposj subclav carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cptr ophth dx img post segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92134","description":"Cptr ophth dx img post segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ inebilizumab-cdon_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1823","description":"Injection_ inebilizumab-cdon_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCC1","description":"ICD-OFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWD0","description":"ICD-GAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trac stand free stand pelvic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0900","description":"Trac stand free stand pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAE0","description":"ICD-MGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSF0","description":"ICD-HCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng ace/arb b-blockertx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4480F","description":"Pt rcvng ace/arb b-blockertx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJB1","description":"ICD-FIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imaging of the head (CT or MRI) was not obtained_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1029","description":"Imaging of the head (CT or MRI) was not obtained_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC45","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAA1","description":"ICD-NBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES315","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX50","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41007","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Augmentation cheek bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21270","description":"Augmentation cheek bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALC1","description":"ICD-KALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKC1","description":"ICD-KFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNC0","description":"ICD-GHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incid ct liver/kid/adre fdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9547","description":"Incid ct liver/kid/adre fdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SurFactor or NuDyn_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4233","description":"SurFactor or NuDyn_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWB0","description":"ICD-PCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44376","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASB1","description":"ICD-CASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1202","description":"HCPCS-C1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/ th nrv exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32664","description":"Thoracoscopy w/ th nrv exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0360T","description":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA124","description":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pleurodesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32650","description":"Thoracoscopy w/pleurodesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLF0","description":"ICD-ICLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic apheresis; with extracorporeal immunoadsorption_ selective adsorption or selective filtration and plasma reinfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36516","description":"Therapeutic apheresis; with extracorporeal immunoadsorption_ selective adsorption or selective filtration and plasma reinfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQC0","description":"ICD-LDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr umbil hern block < 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49582","description":"Rpr umbil hern block < 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENC0","description":"ICD-FENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXB0","description":"ICD-NJXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic implnt urinary 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8606","description":"Synthetic implnt urinary 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 3)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1708","description":"Pfizer-BioNTech Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-2 probe&revrse trnscripj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87538","description":"Hiv-2 probe&revrse trnscripj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKB0","description":"ICD-CEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Th/wght bear quad-lat brim c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2520","description":"Th/wght bear quad-lat brim c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBE0","description":"ICD-BHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEE1","description":"ICD-IAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFC0","description":"ICD-JBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCB1","description":"ICD-GHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44020","description":"Explore small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of arm muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24330","description":"Revision of arm muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNF1","description":"ICD-JBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin copper sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83026","description":"Hemoglobin copper sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDC1","description":"ICD-AIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLF1","description":"ICD-CFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electron elbow adolescent sw","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7185","description":"Electron elbow adolescent sw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system_ including placement of an oral device_ monitoring of patient tolerance to treatment_ and remov","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0881T","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system_ including placement of an oral device_ monitoring of patient tolerance to treatment_ and remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYF1","description":"ICD-KAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 1 visit p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90956","description":"Esrd srv 1 visit p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHC1","description":"ICD-NCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50576","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0424U","description":"Oncology (prostate)_ exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKD1","description":"ICD-CIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20D","description":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27151","description":"Incision of hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Control unit bowel system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0350","description":"Control unit bowel system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEF1","description":"ICD-FIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA226","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nsclc dx unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9067","description":"Onc dx nsclc dx unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJE0","description":"ICD-JEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33019","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ercp lesion ablate w/dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43278","description":"Ercp lesion ablate w/dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5B","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0316","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYF1","description":"ICD-HDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo unilat torsion ball br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2090","description":"Hkafo unilat torsion ball br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKA1","description":"ICD-FAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXE0","description":"ICD-OLXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJE1","description":"ICD-JEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin b12 injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3420","description":"Vitamin b12 injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASC1","description":"ICD-GASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27686","description":"Revise lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syst bp lt 130 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3074F","description":"Syst bp lt 130 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13C","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB06","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYE0","description":"ICD-HBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imp/abut rem dent part max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6112","description":"Imp/abut rem dent part max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAD1","description":"ICD-OAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73060","description":"X-ray exam of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63280","description":"Bx/exc idrl spine lesn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Personalized target development for accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state fu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0889T","description":"Personalized target development for accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB141","description":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64795","description":"Biopsy of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0678","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0678","description":"HCPCS-G0678","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEID0","description":"ICD-MEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARC0","description":"ICD-HARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJC0","description":"ICD-BDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antiviral ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9245","description":"Antiviral ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOD1","description":"ICD-LFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYE0","description":"ICD-OGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVF0","description":"ICD-KBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBA1","description":"ICD-MFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of bile ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47700","description":"Exploration of bile ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNA1","description":"ICD-FFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRE0","description":"ICD-LFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJD0","description":"ICD-GGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVA0","description":"ICD-JCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPA1","description":"ICD-KCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDE1","description":"ICD-ECDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O2 flow reg pos inspir press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1352","description":"O2 flow reg pos inspir press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove mastoid air cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69670","description":"Remove mastoid air cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTE1","description":"ICD-MGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXB0","description":"ICD-BIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ do","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0078","description":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ do","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMA0","description":"ICD-IGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMA0","description":"ICD-MHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXB1","description":"ICD-NKXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ each separat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0836T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ each separat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKD1","description":"ICD-OGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for cholangiogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47532","description":"Injection for cholangiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPE0","description":"ICD-NFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echograp trans r pros study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76873","description":"Echograp trans r pros study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGE0","description":"ICD-KBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No antipla/p2y12 ord_ rs nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9611","description":"No antipla/p2y12 ord_ rs nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBA1","description":"ICD-EGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v index add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88155","description":"Cytopath c/v index add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOA1","description":"ICD-OEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Normal blood pressure reading documented_ follow-up not required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1294","description":"Normal blood pressure reading documented_ follow-up not required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEB0","description":"ICD-AEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEE1","description":"ICD-AHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEC0","description":"ICD-GEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (genitourinary pathogens)_ antibiotic-resistance gene detection_ multiplex amplified probe technique_ urine_ reported as an antimicrobial stewardship risk s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0372U","description":"Infectious disease (genitourinary pathogens)_ antibiotic-resistance gene detection_ multiplex amplified probe technique_ urine_ reported as an antimicrobial stewardship risk s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEC1","description":"ICD-OGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pros info op rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9304","description":"Pros info op rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA11","description":"ICD-3LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect forearm/wrist tum<3cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25077","description":"Resect forearm/wrist tum<3cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ibd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8758","description":"Ibd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asth not controlled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9434","description":"Asth not controlled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADA0","description":"ICD-JADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4048","description":"Cast sup sht leg splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Er and ip hosp <2 in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9521","description":"Er and ip hosp <2 in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glucagon tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80422","description":"Glucagon tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEF1","description":"ICD-FAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMD0","description":"ICD-CBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMC0","description":"ICD-MIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Children With A Competing Diagnosis For Upper Respiratory Infection Within Three Days Of Diagnosis Of Pharyngitis (E.G._ Intestinal Infection_ Pertussis_ Bacterial Infection_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2097","description":"Children With A Competing Diagnosis For Upper Respiratory Infection Within Three Days Of Diagnosis Of Pharyngitis (E.G._ Intestinal Infection_ Pertussis_ Bacterial Infection_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWA0","description":"ICD-GBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23600","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC146","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ex for nonspeech device rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92605","description":"Ex for nonspeech device rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-rays bone survey complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77075","description":"X-rays bone survey complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYC1","description":"ICD-OFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMB0","description":"ICD-ECMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNF0","description":"ICD-NJNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo total proctocolectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44212","description":"Laparo total proctocolectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0428","description":"Bls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLF1","description":"ICD-KGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUA1","description":"ICD-AGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Disease_ Bacterial Vaginosis_ Quantitative Real-Time Amplification Of Rna Markers For Atopobium Vaginae_ Gardnerella Vaginalis_ And Lactobacillus Species_ Utilizing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81513","description":"Infectious Disease_ Bacterial Vaginosis_ Quantitative Real-Time Amplification Of Rna Markers For Atopobium Vaginae_ Gardnerella Vaginalis_ And Lactobacillus Species_ Utilizing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBE1","description":"ICD-AHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00211","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","description":"CPT-00211","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom grad sleeve med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8422","description":"Custom grad sleeve med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB03","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEF1","description":"ICD-NFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPD1","description":"ICD-CGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk thigh lacer glut/ischia m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5682","description":"Bk thigh lacer glut/ischia m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECC0","description":"ICD-FECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0134A","description":"IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Static str toe dev ext/flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1831","description":"Static str toe dev ext/flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITF1","description":"ICD-FITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGF1","description":"ICD-FFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5B","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKE1","description":"ICD-JEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEC0","description":"ICD-ABEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYC0","description":"ICD-HGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sodium thiosulfate (hope)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0209","description":"Injection_ sodium thiosulfate (hope)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDF0","description":"ICD-JDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFA1","description":"ICD-FBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo ligate spermatic vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55550","description":"Laparo ligate spermatic vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18E","description":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMB0","description":"ICD-BEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLA0","description":"ICD-MHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEND0","description":"ICD-FEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUE1","description":"ICD-IFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluoride applicator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5986","description":"Fluoride applicator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Barium swallow test ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3142F","description":"Barium swallow test ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCB0","description":"ICD-CCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCB0","description":"ICD-ACCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITB1","description":"ICD-NITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERE0","description":"ICD-HERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adalimumab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80145","description":"Adalimumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTF1","description":"ICD-EHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst incl t/o complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58291","description":"Vag hyst incl t/o complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop app non-wgt bear dsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5450","description":"Postop app non-wgt bear dsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pet imaging initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0252","description":"Pet imaging initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRD1","description":"ICD-PKRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic evaluation(s)_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0243T","description":"Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic evaluation(s)_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVA0","description":"ICD-KGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANC0","description":"ICD-JANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colon ca scrn not hi rsk ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0121","description":"Colon ca scrn not hi rsk ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXC0","description":"ICD-KFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIME0","description":"ICD-EIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trim nail(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0127","description":"Trim nail(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aud rehab postling hear loss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92633","description":"Aud rehab postling hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"GE GNOTYP GYPC EXONS 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0188U","description":"GE GNOTYP GYPC EXONS 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJA0","description":"ICD-CEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD156","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27894","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC225","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anticoagulant management for a patient taking warfarin_ must include review and interpretation of a new home_ office_ or lab international normalized ratio (INR) test result_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93793","description":"Anticoagulant management for a patient taking warfarin_ must include review and interpretation of a new home_ office_ or lab international normalized ratio (INR) test result_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 81 Years Of Age And Older With A Evidence Of Frailty During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2118","description":"Patients 81 Years Of Age And Older With A Evidence Of Frailty During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARB1","description":"ICD-PARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic analysis of vestibular implant_ unilateral; with subsequent programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0729T","description":"Diagnostic analysis of vestibular implant_ unilateral; with subsequent programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8A","description":"High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAD1","description":"ICD-ICAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUF0","description":"ICD-OGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40500","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXB1","description":"ICD-NBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES230","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMF1","description":"ICD-AHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEE0","description":"ICD-IGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAA0","description":"ICD-BEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAD0","description":"ICD-FDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1301","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1301","description":"CDT-D1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI abdomen w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74183","description":"MRI abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39503","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHA0","description":"ICD-GCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0076","description":"Prolotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTB0","description":"ICD-JBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDA0","description":"ICD-GIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCA0","description":"ICD-ODCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKB1","description":"ICD-CCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATD0","description":"ICD-AATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVB1","description":"ICD-OLVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGD0","description":"ICD-OEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightweight det a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1090","description":"Wheelchair lightweight det a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEC0","description":"ICD-AFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVD1","description":"ICD-JGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood_ l/r_ cmv-neg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9051","description":"Blood_ l/r_ cmv-neg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEB0","description":"ICD-BIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAC0","description":"ICD-MAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHME1","description":"ICD-NHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metered dose inhaler drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3535","description":"Metered dose inhaler drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFF0","description":"ICD-BAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUF0","description":"ICD-NGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIF0","description":"ICD-OFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Melphalan oral 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8600","description":"Melphalan oral 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDB0","description":"ICD-GFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22C","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt queried symp resp insuff","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1503F","description":"Pt queried symp resp insuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part hand little/ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6010","description":"Part hand little/ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOA0","description":"ICD-GFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIA0","description":"ICD-FCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQB0","description":"ICD-OIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQF1","description":"ICD-CAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88365","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJC1","description":"ICD-FCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETA0","description":"ICD-OETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28306","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOF0","description":"ICD-KDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUA0","description":"ICD-CHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARD0","description":"ICD-OARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCE1","description":"ICD-ABCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IN GNOTYP CD44 EXONS 2 3 6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0191U","description":"IN GNOTYP CD44 EXONS 2 3 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD104","description":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPA1","description":"ICD-JIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJB1","description":"ICD-GAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMD0","description":"ICD-NBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAF1","description":"ICD-JIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEB0","description":"ICD-JHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES204","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of glucagon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82943","description":"Assay of glucagon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQA0","description":"ICD-HEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colorectal cancer screening results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1277","description":"Colorectal cancer screening results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14A","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray of lower spine disk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72295","description":"X-ray of lower spine disk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCC0","description":"ICD-KCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Approp diuretic tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4190F","description":"Approp diuretic tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise mandible lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21040","description":"Excise mandible lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc abd tum over 10 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49205","description":"Exc abd tum over 10 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXB0","description":"ICD-KBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Splint wrist or ankle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8451","description":"Splint wrist or ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEA1","description":"ICD-NAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy contrl bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32654","description":"Thoracoscopy contrl bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAB1","description":"ICD-OKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAB1","description":"ICD-JCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIB1","description":"ICD-NJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIB0","description":"ICD-JCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ischial bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27060","description":"Removal of ischial bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBC1","description":"ICD-BFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWD1","description":"ICD-GIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDB1","description":"ICD-OCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTC0","description":"ICD-OCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mrs disc pain alg alys data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0611T","description":"Mrs disc pain alg alys data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDF1","description":"ICD-KEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval npgs apnea 1 ses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0435T","description":"Prgrmg eval npgs apnea 1 ses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0668","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","description":"HCPCS-G0668","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26455","description":"Incision of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD235","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYC0","description":"ICD-HBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHC0","description":"ICD-NDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drill skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61108","description":"Drill skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10006","description":"Fine needle aspiration biopsy_ including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIF0","description":"ICD-JAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRC0","description":"ICD-PHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNF0","description":"ICD-FCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lateral thoracic extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1210","description":"Lateral thoracic extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply spine prosth device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22851","description":"Apply spine prosth device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rsect hip tum incl femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27078","description":"Rsect hip tum incl femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mh clubhouse svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2030","description":"Mh clubhouse svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFD0","description":"ICD-CIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRC1","description":"ICD-PKRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3290","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3290","description":"HCPCS-J3290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1024","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Melan follow-up complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015F","description":"Melan follow-up complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11C","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng arm splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4020","description":"Cast sup lng arm splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00848","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","description":"CPT-00848","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap gastr bypass incl smll i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43645","description":"Lap gastr bypass incl smll i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient not screened for future fall risk_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1070","description":"Patient not screened for future fall risk_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Managem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0703T","description":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Managem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0583U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","description":"CPT-0583U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYE0","description":"ICD-OLYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMB1","description":"ICD-JBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFE0","description":"ICD-CDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYB1","description":"ICD-GAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC131","description":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluoro exam of g/colon tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49465","description":"Fluoro exam of g/colon tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mattress foam rubber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0272","description":"Mattress foam rubber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLB0","description":"ICD-OBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of non-biodegradable drug delivery implants_ 4 or more (services for subdermal rod implant)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0516","description":"Insertion of non-biodegradable drug delivery implants_ 4 or more (services for subdermal rod implant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90451","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIC1","description":"ICD-MJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open red comp malar/zygma fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7750","description":"Open red comp malar/zygma fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUE0","description":"ICD-FGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0601","description":"HCPCS-A0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGE1","description":"ICD-KHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUC1","description":"ICD-JAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof_ or 1% of body surface area of infants and childre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0479T","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof_ or 1% of body surface area of infants and childre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHA0","description":"ICD-KIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIE1","description":"ICD-GBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEF0","description":"ICD-AEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGID1","description":"ICD-EGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ plazomicin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9039","description":"Injection_ plazomicin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27511","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1A","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD241","description":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth blood vessel repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77051","description":"Anesth blood vessel repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYD1","description":"ICD-OEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFF1","description":"ICD-FAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA25","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSF1","description":"ICD-GFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strep a dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87651","description":"Strep a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDA1","description":"ICD-FGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUF0","description":"ICD-BEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEE0","description":"ICD-BEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64600","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64654","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","description":"CPT-64654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOD1","description":"ICD-DEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWB0","description":"ICD-OIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18B","description":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLD1","description":"ICD-BGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOC1","description":"ICD-GAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXD1","description":"ICD-OFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSC1","description":"ICD-LGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSD0","description":"ICD-DCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBA1","description":"ICD-IDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clearance of airways","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31725","description":"Clearance of airways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient does not have a caregiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2184","description":"Patient does not have a caregiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANF0","description":"ICD-OANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroscopy (separate procedure)_ up to 1 hour physician or other qualified health care professional time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76000","description":"Fluoroscopy (separate procedure)_ up to 1 hour physician or other qualified health care professional time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCA1","description":"ICD-AHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATD1","description":"ICD-GATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXC0","description":"ICD-BHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam filled propulsion tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2216","description":"Foam filled propulsion tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCD0","description":"ICD-KBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ntrk3 (Neurotrophic Receptor Tyrosine Kinase 3) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81193","description":"Ntrk3 (Neurotrophic Receptor Tyrosine Kinase 3) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nivolumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9299","description":"Injection_ nivolumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVD0","description":"ICD-CEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMD1","description":"ICD-CCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCF0","description":"ICD-MDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Masters two step","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3904","description":"Masters two step","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHC1","description":"ICD-JAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBF0","description":"ICD-IIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ corticotropin (ANI)_ up to 40 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0802","description":"Injection_ corticotropin (ANI)_ up to 40 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHC1","description":"ICD-JBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKC1","description":"ICD-GGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEE1","description":"ICD-BDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQE1","description":"ICD-CBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal t1-3_n1-2noprg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9092","description":"Onc dx rectal t1-3_n1-2noprg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADA0","description":"ICD-NADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antipsychotics nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80343","description":"Antipsychotics nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMD1","description":"ICD-GFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJD0","description":"ICD-KAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multi-axial ankle/ft prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5979","description":"Multi-axial ankle/ft prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECC0","description":"ICD-GECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTE0","description":"ICD-IFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exemestane_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0156","description":"Exemestane_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB125","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood chloride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82435","description":"Assay of blood chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvas vasc dx study proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93998","description":"Noninvas vasc dx study proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73110","description":"X-ray exam of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJB0","description":"ICD-GIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQD0","description":"ICD-LAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHB1","description":"ICD-EGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWE1","description":"ICD-LCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lap enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83670","description":"Assay of lap enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPE1","description":"ICD-KDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXD1","description":"ICD-KHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home infusion each addtl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99602","description":"Home infusion each addtl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1434","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","description":"HCPCS-M1434","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gi nuclear procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78299","description":"Gi nuclear procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMF0","description":"ICD-EHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSE1","description":"ICD-PLSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50953","description":"Endoscopy of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation vad in person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93750","description":"Interrogation vad in person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOB0","description":"ICD-KCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJB1","description":"ICD-FHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACD1","description":"ICD-OACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXC0","description":"ICD-GDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0690U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690U","description":"CPT-0690U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTC0","description":"ICD-OFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCF1","description":"ICD-KBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPF1","description":"ICD-OFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of pregnanediol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84135","description":"Assay of pregnanediol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIF0","description":"ICD-CAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruct premalg lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17000","description":"Destruct premalg lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEID1","description":"ICD-OEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCD0","description":"ICD-FHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJC1","description":"ICD-OHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0188T","description":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEC1","description":"ICD-GCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0145","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGF1","description":"ICD-KGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB11","description":"ICD-1AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWE1","description":"ICD-GIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLF0","description":"ICD-CHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval opioid use instr/pt int","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9584","description":"Eval opioid use instr/pt int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15A","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETC1","description":"ICD-FETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFF0","description":"ICD-OKFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27230","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote dx retinal imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92227","description":"Remote dx retinal imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 11-20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99442","description":"Phone e/m phys/qhp 11-20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJA1","description":"ICD-NIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA205","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIA1","description":"ICD-GFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXE0","description":"ICD-KCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Hymovis_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9471","description":"Hyaluronan or derivative_ Hymovis_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maxillary sinusotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7560","description":"Maxillary sinusotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTB1","description":"ICD-EBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCA1","description":"ICD-KCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crutch underarm each no wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0116","description":"Crutch underarm each no wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deb skin bone at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11012","description":"Deb skin bone at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of cheek nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64734","description":"Incision of cheek nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42415","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGID0","description":"ICD-CGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWF0","description":"ICD-OHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHE0","description":"ICD-CAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01732","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","description":"CPT-01732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB21","description":"ICD-3LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suprv interfacilty transport","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99485","description":"Suprv interfacilty transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWC0","description":"ICD-HCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver imaging with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78202","description":"Liver imaging with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2168","description":"Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEA1","description":"ICD-JHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIF0","description":"ICD-JDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients With Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2151","description":"Patients With Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","description":"HCPCS-J9038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA244","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57220","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBF0","description":"ICD-OGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTA0","description":"ICD-NHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8E","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRD1","description":"ICD-LHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAC0","description":"ICD-IHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECC1","description":"ICD-GECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACF1","description":"ICD-JACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6700","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","description":"HCPCS-L6700","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSB1","description":"ICD-GBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVD1","description":"ICD-JDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHC1","description":"ICD-IHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1901","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1901","description":"CDT-D1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ONC NONSM CLL LNG CA ALYS 23","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0179U","description":"ONC NONSM CLL LNG CA ALYS 23","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB05","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDA1","description":"ICD-CEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant total heart system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051T","description":"Implant total heart system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSC1","description":"ICD-CBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB204","description":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped crit care age 2-5 subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99476","description":"Ped crit care age 2-5 subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBC1","description":"ICD-OFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag ctr rigi pos pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0643","description":"Lso sag ctr rigi pos pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA11","description":"ICD-4EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infratemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61591","description":"Infratemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc shoulder les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23075","description":"Exc shoulder les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAD1","description":"ICD-NBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23B","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ant resin-based cmpst crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2390","description":"Ant resin-based cmpst crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNC1","description":"ICD-NFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC235","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJA1","description":"ICD-GDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No off assis eol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9382","description":"No off assis eol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSA0","description":"ICD-LHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMD0","description":"ICD-MFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAB0","description":"ICD-KGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYE0","description":"ICD-CFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGC0","description":"ICD-GHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assess dyspnea not present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1018F","description":"Assess dyspnea not present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMA0","description":"ICD-JBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24D","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74249","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASB1","description":"ICD-DASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKB1","description":"ICD-BGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEE0","description":"ICD-FBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANC0","description":"ICD-NANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMD1","description":"ICD-MEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWA0","description":"ICD-KIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0108","description":"Stroke with Motor <26.15 & Age >84.5_ without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYC1","description":"ICD-LGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft axill/fem/fem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35533","description":"Art byp grft axill/fem/fem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLA1","description":"ICD-BHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDC1","description":"ICD-GCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNB1","description":"ICD-BDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJD1","description":"ICD-GEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJD0","description":"ICD-KGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPD0","description":"ICD-NCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHF0","description":"ICD-CEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA52","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGA1","description":"ICD-OKGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFD0","description":"ICD-JDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINB1","description":"ICD-GINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWD1","description":"ICD-OGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Erwinaze injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9019","description":"Erwinaze injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect foot/toe tumor 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28047","description":"Resect foot/toe tumor 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAB1","description":"ICD-MKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcath closure of asd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93580","description":"Transcath closure of asd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUB1","description":"ICD-OFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dispensing fee binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5160","description":"Dispensing fee binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"On Date Of Encounter_ Patient Is Not Able To Participate In Assessment Or Screening_ Including Non-Verbal Patients_ Delirious_ Severely Aphasic_ Severely Developmentally Delay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0037","description":"On Date Of Encounter_ Patient Is Not Able To Participate In Assessment Or Screening_ Including Non-Verbal Patients_ Delirious_ Severely Aphasic_ Severely Developmentally Delay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage ext line_ dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4672","description":"Drainage ext line_ dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRC1","description":"ICD-OFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of finger abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26010","description":"Drainage of finger abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLE1","description":"ICD-KBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWA0","description":"ICD-KDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21088","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPF0","description":"ICD-CEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Redo endovas vena cava filtr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37192","description":"Redo endovas vena cava filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone/skin graft iliac crest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20970","description":"Bone/skin graft iliac crest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67299","description":"Eye surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ granisetron extended release_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9486","description":"Injection_ granisetron extended release_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKE1","description":"ICD-BAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stenger test speech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92577","description":"Stenger test speech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOF0","description":"ICD-HDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBD1","description":"ICD-FBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCA0","description":"ICD-JBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFF1","description":"ICD-KHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHA0","description":"ICD-FDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Chlamydia trachomatis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87810","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Chlamydia trachomatis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special stains group 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88312","description":"Special stains group 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWA0","description":"ICD-LCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA44","description":"Very High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gauze > 48 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6221","description":"Gauze > 48 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABF0","description":"ICD-BABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQD1","description":"ICD-CHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCC0","description":"ICD-FDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUB0","description":"ICD-JHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB160","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQC0","description":"ICD-CIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA245","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMD0","description":"ICD-CEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped hospital bed semi/elect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0329","description":"Ped hospital bed semi/elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIID0","description":"ICD-MIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mh health assess by non-md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0031","description":"Mh health assess by non-md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transport chair_ ped size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1037","description":"Transport chair_ ped size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6783","description":"Crown 3/4 porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6752","description":"Crown porcelain noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70210","description":"X-ray exam of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mcp joint repl 2 pc or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8631","description":"Mcp joint repl 2 pc or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOC0","description":"ICD-LFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWF0","description":"ICD-CAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65125","description":"Revise ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBE1","description":"ICD-JIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDD1","description":"ICD-NDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24A","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOB1","description":"ICD-DCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPA0","description":"ICD-CDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disease activity not assessed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1006","description":"Disease activity not assessed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECA0","description":"ICD-JECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELB0","description":"ICD-MELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITB0","description":"ICD-OITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0018","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort iii w/o lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21154","description":"Lefort iii w/o lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ heparin sodium (pfizer)_ not therapeutically equivalent to j1644_ per 1000 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1643","description":"Injection_ heparin sodium (pfizer)_ not therapeutically equivalent to j1644_ per 1000 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA34","description":"Default_ /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Max MRI image capture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0385","description":"Max MRI image capture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIB0","description":"ICD-NLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCF1","description":"ICD-OLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLC1","description":"ICD-KFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL17","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWE0","description":"ICD-PLWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWB0","description":"ICD-HEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCD1","description":"ICD-FCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABA0","description":"ICD-JABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAD1","description":"ICD-AIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep corneal endo allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65757","description":"Prep corneal endo allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACC1","description":"ICD-FACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87638","description":"CPT-87638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI orbit/face/neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70540","description":"MRI orbit/face/neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine osmolality","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83935","description":"Assay of urine osmolality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVD0","description":"ICD-BCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERA1","description":"ICD-LERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEE1","description":"ICD-ACEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBE0","description":"ICD-OGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22830","description":"Exploration of spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skn sub grft f/n/hf/g child","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15277","description":"Skn sub grft f/n/hf/g child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9766","description":"Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63251","description":"Anesth removal of nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flowcytometry/ tc 1 marker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88184","description":"Flowcytometry/ tc 1 marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prior history of known cvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1256","description":"Prior history of known cvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspiration orbital contents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67415","description":"Aspiration orbital contents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Out-of-hosp on call service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99027","description":"Out-of-hosp on call service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPA1","description":"ICD-FDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENF1","description":"ICD-JENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext pwrd shlder lock/unlock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6648","description":"Ext pwrd shlder lock/unlock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKA0","description":"ICD-JBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27756","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGF0","description":"ICD-KFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr wc drivewheel gear repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2369","description":"Pwr wc drivewheel gear repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDA0","description":"ICD-GHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMF1","description":"ICD-GCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing brief counseling (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2201","description":"Documentation of medical reason(s) for not providing brief counseling (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCD1","description":"ICD-ICCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel-bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44660","description":"Repair bowel-bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMF1","description":"ICD-JGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIE0","description":"ICD-EIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWF0","description":"ICD-KFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIF0","description":"ICD-ICIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ankle control ortho pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4350","description":"Ankle control ortho pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8E","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKD1","description":"ICD-JCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFC0","description":"ICD-CDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLC0","description":"ICD-NCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEC1","description":"ICD-AHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic seal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0456T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic seal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0426","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0426","description":"CDT-D0426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMC0","description":"ICD-CDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99412","description":"Preventive counseling group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCA0","description":"ICD-FFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone 20 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1020","description":"Methylprednisolone 20 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","description":"CPT-01472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Budesonide non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7633","description":"Budesonide non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCC1","description":"ICD-ACCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUF1","description":"ICD-GGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHD0","description":"ICD-OHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caster wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2225","description":"Caster wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHF1","description":"ICD-IAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Restore/remodel ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33548","description":"Restore/remodel ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47480","description":"Incision of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOD1","description":"ICD-HHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOC0","description":"ICD-ODOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNB1","description":"ICD-OJNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC34","description":"Very High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A5103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5103","description":"HCPCS-A5103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE150","description":"Clinically Complex _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL45","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00670","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","description":"CPT-00670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQD1","description":"ICD-OHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWE0","description":"ICD-PCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLB0","description":"ICD-KHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKE0","description":"ICD-KIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myelography thoracic spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72255","description":"Myelography thoracic spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUA0","description":"ICD-NHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deb musc/fascia add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11046","description":"Deb musc/fascia add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12B","description":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXE0","description":"ICD-NHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHE1","description":"ICD-IDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst hgh nbl mtl 2 srfc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6610","description":"Onlay cst hgh nbl mtl 2 srfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Copy number (EG_ intellectual disability_ dysmorphology)_ sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0156U","description":"Copy number (EG_ intellectual disability_ dysmorphology)_ sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA31","description":"ICD-4CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removable unilateral partial denture - one piece cast metal_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5282","description":"Removable unilateral partial denture - one piece cast metal_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC255","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFD1","description":"ICD-FBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko w adj flex/ext rotat mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1846","description":"Ko w adj flex/ext rotat mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of jaw 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70110","description":"X-ray exam of jaw 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDD0","description":"ICD-EDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth iridectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14751","description":"Anesth iridectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac drug stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93024","description":"Cardiac drug stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18B","description":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADB0","description":"ICD-MADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDB0","description":"ICD-MGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYD1","description":"ICD-HIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQD1","description":"ICD-PBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct neck spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72127","description":"Ct neck spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fmr1 gene detection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81243","description":"Fmr1 gene detection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAME1","description":"ICD-CAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHD0","description":"ICD-NEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA40","description":"Ultra High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQE1","description":"ICD-CDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEE0","description":"ICD-AAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB250","description":"Reduced Physical Function _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUF0","description":"ICD-CAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTA0","description":"ICD-BGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQE1","description":"ICD-PDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXD0","description":"ICD-JIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEF0","description":"ICD-MFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht inj antiemetic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9370","description":"Ht inj antiemetic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise thigh muscles/tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27400","description":"Revise thigh muscles/tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compounded drug_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7999","description":"Compounded drug_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement (including removal of existing device)_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69730","description":"Replacement (including removal of existing device)_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1109T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1109T","description":"CPT-1109T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESC0","description":"ICD-HESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA10","description":"Default_ /5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUC1","description":"ICD-GGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Varus/valgus strap padded/li","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2270","description":"Varus/valgus strap padded/li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUB1","description":"ICD-FIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWC0","description":"ICD-KCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEC1","description":"ICD-CIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj trimetrexate glucoronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3305","description":"Inj trimetrexate glucoronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cycler dialysis machine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1594","description":"Cycler dialysis machine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFA0","description":"ICD-KGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMD0","description":"ICD-GIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin substitute_ synthetic_ resorbable_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1849","description":"Skin substitute_ synthetic_ resorbable_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI and WAIS)_ with qualified health","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96102","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI and WAIS)_ with qualified health","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILC0","description":"ICD-FILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ durvalumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9173","description":"Injection_ durvalumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKF0","description":"ICD-CBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOE1","description":"ICD-LAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGC0","description":"ICD-BHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE156","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient lift hydraulic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0630","description":"Patient lift hydraulic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc foot/toe tum sc 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28039","description":"Exc foot/toe tum sc 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIC0","description":"ICD-CDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst exten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11771","description":"Remove pilonidal cyst exten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQE0","description":"ICD-HEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGA0","description":"ICD-CEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIA0","description":"ICD-FGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVE0","description":"ICD-NIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric febrile illness (Kawasaki disease [KD])_ interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1)_ RNA_ using reverse transc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0389U","description":"Pediatric febrile illness (Kawasaki disease [KD])_ interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1)_ RNA_ using reverse transc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDB1","description":"ICD-MCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUB0","description":"ICD-IGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJD1","description":"ICD-KCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXA0","description":"ICD-OIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDF1","description":"ICD-GFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASA1","description":"ICD-PASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISF1","description":"ICD-CISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25500","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/4.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2205","description":"Lens sphcy bifocal 4.00d/4.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of reason(s) sentinel lymph node biopsy not performed (e.g._ reasons could include but not limited to; non-invasive cancer_ incidental discovery of breast cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8880","description":"Documentation of reason(s) sentinel lymph node biopsy not performed (e.g._ reasons could include but not limited to; non-invasive cancer_ incidental discovery of breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAD1","description":"ICD-BAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mecp2 gene known variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81303","description":"Mecp2 gene known variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASE0","description":"ICD-KASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Above elbow myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6955","description":"Above elbow myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose and 0.45% saline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5010","description":"5% dextrose and 0.45% saline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEB0","description":"ICD-NHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKC1","description":"ICD-JDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAF1","description":"ICD-CIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjust max prost appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5992","description":"Adjust max prost appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cellesta_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4184","description":"Cellesta_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0647U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0647U","description":"CPT-0647U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chronic pain management and treatment_ monthly bundle including_ diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3002","description":"Chronic pain management and treatment_ monthly bundle including_ diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI for tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77022","description":"MRI for tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAC0","description":"ICD-ECAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ (AuroMedics)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9071","description":"Injection_ cyclophosphamide_ (AuroMedics)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interprof phone/online 21-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99448","description":"Interprof phone/online 21-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYF1","description":"ICD-OKYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFF0","description":"ICD-JFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cnslng chldbrng women epi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4340F","description":"Cnslng chldbrng women epi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWF1","description":"ICD-HFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUD0","description":"ICD-MIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28H","description":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ hips_ bilateral_ minimum of two views of each hip_ including anteroposterior view of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73520","description":"Radiologic examination_ hips_ bilateral_ minimum of two views of each hip_ including anteroposterior view of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETD0","description":"ICD-FETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58578","description":"Laparo proc uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBC1","description":"ICD-KDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolong e&m/psyctx serv o/p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99354","description":"Prolong e&m/psyctx serv o/p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJE1","description":"ICD-FAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert vad artery access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33990","description":"Insert vad artery access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEA0","description":"ICD-IDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEA0","description":"ICD-OJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8A","description":"Medium Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputate upper arm & implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24931","description":"Amputate upper arm & implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEA0","description":"ICD-NCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meperidine/promethazine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2180","description":"Meperidine/promethazine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0503U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","description":"CPT-0503U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWB0","description":"ICD-KEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC11","description":"ICD-2LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYF1","description":"ICD-GCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33956","description":"Ecmo/ecls insj ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIF1","description":"ICD-FFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj ceftazidime per 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0713","description":"Inj ceftazidime per 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRF0","description":"ICD-PHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA105","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQD0","description":"ICD-CGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspergillus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86606","description":"Aspergillus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGA0","description":"ICD-GFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEF1","description":"ICD-IIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periph field stimul revise","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0284T","description":"Periph field stimul revise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo unilat torsion cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2080","description":"Hkafo unilat torsion cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA240","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWD1","description":"ICD-OEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMB1","description":"ICD-EGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of hip bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27147","description":"Revision of hip bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33966","description":"Ecmo/ecls rmvl prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO elbow_ wrist or hand intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9737","description":"Patient unable to complete the FOTO elbow_ wrist or hand intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arm supp att to wc rancho ty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2627","description":"Arm supp att to wc rancho ty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maint drug infus cath per wk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4221","description":"Maint drug infus cath per wk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1102T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1102T","description":"CPT-1102T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUF1","description":"ICD-KHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHA0","description":"ICD-CCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYE1","description":"ICD-PAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65815","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYA0","description":"ICD-DIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDB0","description":"ICD-OKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caspofungin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0637","description":"Caspofungin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAC1","description":"ICD-MEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47539","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ex for nonspeech dev rx add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92618","description":"Ex for nonspeech dev rx add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Synvisc or synvisc-one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7325","description":"Synvisc or synvisc-one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56810","description":"Repair of perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHE1","description":"ICD-JIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA31","description":"ICD-3HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50900","description":"Repair of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX16","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart chambers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33670","description":"Repair of heart chambers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIB0","description":"ICD-IFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPE0","description":"ICD-NIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; first vein treated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36473","description":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; first vein treated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCC0","description":"ICD-OHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hpv low-risk types","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87623","description":"Hpv low-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAF1","description":"ICD-KDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIID1","description":"ICD-MIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOF1","description":"ICD-CGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of gastrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82941","description":"Assay of gastrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0402","description":"HCPCS-C0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCA0","description":"ICD-KFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMB0","description":"ICD-OLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGA1","description":"ICD-JGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0C","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23540","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE146","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELC1","description":"ICD-OELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHE0","description":"ICD-ODHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLB1","description":"ICD-JBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27792","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWF0","description":"ICD-LFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tonguemuscle_ controlled by hardware remote","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0490","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tonguemuscle_ controlled by hardware remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1096","description":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture belly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35122","description":"Repair artery rupture belly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score shdl >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8663","description":"Fun stat score shdl >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGA0","description":"ICD-FHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45100","description":"Biopsy of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCB1","description":"ICD-OFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair brain fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62100","description":"Repair brain fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFB0","description":"ICD-CBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWC1","description":"ICD-HBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFC0","description":"ICD-FCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRB0","description":"ICD-CGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01484","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","description":"CPT-01484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44385","description":"Endoscopy of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had encephalitis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1162","description":"Patient had encephalitis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine hydrochloride_ 20 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2371","description":"Injection_ phenylephrine hydrochloride_ 20 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral hygiene instruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1330","description":"Oral hygiene instruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDE0","description":"ICD-ADDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tetanus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86774","description":"Tetanus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28I","description":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYA0","description":"ICD-OJYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIE1","description":"ICD-EIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJF1","description":"ICD-KFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJD1","description":"ICD-BBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALF1","description":"ICD-OALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnio Wound_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4181","description":"Amnio Wound_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBC0","description":"ICD-GCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81286","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0903","description":"HCPCS-B0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"B-amyloid (Abeta42) and phospho tau (181P) (pTau181)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0445U","description":"B-amyloid (Abeta42) and phospho tau (181P) (pTau181)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59850","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARF0","description":"ICD-HARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAC0","description":"ICD-CFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWE1","description":"ICD-HEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse esophagus & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43340","description":"Fuse esophagus & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARA1","description":"ICD-OARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed hvy dty xtra wide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0303","description":"Hosp bed hvy dty xtra wide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer reservoir bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7009","description":"Nebulizer reservoir bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dextroamphetamine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0160","description":"Dextroamphetamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRF1","description":"ICD-PCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15B","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71030","description":"Chest x-ray 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTD0","description":"ICD-MJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28B","description":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBA0","description":"ICD-JIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Above elbow prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6500","description":"Above elbow prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reusable pull-on any size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4536","description":"Reusable pull-on any size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cholangiography_ percutaneous_ transhepatic_ radiological supervisionand interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74320","description":"Cholangiography_ percutaneous_ transhepatic_ radiological supervisionand interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB31","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient was not admitted to the ICU in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9854","description":"Patient was not admitted to the ICU in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFE1","description":"ICD-GIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect thigh/knee tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27329","description":"Resect thigh/knee tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80330","description":"Analgesics non-opioid 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPB1","description":"ICD-KIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove contraceptive capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11976","description":"Remove contraceptive capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no offer eol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9381","description":"Doc med reas no offer eol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPD1","description":"ICD-FCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1097T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1097T","description":"CPT-1097T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cpk in blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82552","description":"Assay of cpk in blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEB1","description":"ICD-JIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0552","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","description":"HCPCS-G0552","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12C","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht muscle image planar sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78453","description":"Ht muscle image planar sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB145","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9310","description":"Injection_ rituximab_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELC1","description":"ICD-CELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"F emb trns canc case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4018","description":"F emb trns canc case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap close enterostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44227","description":"Lap close enterostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tenoglide tendon prot_ cm2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9356","description":"Tenoglide tendon prot_ cm2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92083","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCE1","description":"ICD-NFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"New episode for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1127F","description":"New episode for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elevated or hypertensive blood pressure reading documented_ indicated follow-up not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1279","description":"Elevated or hypertensive blood pressure reading documented_ indicated follow-up not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Footrest complete assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0045","description":"Footrest complete assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUA0","description":"ICD-BHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2039","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","description":"HCPCS-A2039","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXA1","description":"ICD-KAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert pessary/other device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57160","description":"Insert pessary/other device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWF1","description":"ICD-PCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILF0","description":"ICD-CILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc expectant management pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9053","description":"Onc expectant management pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation tx delivery imrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6015","description":"Radiation tx delivery imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visual ep acuity screen auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0333T","description":"Visual ep acuity screen auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILE1","description":"ICD-FILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMA0","description":"ICD-ACMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYD1","description":"ICD-OBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB30","description":"Ultra High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Norsn for gc chl syp test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9230","description":"Norsn for gc chl syp test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monitor_ Cardiac_ Including Intracardiac Lead And All System Components (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1833","description":"Monitor_ Cardiac_ Including Intracardiac Lead And All System Components (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intestine transplnt cadaver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44135","description":"Intestine transplnt cadaver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDC0","description":"ICD-AGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L8721","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8721","description":"HCPCS-L8721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMF1","description":"ICD-CGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA31","description":"ICD-2HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVE0","description":"ICD-NFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11A","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recement supp part denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6093","description":"Recement supp part denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLA0","description":"ICD-ICLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; first 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92622","description":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; first 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99285","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNA0","description":"ICD-FGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28C","description":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILA1","description":"ICD-IILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01850","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","description":"CPT-01850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPC0","description":"ICD-FAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCC0","description":"ICD-CGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIC0","description":"ICD-MDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prostate ca screening; dre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0102","description":"Prostate ca screening; dre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide (sandoz)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9074","description":"Injection_ cyclophosphamide (sandoz)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDE1","description":"ICD-EFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGA0","description":"ICD-JCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHE1","description":"ICD-CCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSA1","description":"ICD-DHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXA1","description":"ICD-NBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECE0","description":"ICD-IECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair standard detach a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1140","description":"Wheelchair standard detach a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVB1","description":"ICD-NBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biovance tri-layer or biovance 3l_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4283","description":"Biovance tri-layer or biovance 3l_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at 12 months as demonstrated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1019","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at 12 months as demonstrated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFE1","description":"ICD-JCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25675","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTC1","description":"ICD-BDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIB0","description":"ICD-EBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSD0","description":"ICD-HCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCED0","description":"ICD-CCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSE1","description":"ICD-PHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Protein analysis w/probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88372","description":"Protein analysis w/probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med abortion inc all ex drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0199","description":"Med abortion inc all ex drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQD0","description":"ICD-KCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE221","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8G","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAE0","description":"ICD-KHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23B","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g._ patient with adverse effect_ alle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9781","description":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g._ patient with adverse effect_ alle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDD1","description":"ICD-KCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWC0","description":"ICD-LCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBD1","description":"ICD-KFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILF0","description":"ICD-FILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLC0","description":"ICD-EGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; initial device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0449T","description":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; initial device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Toxoplasma antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86778","description":"Toxoplasma antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXA1","description":"ICD-OCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSF0","description":"ICD-OCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEE1","description":"ICD-JAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCB1","description":"ICD-BBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFA0","description":"ICD-CFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1B","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWF0","description":"ICD-PHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65860","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKD1","description":"ICD-KHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDB0","description":"ICD-BDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFE1","description":"ICD-GEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA104","description":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQC0","description":"ICD-GEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/ leg re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1190","description":"Wheelchair amputee w/ leg re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNF1","description":"ICD-KGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a certified peer sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0140","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a certified peer sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQF1","description":"ICD-KFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVB0","description":"ICD-OFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUE0","description":"ICD-ECUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETC0","description":"ICD-BETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCB0","description":"ICD-NDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRA0","description":"ICD-PJRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18A","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC21","description":"ICD-3JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHF0","description":"ICD-IDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tisagenlecleucel_ up to 600 million car-positive viable t-cells_ including leukopheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2042","description":"Tisagenlecleucel_ up to 600 million car-positive viable t-cells_ including leukopheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE244","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB14","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUD0","description":"ICD-MAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bicarbonate conc sol per gal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4706","description":"Bicarbonate conc sol per gal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKC1","description":"ICD-JFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOF1","description":"ICD-OIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAA0","description":"ICD-ECAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0069","description":"Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPD0","description":"ICD-CFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUC1","description":"ICD-IHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44364","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPA1","description":"ICD-OHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone diacetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3302","description":"Triamcinolone diacetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLC1","description":"ICD-FBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhs/hospice of lpn ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0300","description":"Hhs/hospice of lpn ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous islet celltrans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0341","description":"Percutaneous islet celltrans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy lesion ablate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43229","description":"Esophagoscopy lesion ablate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLC1","description":"ICD-IBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRF1","description":"ICD-GHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostoma valve w diaphra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7501","description":"Tracheostoma valve w diaphra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFC1","description":"ICD-FCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOA0","description":"ICD-CCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC31","description":"ICD-1EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNF1","description":"ICD-BDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB240","description":"Special Care High _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photodynamic tx addl 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96571","description":"Photodynamic tx addl 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81239","description":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJD0","description":"ICD-JHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLB1","description":"ICD-EGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACC0","description":"ICD-MACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Propranolol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1800","description":"Propranolol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTC1","description":"ICD-EFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWD0","description":"ICD-DGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQE1","description":"ICD-LCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine screen for bacteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81007","description":"Urine screen for bacteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin fluid swg & stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5728","description":"Knee-shin fluid swg & stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-anns_ biosimilar_ (kanjinti)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5117","description":"Injection_ trastuzumab-anns_ biosimilar_ (kanjinti)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOF1","description":"ICD-OHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKD1","description":"ICD-OIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whlchr special size/constrc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1220","description":"Whlchr special size/constrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1315","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAC1","description":"ICD-IHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29843","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFC1","description":"ICD-JIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPE0","description":"ICD-BBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ carboxydextran-coated superparamagnetic iron oxide_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9697","description":"Injection_ carboxydextran-coated superparamagnetic iron oxide_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUC0","description":"ICD-IFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune rheumatoid arthr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81490","description":"Autoimmune rheumatoid arthr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61570","description":"Remove foreign body brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76979","description":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4A","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCF0","description":"ICD-FCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAB1","description":"ICD-BEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAD1","description":"ICD-FHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFD1","description":"ICD-OAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasm)_ optical genome mapping for copy number alterations_ aneuploidy_ and balanced/complex structural rearrangements_ DNA from blood or bone marr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0413U","description":"Oncology (hematolymphoid neoplasm)_ optical genome mapping for copy number alterations_ aneuploidy_ and balanced/complex structural rearrangements_ DNA from blood or bone marr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCD0","description":"ICD-CFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEA1","description":"ICD-JCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parathyroid planar imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78070","description":"Parathyroid planar imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJE0","description":"ICD-NCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELD1","description":"ICD-EELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCF1","description":"ICD-GGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYD0","description":"ICD-KDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKF0","description":"ICD-CCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAE1","description":"ICD-OCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair lumbar hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49540","description":"Repair lumbar hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ready gradient sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8424","description":"Ready gradient sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML60","description":"Medium Rehab plus Extensive_ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4B","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt instr nrml activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4245F","description":"Pt instr nrml activities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93650","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYD0","description":"ICD-HAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBF1","description":"ICD-ABBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair fem hernia blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49557","description":"Rerepair fem hernia blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEA0","description":"ICD-EGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADC0","description":"ICD-OADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient  compression glove_ custom_ heavy weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6580","description":"Gradient  compression glove_ custom_ heavy weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDD0","description":"ICD-KCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syphilis test non-trep quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86593","description":"Syphilis test non-trep quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTA0","description":"ICD-FBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRE0","description":"ICD-KBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYA0","description":"ICD-LAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDD1","description":"ICD-NEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGID0","description":"ICD-NGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18C","description":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0010","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0134U","description":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEB1","description":"ICD-JGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ sacral_ with integrated neurostimulator_ including imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0786T","description":"Insertion or replacement of percutaneous electrode array_ sacral_ with integrated neurostimulator_ including imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1087T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1087T","description":"CPT-1087T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1823","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","description":"HCPCS-E1823","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA113","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLF0","description":"ICD-AGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","description":"HCPCS-E1032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEA0","description":"ICD-NAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA17","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit anti-hemophil diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9345","description":"Hit anti-hemophil diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEC1","description":"ICD-NIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMD0","description":"ICD-NLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB206","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling_ peritoneal washings_ peritoneal biopsy(ies)_ omentectomy_ and diaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38573","description":"Laparoscopy_ surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling_ peritoneal washings_ peritoneal biopsy(ies)_ omentectomy_ and diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAE1","description":"ICD-MGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIF0","description":"ICD-IGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADF0","description":"ICD-BADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxytetracycline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2460","description":"Oxytetracycline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95144","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mst rcnt hbb < 10g/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8973","description":"Mst rcnt hbb < 10g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Filtered speech hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92571","description":"Filtered speech hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUD1","description":"ICD-IEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBA1","description":"ICD-FHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTE0","description":"ICD-BBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional_ 30 m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99452","description":"Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional_ 30 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLB0","description":"ICD-BCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCA1","description":"ICD-AGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct guide for tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77013","description":"Ct guide for tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22116","description":"Remove extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDB0","description":"ICD-FCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGA1","description":"ICD-GHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag-co shell pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0651","description":"Lso sag-co shell pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHB1","description":"ICD-BAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGE0","description":"ICD-KCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19271","description":"Revision of chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTB1","description":"ICD-CFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUE0","description":"ICD-KEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDA1","description":"ICD-NLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUA1","description":"ICD-NLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHD0","description":"ICD-JBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53230","description":"Removal of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAD1","description":"ICD-KFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64821","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSD0","description":"ICD-LHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl electrode for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0609","description":"Repl electrode for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCA0","description":"ICD-NJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPF0","description":"ICD-GAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99377","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient died prior to the end of the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1060","description":"Patient died prior to the end of the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCME1","description":"ICD-MCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDD0","description":"ICD-NKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Admin ecg contrast agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93352","description":"Admin ecg contrast agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE217","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJE1","description":"ICD-CIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFA0","description":"ICD-FAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADC0","description":"ICD-CADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp animat ret imag series","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0380T","description":"Comp animat ret imag series","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Patient Education/Training And Device Calibration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99473","description":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Patient Education/Training And Device Calibration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPA0","description":"ICD-OBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay porcelin 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2642","description":"Dental onlay porcelin 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0964T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","description":"CPT-0964T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures mand part resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5212","description":"Dentures mand part resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0C","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx bipol_ death_ nhres_ hosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9394","description":"Dx bipol_ death_ nhres_ hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEA0","description":"ICD-CBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prenatal flow sheet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0501F","description":"Prenatal flow sheet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ acute myelogenous leukemia_ DNA analysis_ 194 genes_ interrogation for sequence variants_ copy number variants or rearrangements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0050U","description":"Targeted genomic sequence analysis panel_ acute myelogenous leukemia_ DNA analysis_ 194 genes_ interrogation for sequence variants_ copy number variants or rearrangements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt in the home per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9131","description":"Pt in the home per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01960","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","description":"CPT-01960","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASC0","description":"ICD-PASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13A","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHA1","description":"ICD-BHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPA1","description":"ICD-OJPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGA1","description":"ICD-KHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKF1","description":"ICD-NLKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77407","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACB1","description":"ICD-OACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27435","description":"Incision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKE0","description":"ICD-GEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIB1","description":"ICD-BEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIC1","description":"ICD-FGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOF1","description":"ICD-PDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESB0","description":"ICD-HESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUA0","description":"ICD-EBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15221","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVA1","description":"ICD-NGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB32","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correct metacarpal flaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26565","description":"Correct metacarpal flaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQD0","description":"ICD-PGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQA1","description":"ICD-OAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJB0","description":"ICD-NLJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDB0","description":"ICD-NIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEC0","description":"ICD-BHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95713","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTE1","description":"ICD-JHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBF1","description":"ICD-EBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bed board","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0273","description":"Bed board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla class ii semiquant panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86835","description":"Hla class ii semiquant panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBC1","description":"ICD-EBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAF0","description":"ICD-MJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99349","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1015","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81163","description":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC211","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIC0","description":"ICD-KCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88028","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9069","description":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFC1","description":"ICD-BAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEF1","description":"ICD-IHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTC0","description":"ICD-MCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBF1","description":"ICD-MDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDE1","description":"ICD-EIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2104","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAD1","description":"ICD-OJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABA0","description":"ICD-BABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUE1","description":"ICD-JGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITA1","description":"ICD-JITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elder maltreatment screen documented as positive_ follow-up plan not documented_ documentation the patient is not eligible for follow-up plan at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8941","description":"Elder maltreatment screen documented as positive_ follow-up plan not documented_ documentation the patient is not eligible for follow-up plan at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0A","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAB0","description":"ICD-AFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPD0","description":"ICD-NDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add pwr leg elevation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1010","description":"Add pwr leg elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0061","description":"Anesthesiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJD1","description":"ICD-NDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQF1","description":"ICD-CIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBD1","description":"ICD-NBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEB0","description":"ICD-OGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELD0","description":"ICD-MELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB21","description":"ICD-3CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBB0","description":"ICD-MFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHB1","description":"ICD-EBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAE1","description":"ICD-FDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGE1","description":"ICD-OAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAC1","description":"ICD-IDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUF0","description":"ICD-ODUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYA0","description":"ICD-PAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Large disposable underpad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4541","description":"Large disposable underpad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQB0","description":"ICD-OCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01830","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","description":"CPT-01830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAF1","description":"ICD-GHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetaminophen injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0131","description":"Acetaminophen injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay porc 4/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2644","description":"Dental onlay porc 4/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKA1","description":"ICD-CIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLD1","description":"ICD-FDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12D","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Routine venipuncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36415","description":"Routine venipuncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The MDPP b eneficiary achieved at least 9% weight loss (WL) from his/he r baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9881","description":"The MDPP b eneficiary achieved at least 9% weight loss (WL) from his/he r baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC43","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of citrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82507","description":"Assay of citrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esw wound healing init wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0299T","description":"Esw wound healing init wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj iv push","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96374","description":"Ther/proph/diag inj iv push","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPE0","description":"ICD-NCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2409","description":"Fetal surg noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Matristem micromatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4118","description":"Matristem micromatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNB0","description":"ICD-BDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Image cath fluid colxn visc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49405","description":"Image cath fluid colxn visc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRF1","description":"ICD-HHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-123 sod iodide mic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9516","description":"Iodine i-123 sod iodide mic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8B","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATF0","description":"ICD-AATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Belt_ strap_ sleeve_ garment_ or covering_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4467","description":"Belt_ strap_ sleeve_ garment_ or covering_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture aerobic identify","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87077","description":"Culture aerobic identify","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIB0","description":"ICD-GBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block stellate ganglion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64510","description":"N block stellate ganglion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWB1","description":"ICD-PHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECA0","description":"ICD-AECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEC0","description":"ICD-IAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay blood catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82383","description":"Assay blood catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXD1","description":"ICD-KBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Truss addition to std pad wa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8320","description":"Truss addition to std pad wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD215","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1302","description":"Screening_ diagnostic_ film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEC0","description":"ICD-IDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKE0","description":"ICD-OJKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPA1","description":"ICD-OAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIF1","description":"ICD-CAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12C","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiopulmonary exercise testing_ including measurements of minute ventilation_ CO2 production_ O2 uptake_ and electrocardiographic recordings","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94621","description":"Cardiopulmonary exercise testing_ including measurements of minute ventilation_ CO2 production_ O2 uptake_ and electrocardiographic recordings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50715","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVF1","description":"ICD-NGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE145","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6057","description":"Custom abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHB0","description":"ICD-ICHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microbe susceptible disk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87184","description":"Microbe susceptible disk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit enteral grav diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9341","description":"Hit enteral grav diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFA1","description":"ICD-CIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIC0","description":"ICD-AEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGE1","description":"ICD-JHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHND0","description":"ICD-NHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUF0","description":"ICD-ECUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWD0","description":"ICD-CDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Novafix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4208","description":"Novafix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1442","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","description":"HCPCS-M1442","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47538","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGME1","description":"ICD-CGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay toxin or antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87230","description":"Assay toxin or antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received bone marrow transplant any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1157","description":"Patient received bone marrow transplant any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct bone density axial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77078","description":"Ct bone density axial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIF0","description":"ICD-BBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJE1","description":"ICD-GFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surveillance colonoscopy - personal history of colonic polyps_ colon cancer_ or other malignant neoplasm of rectum_ rectosigmoid junction_ and anus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9936","description":"Surveillance colonoscopy - personal history of colonic polyps_ colon cancer_ or other malignant neoplasm of rectum_ rectosigmoid junction_ and anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRD0","description":"ICD-OFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rx corneoscleral cntact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92317","description":"Rx corneoscleral cntact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUC0","description":"ICD-BFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ho bi thighcuffs w sprdr bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1652","description":"Ho bi thighcuffs w sprdr bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEF0","description":"ICD-IAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of aluminum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82108","description":"Assay of aluminum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add to spinal orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0999","description":"Add to spinal orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove skin tags add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11201","description":"Remove skin tags add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1009T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","description":"CPT-1009T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99215","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alanine amino (alt) (sgpt)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84460","description":"Alanine amino (alt) (sgpt)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEE0","description":"ICD-BAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monitoring feature/devicenoc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9279","description":"Monitoring feature/devicenoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALD1","description":"ICD-OALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIB1","description":"ICD-AEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRA0","description":"ICD-GIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ targeted genomic sequence analysis panel of 361 genes_ interrogation for gene fusions_ translocations_ or other rearrangements_ using DNA fro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0444U","description":"Oncology (solid organ neoplasia)_ targeted genomic sequence analysis panel of 361 genes_ interrogation for gene fusions_ translocations_ or other rearrangements_ using DNA fro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDF1","description":"ICD-GDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFB0","description":"ICD-OIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lipoprotein_ direct measurement; small dense LDL cholesterol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83722","description":"Lipoprotein_ direct measurement; small dense LDL cholesterol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYB1","description":"ICD-DDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74425","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUA1","description":"ICD-MHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cnslng provided symp mngmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4350F","description":"Cnslng provided symp mngmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFA1","description":"ICD-KDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRD0","description":"ICD-HGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aortic circulation assist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33970","description":"Aortic circulation assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLID1","description":"ICD-OLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB224","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67801","description":"Remove eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBC0","description":"ICD-NLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx ovarian recurrence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9116","description":"Onc dx ovarian recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMA1","description":"ICD-NEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acupunct w/o stimul addl 15m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97811","description":"Acupunct w/o stimul addl 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGC0","description":"ICD-BCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMF1","description":"ICD-FGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intro/sheath_fixed_peel-away","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1892","description":"Intro/sheath_fixed_peel-away","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUD0","description":"ICD-CBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meg evoked single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95966","description":"Meg evoked single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57400","description":"Dilation of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHF1","description":"ICD-MLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDE1","description":"ICD-NLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEB0","description":"ICD-GHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHC1","description":"ICD-BHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Oral And/Or Oropharyngeal Cancer)_ Gene Expression Profiling By Rna Sequencing At Least 20 Molecular Features (Eg_ Human And/Or Microbial Mrna)_ Saliva_ Algorithm Re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0296U","description":"Oncology (Oral And/Or Oropharyngeal Cancer)_ Gene Expression Profiling By Rna Sequencing At Least 20 Molecular Features (Eg_ Human And/Or Microbial Mrna)_ Saliva_ Algorithm Re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHA1","description":"ICD-ECHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abscess drainage under x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75989","description":"Abscess drainage under x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9817","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9817","description":"HCPCS-C9817","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PSYC GEN ALYS PANEL 15 GENES","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0175U","description":"PSYC GEN ALYS PANEL 15 GENES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCD0","description":"ICD-KFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lrh hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83727","description":"Assay of lrh hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Beta-2 glycoprotein antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86146","description":"Beta-2 glycoprotein antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJD0","description":"ICD-GHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBC0","description":"ICD-MFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVD1","description":"ICD-CDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEC0","description":"ICD-FCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERC1","description":"ICD-GERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Centerbased day care perdiem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5105","description":"Centerbased day care perdiem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAD0","description":"ICD-ECAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMC1","description":"ICD-EDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBF0","description":"ICD-EIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUC1","description":"ICD-KIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40251","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKD1","description":"ICD-NHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAD0","description":"ICD-GCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLD0","description":"ICD-FDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSE1","description":"ICD-OLSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAD0","description":"ICD-FAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anes mediascpy & dx thorscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52851","description":"Anes mediascpy & dx thorscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-META1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"META1","description":"ICD-META1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14B","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enteral feeding supply kit; elastomeric control fed_ per day_ includes but not limited to feeding/flushing syringe_ administration set tubing_ dressings_ tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4148","description":"Enteral feeding supply kit; elastomeric control fed_ per day_ includes but not limited to feeding/flushing syringe_ administration set tubing_ dressings_ tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL14","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interfyl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4171","description":"Interfyl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aud rehab pre-ling hear loss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92630","description":"Aud rehab pre-ling hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJF0","description":"ICD-FEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpt implant pros dev_no cov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9899","description":"Inpt implant pros dev_no cov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Homecare train pt session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5109","description":"Homecare train pt session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pain assessment not documented as being performed_ documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8442","description":"Pain assessment not documented as being performed_ documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fix partial denture section","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9120","description":"Fix partial denture section","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICA0","description":"ICD-IICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTE0","description":"ICD-GHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9487","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68811","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYA1","description":"ICD-OHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methylergonovin maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2210","description":"Methylergonovin maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCC0","description":"ICD-FFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRB0","description":"ICD-HHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3C","description":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel new rubber standar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3460","description":"Shoe heel new rubber standar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis repeated eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90937","description":"Hemodialysis repeated eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nutrition/Dietician Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4017","description":"Nutrition/Dietician Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBC0","description":"ICD-BDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30124","description":"Removal of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCE1","description":"ICD-JFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trans shoe solid stirrup new","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3630","description":"Trans shoe solid stirrup new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACE0","description":"ICD-GACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC31","description":"ICD-3BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDE0","description":"ICD-GHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCB1","description":"ICD-IFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMF0","description":"ICD-JDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cell function assay w/stim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86352","description":"Cell function assay w/stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBD0","description":"ICD-IHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOF0","description":"ICD-PJOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUB1","description":"ICD-KGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPB0","description":"ICD-BHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0805","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0805","description":"CDT-D0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTA0","description":"ICD-MGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tl201 thallium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9505","description":"Tl201 thallium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct interprete man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0365","description":"Cone beam ct interprete man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quick disconn hook adapter o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6628","description":"Quick disconn hook adapter o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63052","description":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYB0","description":"ICD-LBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAB1","description":"ICD-GIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27724","description":"Repair/graft of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Max ultrasound capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0370","description":"Max ultrasound capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp <5 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99143","description":"Mod sedat phys/qhp <5 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose/water","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7060","description":"5% dextrose/water","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJC0","description":"ICD-FEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj sulf hexa lipid microsph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9950","description":"Inj sulf hexa lipid microsph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJB0","description":"ICD-CDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC52","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1102","description":"HCPCS-B1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Specimen infect agnt concntj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87015","description":"Specimen infect agnt concntj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVA0","description":"ICD-FIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCC1","description":"ICD-CCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlmyd/gonrh tsts docd done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3511F","description":"Chlmyd/gonrh tsts docd done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGD1","description":"ICD-GIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHB1","description":"ICD-MGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOA1","description":"ICD-PCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab-nuna_ biosimilar_ (Byooviz)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5124","description":"Injection_ ranibizumab-nuna_ biosimilar_ (Byooviz)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin a1c level is missing_ or was not performed during the measurement period (12 months)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1212","description":"Hemoglobin a1c level is missing_ or was not performed during the measurement period (12 months)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt talk eval hlthwkr re mdd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2060F","description":"Pt talk eval hlthwkr re mdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NPM1 (nucleophosmin) (eg_ acute myeloid leukemia) gene analysis_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0049U","description":"NPM1 (nucleophosmin) (eg_ acute myeloid leukemia) gene analysis_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHD0","description":"ICD-AGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NuDYN SL or NuDYN SLW_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4286","description":"NuDYN SL or NuDYN SLW_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27240","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKA1","description":"ICD-BEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther fx nasal inf turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30930","description":"Ther fx nasal inf turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLB1","description":"ICD-BCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice in hospice facility","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5006","description":"Hospice in hospice facility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBF0","description":"ICD-MBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIC1","description":"ICD-FAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOC0","description":"ICD-KCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adhesiolysis tube ovary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58740","description":"Adhesiolysis tube ovary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0389T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBD1","description":"ICD-GEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee orthosis (KO)_ single upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1851","description":"Knee orthosis (KO)_ single upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair solid seat insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0992","description":"Wheelchair solid seat insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHD1","description":"ICD-CBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation stating the patient has received or is currently receiving palliative or hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1307","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDD0","description":"ICD-NBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFB1","description":"ICD-CIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2C","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUD0","description":"ICD-FGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIC1","description":"ICD-NLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC111","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYE1","description":"ICD-GEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D8091","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D8091","description":"CDT-D8091","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGD1","description":"ICD-OLGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAED1","description":"ICD-MAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67120","description":"Remove eye implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHD0","description":"ICD-FHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQF1","description":"ICD-LBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hc pro phone call 5-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98966","description":"Hc pro phone call 5-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01922","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","description":"CPT-01922","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBC1","description":"ICD-OBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUA0","description":"ICD-JHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69644","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXD0","description":"ICD-CDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stoma cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5055","description":"Stoma cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optimal care for patients with episodic neurological conditions mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0003","description":"Optimal care for patients with episodic neurological conditions mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone graft peri each addl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3429","description":"Bone graft peri each addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain to peritoneal cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49062","description":"Drain to peritoneal cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQC0","description":"ICD-CAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCE0","description":"ICD-OLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attendant care service /15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5125","description":"Attendant care service /15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPF0","description":"ICD-OHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50551","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Term dev auto grasp feature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6881","description":"Term dev auto grasp feature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone_ Normal Or Abnormal Native","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93595","description":"Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone_ Normal Or Abnormal Native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC120","description":"Special Care High _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC220","description":"Special Care High _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNE0","description":"ICD-JGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test socket hemipelvectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5628","description":"Test socket hemipelvectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33236","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00548","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","description":"CPT-00548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVA0","description":"ICD-CHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWE0","description":"ICD-PFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGA1","description":"ICD-GDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knuckle joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26518","description":"Fusion of knuckle joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24B","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open ablate liver tumor rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47380","description":"Open ablate liver tumor rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGD0","description":"ICD-KHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITA1","description":"ICD-MITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Protamine sulfate per 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4802","description":"Protamine sulfate per 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDID1","description":"ICD-EDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair upper jaw fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30580","description":"Repair upper jaw fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNE0","description":"ICD-CCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Multiple Trajectories For","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61737","description":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Multiple Trajectories For","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove & graft wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25136","description":"Remove & graft wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC31","description":"ICD-1LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBF1","description":"ICD-EHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rectal marker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46030","description":"Removal of rectal marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainable pch ex wear convex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4390","description":"Drainable pch ex wear convex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2172","description":"All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ edaravone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1301","description":"Injection_ edaravone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-fixed paraffin embedded tissue or fresh frozen tissue_ predictive algorithm reported as potential ta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019U","description":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-fixed paraffin embedded tissue or fresh frozen tissue_ predictive algorithm reported as potential ta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial valve init insert","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31647","description":"Bronchial valve init insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83721","description":"Assay of blood lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAME1","description":"ICD-OAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep ak ischial plast molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5560","description":"Prep ak ischial plast molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99254","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacy comp/disp serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9430","description":"Pharmacy comp/disp serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEED1","description":"ICD-NEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2001","description":"HCPCS-B2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0201","description":"HCPCS-A0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special supplies phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99070","description":"Special supplies phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Prescribed Or Currently Being T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2092","description":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Prescribed Or Currently Being T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICE0","description":"ICD-FICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVE0","description":"ICD-FDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cros hearing aid dispens fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5200","description":"Cros hearing aid dispens fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crutch forearm pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0110","description":"Crutch forearm pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine SCmethyltransferase) (eg drug metabolism) gene analysis common variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0169U","description":"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine SCmethyltransferase) (eg drug metabolism) gene analysis common variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB31","description":"ICD-3HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult size pull-on xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4528","description":"Adult size pull-on xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9153","description":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDE0","description":"ICD-FFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prevocational services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6107","description":"Prevocational services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIE1","description":"ICD-NEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGB0","description":"ICD-FDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonpectin based ostomy paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4405","description":"Nonpectin based ostomy paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGC0","description":"ICD-JGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic implant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8699","description":"Prosthetic implant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMB1","description":"ICD-ODMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXB0","description":"ICD-KHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIB0","description":"ICD-AHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","description":"HCPCS-M1407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWA1","description":"ICD-KEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECC1","description":"ICD-CECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 3 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3388F","description":"Ajcc cln cncr stage 3 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply multlay comprs upr arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29583","description":"Apply multlay comprs upr arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB154","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFA0","description":"ICD-GHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWE0","description":"ICD-PKWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyoid myotomy & suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21685","description":"Hyoid myotomy & suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurorraphy w/vein autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64911","description":"Neurorraphy w/vein autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ruptured spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38115","description":"Repair of ruptured spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1A","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE120","description":"Reduced Physical Function _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 hd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0843","description":"Pwc gp2 hd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDE1","description":"ICD-IGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76825","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOD0","description":"ICD-ODOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC31","description":"ICD-2KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDC1","description":"ICD-BCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOC0","description":"ICD-GCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAF1","description":"ICD-FCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA20","description":"Very High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grp psych partial hosp 45-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0410","description":"Grp psych partial hosp 45-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limb exercise test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95875","description":"Limb exercise test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNA1","description":"ICD-GBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB34","description":"High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML40","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHD0","description":"ICD-OFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12B","description":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65210","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIA1","description":"ICD-EEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bath conductivity meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1550","description":"Bath conductivity meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCC0","description":"ICD-NJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITB0","description":"ICD-MITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise diaphragm nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64746","description":"Incise diaphragm nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDC0","description":"ICD-MIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gallium Ga-68 gozetotide_ diagnostic_ (Illuccix)_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9596","description":"Gallium Ga-68 gozetotide_ diagnostic_ (Illuccix)_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSC1","description":"ICD-OLSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUF1","description":"ICD-KIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOE1","description":"ICD-LBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSD0","description":"ICD-CFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGF0","description":"ICD-CHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Warfarin respon genetic test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9143","description":"Warfarin respon genetic test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUA1","description":"ICD-OFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUF1","description":"ICD-BFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect hip/pelv tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27049","description":"Resect hip/pelv tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFD1","description":"ICD-KBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8F","description":"Medium Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKF0","description":"ICD-KHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPA0","description":"ICD-CCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGD1","description":"ICD-JFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Program intake assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1023","description":"Program intake assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays adrenals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75733","description":"Artery x-rays adrenals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFB0","description":"ICD-NFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXF1","description":"ICD-CCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXA1","description":"ICD-NLXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUC1","description":"ICD-IBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0635U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0635U","description":"CPT-0635U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEC1","description":"ICD-BHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photochemotherapy with uv-a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96912","description":"Photochemotherapy with uv-a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5165","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5165","description":"HCPCS-Q5165","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefoperazone sod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0021","description":"Injection_ cefoperazone sod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24505","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ C1 esterase inhibitor (human)_ Haegarda_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9015","description":"Injection_ C1 esterase inhibitor (human)_ Haegarda_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDD0","description":"ICD-ABDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc neg elder mal no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8734","description":"Doc neg elder mal no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Triptorelin pamoate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3315","description":"Triptorelin pamoate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVD1","description":"ICD-NFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNF0","description":"ICD-CDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occult blood other sources","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82271","description":"Occult blood other sources","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert/place heart catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93503","description":"Insert/place heart catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFD0","description":"ICD-OLFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNF0","description":"ICD-JCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE131","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC43","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHE0","description":"ICD-JEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open wedge/bx lung infiltr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32096","description":"Open wedge/bx lung infiltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antipsychotic rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4065F","description":"Antipsychotic rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFD0","description":"ICD-OHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ abdominal aorta_ real time with image documentation_ screening study for abdominal aortic aneurysm (AAA)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76706","description":"Ultrasound_ abdominal aorta_ real time with image documentation_ screening study for abdominal aortic aneurysm (AAA)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of epiglottis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31420","description":"Removal of epiglottis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAE1","description":"ICD-EBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQC1","description":"ICD-OCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWC0","description":"ICD-CFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligate esophagus veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43400","description":"Ligate esophagus veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pms2 gene full seq analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81317","description":"Pms2 gene full seq analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Uvl md cabinet sys 6 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0694","description":"Uvl md cabinet sys 6 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBB1","description":"ICD-MKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGD1","description":"ICD-CIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL43","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28H","description":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWD1","description":"ICD-PBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEC0","description":"ICD-MJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJD1","description":"ICD-OIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEE0","description":"ICD-JAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84234","description":"Assay of progesterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAD1","description":"ICD-EFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLC0","description":"ICD-CHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSC0","description":"ICD-PDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67915","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKD0","description":"ICD-GEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQD1","description":"ICD-OLQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJE1","description":"ICD-NAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMA1","description":"ICD-OAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis c rna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87520","description":"Hepatitis c rna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOE1","description":"ICD-OIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of midfoot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28800","description":"Amputation of midfoot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m medronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9503","description":"Tc99m medronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alpha 1 proteinase inhibitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0256","description":"Alpha 1 proteinase inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sheath below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8400","description":"Sheath below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute resp synd coronavirus 2 (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preserv free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula formula_ for intramus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91305","description":"Severe acute resp synd coronavirus 2 (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preserv free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula formula_ for intramus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient alive as of the last day of the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9787","description":"Patient alive as of the last day of the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28735","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAC1","description":"ICD-MHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDE1","description":"ICD-FGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rec cortico>60d or 1rx 600mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9469","description":"Rec cortico>60d or 1rx 600mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUA0","description":"ICD-OHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLF0","description":"ICD-IFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c seat lift mechanism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0985","description":"W/c seat lift mechanism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem odontogen cyst > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7451","description":"Rem odontogen cyst > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMF1","description":"ICD-FAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fmr1 gene characterization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81244","description":"Fmr1 gene characterization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture interm cmplt mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5811","description":"Denture interm cmplt mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1102","description":"HCPCS-A1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMC1","description":"ICD-NBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUC1","description":"ICD-EHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlordiazepoxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1990","description":"Chlordiazepoxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral occlusal film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0240","description":"Intraoral occlusal film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iop down >15% of pre-svc lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3284F","description":"Iop down >15% of pre-svc lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure ureter/bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50930","description":"Closure ureter/bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sp bone agrft morsel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20937","description":"Sp bone agrft morsel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of larynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31512","description":"Removal of larynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNB0","description":"ICD-OJNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSD0","description":"ICD-OHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Professional services for the administration of antiinfective_ pain management_ chelation_ pulmonary hypertension_ and/or inotr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0068","description":"Professional services for the administration of antiinfective_ pain management_ chelation_ pulmonary hypertension_ and/or inotr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCF0","description":"ICD-AGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPF0","description":"ICD-NDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49322","description":"Laparoscopy aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin beta_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9972","description":"Epoetin beta_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lo sag rig pnl stays pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0626","description":"Lo sag rig pnl stays pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLA0","description":"ICD-OCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corneal tissue processing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2785","description":"Corneal tissue processing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALE0","description":"ICD-EALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEA1","description":"ICD-IFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGID0","description":"ICD-MGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMC0","description":"ICD-IAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elb mold sock flex hinge pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6100","description":"Elb mold sock flex hinge pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22515","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELD0","description":"ICD-JELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUF1","description":"ICD-NGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc abd les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22903","description":"Exc abd les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Salicylate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80179","description":"Salicylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESB0","description":"ICD-CESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1011","description":"Family assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology Care Model (OCM) Monthly Enhanced Oncology Oncology Services (MEOS) payment for enhanced care management services for OCM beneficiaries.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9678","description":"Oncology Care Model (OCM) Monthly Enhanced Oncology Oncology Services (MEOS) payment for enhanced care management services for OCM beneficiaries.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXB1","description":"ICD-OEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVF1","description":"ICD-OJVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAD1","description":"ICD-GAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9899","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syphilis test_ non-treponemal antibody_ immunoassay_ qualitative (RPR)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0065U","description":"Syphilis test_ non-treponemal antibody_ immunoassay_ qualitative (RPR)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVA0","description":"ICD-KCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6013","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYA1","description":"ICD-KFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4394","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","description":"HCPCS-Q4394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92945","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","description":"CPT-92945","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xray endovasc thor ao repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75956","description":"Xray endovasc thor ao repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95165","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCD0","description":"ICD-OHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMC1","description":"ICD-CAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ed svc ckd ind per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0420","description":"Ed svc ckd ind per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKB0","description":"ICD-BCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFC1","description":"ICD-KCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prefab post/core + crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2954","description":"Prefab post/core + crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual reticulocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85044","description":"Manual reticulocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photochemotherapy uv-a or b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96913","description":"Photochemotherapy uv-a or b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAD0","description":"ICD-EDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No f/u eval q3mo opiod tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9563","description":"No f/u eval q3mo opiod tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWD0","description":"ICD-GGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18C","description":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUF0","description":"ICD-IDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUD1","description":"ICD-CHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m depreotide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9536","description":"Tc99m depreotide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIB0","description":"ICD-AFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFE1","description":"ICD-JHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVF1","description":"ICD-FEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUE0","description":"ICD-JGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8902","description":"Mra w/o fol w/cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSF0","description":"ICD-DHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDB1","description":"ICD-FIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUA0","description":"ICD-KIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0553U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","description":"CPT-0553U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHME0","description":"ICD-MHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLE0","description":"ICD-MKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCC0","description":"ICD-OCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEF0","description":"ICD-ACEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGA0","description":"ICD-CHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE131","description":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPA0","description":"ICD-GDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPF1","description":"ICD-OCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"K flow/funct image w/drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78708","description":"K flow/funct image w/drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epidrm a-grft f/n/hf/g addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15116","description":"Epidrm a-grft f/n/hf/g addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo doub solid stirrup calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1990","description":"Afo doub solid stirrup calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANF1","description":"ICD-CANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47490","description":"Incision of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clsd red simp malar/zygom fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7660","description":"Clsd red simp malar/zygom fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth sperm duct surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92251","description":"Anesth sperm duct surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor stent ather s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9602","description":"Perc d-e cor stent ather s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic(s) training_ upper and/or lower extremity(ies)_ initial prosthetic(s) encounter_ each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97761","description":"Prosthetic(s) training_ upper and/or lower extremity(ies)_ initial prosthetic(s) encounter_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part hand myo exclu term dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6026","description":"Part hand myo exclu term dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNA0","description":"ICD-JFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJD0","description":"ICD-OCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81426","description":"Genome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8B","description":"High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL14","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAF1","description":"ICD-EIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFC1","description":"ICD-NBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE125","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCD1","description":"ICD-KGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQB1","description":"ICD-PHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECD0","description":"ICD-NECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sialodochoplasty","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7982","description":"Sialodochoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOB1","description":"ICD-CFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGD0","description":"ICD-OHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRE1","description":"ICD-GFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMB0","description":"ICD-BAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSA0","description":"ICD-OJSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal non-stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59025","description":"Fetal non-stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulp vitality test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0460","description":"Pulp vitality test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBF0","description":"ICD-GCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTD1","description":"ICD-JHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJF1","description":"ICD-OEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35182","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGA1","description":"ICD-CBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQC1","description":"ICD-PDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67906","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKD1","description":"ICD-NCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAA1","description":"ICD-IFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEB1","description":"ICD-GGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACC1","description":"ICD-JACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIB1","description":"ICD-CEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0404","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0404","description":"CDT-D0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion/graft of hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26844","description":"Fusion/graft of hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of hypotony","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1326","description":"Patients with a diagnosis of hypotony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERC0","description":"ICD-GERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGF1","description":"ICD-BEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHE0","description":"ICD-JBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGB0","description":"ICD-KAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKF1","description":"ICD-KFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD154","description":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pin radioulnar dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25671","description":"Pin radioulnar dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repeat thyroid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60260","description":"Repeat thyroid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow mold outsid lock hinge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6200","description":"Elbow mold outsid lock hinge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJF0","description":"ICD-GGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13B","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin seal protect moisturizr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6250","description":"Skin seal protect moisturizr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPA1","description":"ICD-GEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAED1","description":"ICD-CAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95723","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLA0","description":"ICD-NGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34705","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMB0","description":"ICD-BDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPC1","description":"ICD-ODPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28H","description":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAID0","description":"ICD-IAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERC1","description":"ICD-LERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15A","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVD0","description":"ICD-FBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4540","description":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEF1","description":"ICD-MBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQA0","description":"ICD-KFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJB0","description":"ICD-GAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNE0","description":"ICD-JDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repeat drainage of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33011","description":"Repeat drainage of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC46","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNC0","description":"ICD-KBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAA0","description":"ICD-NBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGC1","description":"ICD-NCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCA1","description":"ICD-CDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTE0","description":"ICD-OJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJC1","description":"ICD-CAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23C","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of imperforated anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46742","description":"Repair of imperforated anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA221","description":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv3 vacc no prsv 3 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90656","description":"Iiv3 vacc no prsv 3 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJF0","description":"ICD-NBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNE0","description":"ICD-NKNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLF0","description":"ICD-AFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Betamethasone acet&sod phosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0702","description":"Betamethasone acet&sod phosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFE0","description":"ICD-OGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression gauntlet_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6565","description":"Gradient compression gauntlet_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42507","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJED1","description":"ICD-OJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAE0","description":"ICD-IDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXE1","description":"ICD-BGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98012","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","description":"CPT-98012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37275","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","description":"CPT-37275","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECF1","description":"ICD-CECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETE0","description":"ICD-FETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC116","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMF0","description":"ICD-JEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVE0","description":"ICD-GBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unspecified diagnostic proce","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0999","description":"Unspecified diagnostic proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQB1","description":"ICD-LDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixation of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27860","description":"Fixation of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNF1","description":"ICD-OCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOE1","description":"ICD-GBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDA0","description":"ICD-OBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPA1","description":"ICD-FCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5168","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5168","description":"HCPCS-Q5168","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEC0","description":"ICD-MHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1002","description":"Custom item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reset dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21485","description":"Reset dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA34","description":"Low Rehab_ ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ankle bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28130","description":"Removal of ankle bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSD1","description":"ICD-PKSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIC0","description":"ICD-BFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ apolipoprotein A4 (ApoA4)_ CD5 antigen-like (CD5L)_ and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0385U","description":"Nephrology (chronic kidney disease)_ apolipoprotein A4 (ApoA4)_ CD5 antigen-like (CD5L)_ and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of System Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Unable To Locate Previous Colonoscopy Report_ Previous Colonoscopy Rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9999","description":"Documentation Of System Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Unable To Locate Previous Colonoscopy Report_ Previous Colonoscopy Rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKB1","description":"ICD-BCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IV Injection_ bebtelovimab_ includes injection and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0222","description":"IV Injection_ bebtelovimab_ includes injection and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pacemaker monitr digital/vis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0615","description":"Pacemaker monitr digital/vis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFF0","description":"ICD-CFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatric service/therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90899","description":"Psychiatric service/therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETC1","description":"ICD-JETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTF0","description":"ICD-MCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGF0","description":"ICD-OLGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antistreptolysin o screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86063","description":"Antistreptolysin o screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lutetium Lu 177 vipivotide tetraxetan_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9607","description":"Lutetium Lu 177 vipivotide tetraxetan_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMB0","description":"ICD-NCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHA1","description":"ICD-CIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTB1","description":"ICD-NBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHB1","description":"ICD-OEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB212","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSA0","description":"ICD-GGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILE1","description":"ICD-IILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct scan for localization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77011","description":"Ct scan for localization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACC0","description":"ICD-FACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHE0","description":"ICD-FAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHED0","description":"ICD-CHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIB1","description":"ICD-EDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPF0","description":"ICD-BIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onlay repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2982","description":"Onlay repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient was in hospice or receiving palliative care at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1059","description":"Patient was in hospice or receiving palliative care at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRB0","description":"ICD-HDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKC0","description":"ICD-BDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOE0","description":"ICD-PEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Forensic autopsy (necropsy)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88040","description":"Forensic autopsy (necropsy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23184","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23450","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METE1","description":"ICD-METE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Durable medical equipment mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1399","description":"Durable medical equipment mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Appropos mthd offloading rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4269F","description":"Appropos mthd offloading rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXF0","description":"ICD-KFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEB1","description":"ICD-IFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQC1","description":"ICD-CIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18G","description":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychophysiological therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90876","description":"Psychophysiological therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPE1","description":"ICD-CIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXF0","description":"ICD-GDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNA0","description":"ICD-FCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOE0","description":"ICD-HEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRD0","description":"ICD-CGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Msh6 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81299","description":"Msh6 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 21-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99443","description":"Phone e/m phys/qhp 21-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automatic bp monitor_ dial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4670","description":"Automatic bp monitor_ dial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28A","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWC0","description":"ICD-CCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSC0","description":"ICD-KHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise & repair chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32906","description":"Revise & repair chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11B","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain bladder by needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51100","description":"Drain bladder by needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_eptinezumab-jjmr_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9063","description":"Injection_eptinezumab-jjmr_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"John cunningham antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86711","description":"John cunningham antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKD1","description":"ICD-OKKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQB1","description":"ICD-PAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor X_ (human)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7175","description":"Injection_ Factor X_ (human)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2046","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2046","description":"HCPCS-A2046","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEB1","description":"ICD-ACEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical revision procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4268","description":"Surgical revision procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0777T","description":"Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJF0","description":"ICD-NLJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOB1","description":"ICD-GBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVC1","description":"ICD-GAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUA0","description":"ICD-ACUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICB1","description":"ICD-FICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63275","description":"Bx/exc xdrl spine lesn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cine/video x-rays add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76125","description":"Cine/video x-rays add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB22","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHF1","description":"ICD-NHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJF0","description":"ICD-OHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAC0","description":"ICD-MIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMD0","description":"ICD-JIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB155","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHE0","description":"ICD-CEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/endoscope us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45391","description":"Colonoscopy w/endoscope us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNA1","description":"ICD-OBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVF1","description":"ICD-ODVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUA1","description":"ICD-BFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECD1","description":"ICD-GECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp common ipsi carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35601","description":"Art byp common ipsi carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1557","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1557","description":"HCPCS-L1557","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCC1","description":"ICD-CHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0502","description":"HCPCS-C0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove self-contd penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54415","description":"Remove self-contd penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXE0","description":"ICD-NKXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVD1","description":"ICD-KEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ rimabotulinumtoxinb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0587","description":"Inj_ rimabotulinumtoxinb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway pressure filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7038","description":"Pos airway pressure filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine_ entire_ survey study_ anteroposterior an lateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72010","description":"Radiologic examination_ spine_ entire_ survey study_ anteroposterior an lateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB20","description":"Medium Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASF1","description":"ICD-CASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronidase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3470","description":"Hyaluronidase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68326","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9183","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","description":"HCPCS-J9183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow mold sock suspension t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6110","description":"Elbow mold sock suspension t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUB1","description":"ICD-KCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27437","description":"Revise kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28A","description":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICE0","description":"ICD-AICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71023","description":"Chest x-ray and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft axillary-axilry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35518","description":"Art byp grft axillary-axilry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJB0","description":"ICD-BFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23B","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEE1","description":"ICD-GBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lidocaine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80176","description":"Assay of lidocaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Janssen Covid-19 Vaccine Administration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0031A","description":"Janssen Covid-19 Vaccine Administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITA1","description":"ICD-IITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMD0","description":"ICD-KGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCD1","description":"ICD-OBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVE1","description":"ICD-OLVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54440","description":"Repair of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair wide w/ foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1093","description":"Wheelchair wide w/ foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43116","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJA1","description":"ICD-NHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44405","description":"Colonoscopy w/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGE0","description":"ICD-GHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Htlv/hiv confirmj antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86689","description":"Htlv/hiv confirmj antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hocm 350-399mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9963","description":"Hocm 350-399mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLD1","description":"ICD-EDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETE1","description":"ICD-CETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUD1","description":"ICD-NBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEF0","description":"ICD-IFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9738","description":"Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28I","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA216","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAE1","description":"ICD-EGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJF1","description":"ICD-CBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01935","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01935","description":"CPT-01935","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJD1","description":"ICD-OBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXF0","description":"ICD-FDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt has no resp insufficiency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1505F","description":"Pt has no resp insufficiency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00140","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","description":"CPT-00140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHA0","description":"ICD-FBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50120","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPE0","description":"ICD-JGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74290","description":"Contrast x-ray gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ho frejka cov only pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1610","description":"Ho frejka cov only pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAA0","description":"ICD-AEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVA1","description":"ICD-BHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKE1","description":"ICD-OJKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Baseline mrs > 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1236","description":"Baseline mrs > 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68362","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJB0","description":"ICD-OEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB05","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBB1","description":"ICD-EHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINF1","description":"ICD-CINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC31","description":"ICD-3EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00600","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","description":"CPT-00600","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ moxetumomab pasudotox-tdfk_ 0.01 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9313","description":"Injection_ moxetumomab pasudotox-tdfk_ 0.01 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair diaphragm laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39501","description":"Repair diaphragm laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63282","description":"Bx/exc idrl spine lesn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHB1","description":"ICD-NFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"So acro/clav can web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3670","description":"So acro/clav can web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"J-cell batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4234","description":"J-cell batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFD1","description":"ICD-OIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28103","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAD0","description":"ICD-CCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASD1","description":"ICD-KASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBD1","description":"ICD-OBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNF0","description":"ICD-GFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMC1","description":"ICD-EEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVD0","description":"ICD-BDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQC1","description":"ICD-OKQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDA1","description":"ICD-OKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQB0","description":"ICD-OJQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Russell viper venom diluted","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85613","description":"Russell viper venom diluted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGF1","description":"ICD-KAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8E","description":"High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDA1","description":"ICD-CGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1308","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","description":"HCPCS-J1308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gamunex-c/gammaked","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1561","description":"Gamunex-c/gammaked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPC1","description":"ICD-OGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4243","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4243","description":"HCPCS-Q4243","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBF1","description":"ICD-GIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOE1","description":"ICD-DGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49617","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITD0","description":"ICD-OITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPD1","description":"ICD-BIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPD0","description":"ICD-BAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDB0","description":"ICD-MCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63091","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYD1","description":"ICD-PGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWC1","description":"ICD-CDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45395","description":"Lap removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFB1","description":"ICD-NBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCF0","description":"ICD-JGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20A","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJB0","description":"ICD-OLJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFB1","description":"ICD-FDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHF0","description":"ICD-NFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFE1","description":"ICD-NKFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFB1","description":"ICD-BDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB240","description":"Clinically Complex _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVE1","description":"ICD-BGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEE1","description":"ICD-EIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAB1","description":"ICD-JIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFA0","description":"ICD-JIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVF1","description":"ICD-OEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1083T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1083T","description":"CPT-1083T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99347","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADD0","description":"ICD-NADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90471","description":"Immunization admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1B","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMF0","description":"ICD-FIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIB1","description":"ICD-KAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Palonosetron hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2469","description":"Palonosetron hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDB0","description":"ICD-KFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8B","description":"Medium Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rural health clinic or federally qualified health center (RHC or FQHC) only_ general care management_ 20 minutes or more of clinical staff time for chronic care management ser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0511","description":"Rural health clinic or federally qualified health center (RHC or FQHC) only_ general care management_ 20 minutes or more of clinical staff time for chronic care management ser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEE1","description":"ICD-NBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUC0","description":"ICD-MFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair modified fontan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33615","description":"Repair modified fontan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surg on vag/urethral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94251","description":"Anesth surg on vag/urethral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGF0","description":"ICD-BBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEF1","description":"ICD-NCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBME1","description":"ICD-KBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4437","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","description":"HCPCS-Q4437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQF0","description":"ICD-HIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1465","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","description":"HCPCS-M1465","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE126","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBC0","description":"ICD-EFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB43","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2001","description":"HCPCS-A2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-hypertensive or hypertensive blood pressure reading documented_ indicated follow-up not documented_ Patient not eligible/ not appropriate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8951","description":"Pre-hypertensive or hypertensive blood pressure reading documented_ indicated follow-up not documented_ Patient not eligible/ not appropriate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA11","description":"ICD-4KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3B","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDB0","description":"ICD-OCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42972","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo by both infusion and o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0085","description":"Chemo by both infusion and o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXB0","description":"ICD-KCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEB1","description":"ICD-KAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNC1","description":"ICD-ODNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"P32 chromic phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9564","description":"P32 chromic phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQE1","description":"ICD-HFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4416","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","description":"HCPCS-Q4416","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"implant/abutment supported interim fixed denture for edentulous arch – maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6119","description":"implant/abutment supported interim fixed denture for edentulous arch – maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELA1","description":"ICD-GELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXF1","description":"ICD-NKXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens polycarb or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2784","description":"Lens polycarb or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam pelvic complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76856","description":"Us exam pelvic complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obinutuzumab inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9301","description":"Obinutuzumab inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBE1","description":"ICD-OHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6039","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","description":"HCPCS-L6039","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYA1","description":"ICD-GAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKE0","description":"ICD-GFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYD1","description":"ICD-DEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom grad glove heavy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8426","description":"Custom grad glove heavy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX20","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTC0","description":"ICD-BBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm system binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5282","description":"Ald fm/dm system binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAF1","description":"ICD-OCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIB0","description":"ICD-AGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL20","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUF0","description":"ICD-IHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove armpit lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38745","description":"Remove armpit lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDA0","description":"ICD-JDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTE0","description":"ICD-OLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYD1","description":"ICD-OHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMF0","description":"ICD-MFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61642","description":"Dilate ic vasospasm add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDF0","description":"ICD-OIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjv hrmnl thxpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4164F","description":"Adjv hrmnl thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHD1","description":"ICD-CIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOA1","description":"ICD-DFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUE0","description":"ICD-KCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor viia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7189","description":"Factor viia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILC0","description":"ICD-CILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88016","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27503","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDD1","description":"ICD-FEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANF1","description":"ICD-KANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01272","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","description":"CPT-01272","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPF1","description":"ICD-FAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTB0","description":"ICD-IHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCE1","description":"ICD-EHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWC1","description":"ICD-PLWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27752","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg </4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64897","description":"Nerve graft arm/leg </4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOC0","description":"ICD-PCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psytx crisis ea addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90840","description":"Psytx crisis ea addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42180","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGC0","description":"ICD-FGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl perph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33965","description":"Ecmo/ecls rmvl perph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51500","description":"Removal of bladder cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01860","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","description":"CPT-01860","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLE1","description":"ICD-OCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALA1","description":"ICD-GALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUD1","description":"ICD-EBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIF0","description":"ICD-OAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct angiography neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70498","description":"Ct angiography neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28116","description":"Revision of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTE1","description":"ICD-KDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIA0","description":"ICD-OIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0401","description":"HCPCS-A0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKD0","description":"ICD-OCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKB0","description":"ICD-JIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60521","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of skull tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61563","description":"Excision of skull tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETE1","description":"ICD-OETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJF1","description":"ICD-NIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBF1","description":"ICD-BIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADE0","description":"ICD-KADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAID1","description":"ICD-BAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of folic acid rbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82747","description":"Assay of folic acid rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal hemoglobin assay qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83033","description":"Fetal hemoglobin assay qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEC0","description":"ICD-ICEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBB0","description":"ICD-IHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mh svc plan dev by non-md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0032","description":"Mh svc plan dev by non-md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXC1","description":"ICD-KEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWD1","description":"ICD-CEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKB0","description":"ICD-OFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLE0","description":"ICD-OHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGF1","description":"ICD-CIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVD1","description":"ICD-FEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup gauntlet fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4014","description":"Cast sup gauntlet fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1155","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98971","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIC0","description":"ICD-KBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAF0","description":"ICD-OBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hsv dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87528","description":"Hsv dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMC1","description":"ICD-BGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUD0","description":"ICD-OLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA31","description":"ICD-2CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose in lactated ringer_s_ 1000 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5011","description":"5% dextrose in lactated ringer_s_ 1000 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O2 contents gas cubic ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8120","description":"O2 contents gas cubic ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj nalbuphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2300","description":"Inj nalbuphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amino acids quan 6 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82139","description":"Amino acids quan 6 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj potassium chloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3480","description":"Inj potassium chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTC0","description":"ICD-NBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA212","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJF1","description":"ICD-OKJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ intravas ultrasound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1753","description":"Cath_ intravas ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSB0","description":"ICD-GCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBE1","description":"ICD-KHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESE0","description":"ICD-DESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIA0","description":"ICD-GCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCA1","description":"ICD-KDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28X","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMB0","description":"ICD-GGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supply allowance for therapeutic continuous glucose monitor (CGM)_ includes all supples and accessories_ 1 unit = 1 mo. supply","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0553","description":"Supply allowance for therapeutic continuous glucose monitor (CGM)_ includes all supples and accessories_ 1 unit = 1 mo. supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANC1","description":"ICD-OANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINB0","description":"ICD-OINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96164","description":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Agglutinins febrile antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86000","description":"Agglutinins febrile antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMF0","description":"ICD-IFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iliac aneurysm endovas rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75954","description":"Iliac aneurysm endovas rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0658","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","description":"HCPCS-E0658","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 1","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1781","description":"vaccine administration-human papillomavirus - Dose 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-77439","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","description":"CPT-77439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab_ via sustained release intravitreal implant (Susvimo)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9093","description":"Injection_ ranibizumab_ via sustained release intravitreal implant (Susvimo)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22C","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVB0","description":"ICD-NBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNC0","description":"ICD-BGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBB1","description":"ICD-KGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRE0","description":"ICD-LGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVF1","description":"ICD-KDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (hikma) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0137","description":"Injection_ acetaminophen (hikma) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVA1","description":"ICD-OHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDC1","description":"ICD-GBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISB1","description":"ICD-DISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20C","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegcetacoplan_ intravitreal_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2781","description":"Injection_ pegcetacoplan_ intravitreal_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Protein e-phoresis/urine/csf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84166","description":"Protein e-phoresis/urine/csf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respite care_ in the home_ p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9125","description":"Respite care_ in the home_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18E","description":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Growth hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80428","description":"Growth hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHE1","description":"ICD-BDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTA1","description":"ICD-JGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97154","description":"Group adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCC0","description":"ICD-CCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAE0","description":"ICD-JDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAD1","description":"ICD-BEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCD0","description":"ICD-GBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLA0","description":"ICD-ADLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHD1","description":"ICD-OAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOC1","description":"ICD-LIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGB0","description":"ICD-NDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo bk ultra-light material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5940","description":"Endo bk ultra-light material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0537","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","description":"HCPCS-G0537","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQB0","description":"ICD-CHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4368","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","description":"HCPCS-Q4368","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVD1","description":"ICD-NBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIE1","description":"ICD-IGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXF0","description":"ICD-CFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13D","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94762","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMC1","description":"ICD-AIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEA0","description":"ICD-CEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA42","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKF0","description":"ICD-KBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEE1","description":"ICD-MGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01140","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","description":"CPT-01140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHE1","description":"ICD-GBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPF1","description":"ICD-BEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin sys hydraul stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5848","description":"Knee-shin sys hydraul stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA21","description":"ICD-3AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIA0","description":"ICD-JDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18A","description":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adhesive remover per ounce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4455","description":"Adhesive remover per ounce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27393","description":"Lengthening of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74450","description":"X-ray urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALB0","description":"ICD-IALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52354","description":"Cystouretero w/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACE0","description":"ICD-EACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/dual leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33230","description":"Insrt pulse gen w/dual leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTC1","description":"ICD-BGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUF1","description":"ICD-BGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKA0","description":"ICD-JGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBE1","description":"ICD-ECBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5C","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAC1","description":"ICD-OHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cncr 0/ia melan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3321F","description":"Ajcc cncr 0/ia melan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGC0","description":"ICD-CAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDA1","description":"ICD-JIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVB1","description":"ICD-KDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aducanumab-avwa_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0172","description":"Injection_ aducanumab-avwa_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo torsion bil rot straps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2040","description":"Hkafo torsion bil rot straps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse pancreas and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48548","description":"Fuse pancreas and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0607U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","description":"CPT-0607U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAD0","description":"ICD-AGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no pt cat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9429","description":"Doc med reas no pt cat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTA1","description":"ICD-JCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDE0","description":"ICD-KEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIE1","description":"ICD-CDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDF0","description":"ICD-GCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ivf canc a stim case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4017","description":"Ivf canc a stim case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1140","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTE1","description":"ICD-OJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDA1","description":"ICD-MCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1A","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-61715","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","description":"CPT-61715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Protein c concentrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2724","description":"Protein c concentrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64804","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCA0","description":"ICD-CHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOD1","description":"ICD-CHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITD1","description":"ICD-FITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77065","description":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTC0","description":"ICD-AFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42225","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCID0","description":"ICD-NCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUD0","description":"ICD-NLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ age 12 years or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31552","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ age 12 years or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYD0","description":"ICD-LCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGID1","description":"ICD-CGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1802","description":"HCPCS-B1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALC1","description":"ICD-GALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transperi needle place pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55875","description":"Transperi needle place pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open biopsy of lung pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32098","description":"Open biopsy of lung pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBC1","description":"ICD-CFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCA1","description":"ICD-IGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGC0","description":"ICD-FBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA213","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amino acids quant 2-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82136","description":"Amino acids quant 2-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subepithelial tissue graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4273","description":"Subepithelial tissue graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETD0","description":"ICD-CETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWB1","description":"ICD-HFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWD0","description":"ICD-GDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEA0","description":"ICD-ICEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPC1","description":"ICD-CEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITF1","description":"ICD-BITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family training & counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1027","description":"Family training & counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASA0","description":"ICD-PASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61592","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKC1","description":"ICD-NAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quality care for the treatment of ear_ nose_ and throat disorders mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1367","description":"Quality care for the treatment of ear_ nose_ and throat disorders mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL21","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1 pc ost pouch w filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5056","description":"1 pc ost pouch w filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPB1","description":"ICD-CEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMD1","description":"ICD-EBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92637","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","description":"CPT-92637","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVA0","description":"ICD-NAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC21","description":"ICD-3AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA206","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE116","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYF0","description":"ICD-CEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHA1","description":"ICD-BFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29886","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBD1","description":"ICD-ECBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAD1","description":"ICD-MEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41116","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBE0","description":"ICD-FEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCV2 3MCG TRS-SUCR 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0082A","description":"ADM SARSCV2 3MCG TRS-SUCR 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAA0","description":"ICD-EGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISC1","description":"ICD-KISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDB1","description":"ICD-NCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Paraffin bath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97018","description":"Paraffin bath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBF1","description":"ICD-BBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24420","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSB0","description":"ICD-CDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove in/ex hem groups 2+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46260","description":"Remove in/ex hem groups 2+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTE0","description":"ICD-NBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMA0","description":"ICD-EEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G9871","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","description":"HCPCS-G9871","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPD1","description":"ICD-CIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEA0","description":"ICD-EHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOB1","description":"ICD-GDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBB0","description":"ICD-GEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD220","description":"Special Care Low _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQC0","description":"ICD-OBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/ch access det adj armrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0973","description":"W/ch access det adj armrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0234","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0234","description":"HCPCS-Q0234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL34","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening for sleep related breathing disorders","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9957","description":"Screening for sleep related breathing disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJC1","description":"ICD-GEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00567","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","description":"CPT-00567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for hip x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27093","description":"Injection for hip x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip flexible cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5966","description":"Hip flexible cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhcp-svs of csw_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0155","description":"Hhcp-svs of csw_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95710","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cymetra injectable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4112","description":"Cymetra injectable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILD1","description":"ICD-OILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB54","description":"High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADB0","description":"ICD-OADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artiss fibrin sealant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9250","description":"Artiss fibrin sealant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rubella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86762","description":"Rubella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94760","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPC0","description":"ICD-JDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUE1","description":"ICD-JCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ Chemotherapeutic Drug Cytotoxicity Assay Of Cancer Stem Cells (Cscs)_ From Cultured Cscs And Primary Tumor Cells_ Categorical Drug Response Reported Based On Percent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0564T","description":"Oncology_ Chemotherapeutic Drug Cytotoxicity Assay Of Cancer Stem Cells (Cscs)_ From Cultured Cscs And Primary Tumor Cells_ Categorical Drug Response Reported Based On Percent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPB0","description":"ICD-KEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAE1","description":"ICD-ABAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0948T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","description":"CPT-0948T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTC0","description":"ICD-MLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPC1","description":"ICD-NEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCB1","description":"ICD-JHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy nail unit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11755","description":"Biopsy nail unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHD1","description":"ICD-JAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKD0","description":"ICD-NAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIC0","description":"ICD-IFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXB0","description":"ICD-JEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deluxe lens feature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2702","description":"Deluxe lens feature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCID0","description":"ICD-OCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBA0","description":"ICD-NJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPF0","description":"ICD-NLPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLC1","description":"ICD-GHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDD0","description":"ICD-CCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0525T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJF0","description":"ICD-CHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us bone density measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76977","description":"Us bone density measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients With Mechanical Prosthetic Heart Valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0043","description":"Patients With Mechanical Prosthetic Heart Valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMA1","description":"ICD-CAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5D","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ travoprost_ intracameral implant_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7355","description":"Injection_ travoprost_ intracameral implant_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trichogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96902","description":"Trichogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0797T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42227","description":"Lengthening of palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dicom format doc on rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9340","description":"Dicom format doc on rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8D","description":"Very High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vacc 3 dose immunsup im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90740","description":"Hepb vacc 3 dose immunsup im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 90-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0518","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 90-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electric breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0603","description":"Electric breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy pouch solid deodorant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4395","description":"Ostomy pouch solid deodorant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPB1","description":"ICD-OLPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor viii ahg 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85240","description":"Clot factor viii ahg 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periacetabular osteotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2115","description":"Periacetabular osteotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKC1","description":"ICD-JCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBD1","description":"ICD-MKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8040","description":"Nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHED1","description":"ICD-OHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAD1","description":"ICD-MAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI lower extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73718","description":"MRI lower extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20C","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18X","description":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx septal&nose fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21337","description":"Closed tx septal&nose fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microdissection manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88381","description":"Microdissection manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXC0","description":"ICD-FDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBA0","description":"ICD-GIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ibutilide fumarate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1742","description":"Ibutilide fumarate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJC0","description":"ICD-GHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below knee flex cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5962","description":"Below knee flex cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmoscopy/dynamometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92260","description":"Ophthalmoscopy/dynamometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCD0","description":"ICD-MGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYC0","description":"ICD-PBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHC1","description":"ICD-CEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped hydrolyzed/amino acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4161","description":"Ef ped hydrolyzed/amino acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00700","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","description":"CPT-00700","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLA0","description":"ICD-MFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18H","description":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASE0","description":"ICD-LASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0204","description":"HCPCS-C0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITF1","description":"ICD-OITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","description":"CPT-15016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Safety concerns screening not provided_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9925","description":"Safety concerns screening not provided_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge resin w/noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6252","description":"Bridge resin w/noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amalgam one surface permanen","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2140","description":"Amalgam one surface permanen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC21","description":"ICD-2FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy remov fb/fibrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32653","description":"Thoracoscopy remov fb/fibrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXE0","description":"ICD-BEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8C","description":"Very High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGC0","description":"ICD-JEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 4 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP04","description":"Auto.test pane pricing code_ 4 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMC0","description":"ICD-NGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stk cabg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8573","description":"Stk cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special anesthesia procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99135","description":"Special anesthesia procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22D","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj testosterone cypionate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1071","description":"Inj testosterone cypionate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTC1","description":"ICD-KFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEME0","description":"ICD-FEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSA1","description":"ICD-PDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSE0","description":"ICD-ODSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gated heart planar single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78472","description":"Gated heart planar single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEE0","description":"ICD-JGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25B","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLF0","description":"ICD-BFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sensory integration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97533","description":"Sensory integration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release eye tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67343","description":"Release eye tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTC1","description":"ICD-JCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97130","description":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWA0","description":"ICD-GCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAD0","description":"ICD-FGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPE1","description":"ICD-FDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso s/c shell/panel prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0639","description":"Lso s/c shell/panel prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCA0","description":"ICD-EBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hip prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27090","description":"Removal of hip prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMD1","description":"ICD-FFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDD0","description":"ICD-NIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILC0","description":"ICD-KILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCF0","description":"ICD-GCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQB0","description":"ICD-DBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVE1","description":"ICD-GFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of eyelid abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67700","description":"Drainage of eyelid abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Omental flap intra-abdom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49905","description":"Omental flap intra-abdom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWC1","description":"ICD-LDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSB1","description":"ICD-ODSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96934","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOA1","description":"ICD-GDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ (aristada)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1944","description":"Injection_ aripiprazole lauroxil_ (aristada)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ labetalol hydrochloride_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1920","description":"Injection_ labetalol hydrochloride_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy vag lesions complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57065","description":"Destroy vag lesions complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0788","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0788","description":"HCPCS-E0788","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Io radiation tx management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77469","description":"Io radiation tx management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVB1","description":"ICD-FBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-imaging heart function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78414","description":"Non-imaging heart function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNC1","description":"ICD-FFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILB1","description":"ICD-IILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYF1","description":"ICD-HIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANE0","description":"ICD-BANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFA0","description":"ICD-BAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX26","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILB0","description":"ICD-BILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPD1","description":"ICD-KHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUE1","description":"ICD-CCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant (teva) not therapeutically equivalent to j9395_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9393","description":"Injection_ fulvestrant (teva) not therapeutically equivalent to j9395_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAC1","description":"ICD-MKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open tx nose fx w/skele fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21330","description":"Open tx nose fx w/skele fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSD1","description":"ICD-CBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELE0","description":"ICD-OELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATA0","description":"ICD-EATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACF0","description":"ICD-AACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHD1","description":"ICD-NJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retainer Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6753","description":"Retainer Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXE1","description":"ICD-OFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQD0","description":"ICD-KHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPB1","description":"ICD-KGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFC1","description":"ICD-JGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise spinal cord tract(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63170","description":"Incise spinal cord tract(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQC0","description":"ICD-CGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSB0","description":"ICD-LBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIC0","description":"ICD-GBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOA0","description":"ICD-KEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDC0","description":"ICD-OHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDD1","description":"ICD-MLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conversion ext bil drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47535","description":"Conversion ext bil drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0664","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","description":"HCPCS-G0664","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0988T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","description":"CPT-0988T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRA1","description":"ICD-HIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOF1","description":"ICD-HBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34421","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC145","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair lung hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32800","description":"Repair lung hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIA0","description":"ICD-ADIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-47384","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","description":"CPT-47384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay aminolevulinic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82135","description":"Assay aminolevulinic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; set-up_ patient training_ configuration of monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0534T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; set-up_ patient training_ configuration of monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells_ including leukapheresis and dose preparation procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9098","description":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells_ including leukapheresis and dose preparation procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental consultation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9310","description":"Dental consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29880","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEF1","description":"ICD-KDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTC0","description":"ICD-IGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITC1","description":"ICD-OITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXE0","description":"ICD-FBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair tooth socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41874","description":"Repair tooth socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX60","description":"Very High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17281","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNA0","description":"ICD-OKNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKF1","description":"ICD-OIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHE1","description":"ICD-GIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skn splt a-grft f/n/hf/g add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15121","description":"Skn splt a-grft f/n/hf/g add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastroenterology (Barrett’s esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 methylation analysis_ prognostic and predictive algorithm reported as a risk score for progression to high-g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0386U","description":"Gastroenterology (Barrett’s esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 methylation analysis_ prognostic and predictive algorithm reported as a risk score for progression to high-g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMA0","description":"ICD-FCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXE1","description":"ICD-NAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4030F","description":"Oxygen therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8X","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postpartum care visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0503F","description":"Postpartum care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXA1","description":"ICD-GDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urethrlys transvag w/ scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53500","description":"Urethrlys transvag w/ scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; initial electrode arra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64596","description":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; initial electrode arra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diazoxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1730","description":"Diazoxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAA1","description":"ICD-MJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAD1","description":"ICD-BIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ascent_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4213","description":"Ascent_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31528","description":"Laryngoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ abdominal_ with contrast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9744","description":"Ultrasound_ abdominal_ with contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0658T","description":"Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWD0","description":"ICD-GBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23466","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysate conc sol add 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4766","description":"Dialysate conc sol add 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRE1","description":"ICD-PGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical trays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4550","description":"Surgical trays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVB1","description":"ICD-CHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/sac fb remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32658","description":"Thoracoscopy w/sac fb remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1502","description":"HCPCS-B1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31239","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCD0","description":"ICD-CDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAD1","description":"ICD-NHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCC1","description":"ICD-EDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGA1","description":"ICD-FAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cinacalcet_ oral_ 1 mg_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0604","description":"Cinacalcet_ oral_ 1 mg_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echocardiography contrast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9700","description":"Echocardiography contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0559T","description":"Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIA0","description":"ICD-MCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJD0","description":"ICD-BIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHED0","description":"ICD-JHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (heart transplant)_ cell-free DNA_ PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets)_ plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0055U","description":"Cardiology (heart transplant)_ cell-free DNA_ PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets)_ plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWB1","description":"ICD-DHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSF1","description":"ICD-CHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDD1","description":"ICD-FHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOF1","description":"ICD-KAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin barrier solid 4x4 equiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4372","description":"Skin barrier solid 4x4 equiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPE0","description":"ICD-JFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWB0","description":"ICD-PHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDC1","description":"ICD-CEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLB0","description":"ICD-BDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days_ including at least weekly downloads of pulmonary artery pressure recordings_ interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93264","description":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days_ including at least weekly downloads of pulmonary artery pressure recordings_ interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIF0","description":"ICD-GCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUE1","description":"ICD-CAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medicaid certified community behavioral health clinic services_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1040","description":"Medicaid certified community behavioral health clinic services_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPD0","description":"ICD-NBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWE0","description":"ICD-GHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2C","description":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILD1","description":"ICD-AILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA03","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBA1","description":"ICD-JIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKD1","description":"ICD-CCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHME1","description":"ICD-AHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJC1","description":"ICD-NIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKD0","description":"ICD-KAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUF1","description":"ICD-FFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQD0","description":"ICD-LIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5166","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5166","description":"HCPCS-Q5166","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apheresis adsorp/reinfuse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36515","description":"Apheresis adsorp/reinfuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDB1","description":"ICD-ICDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPD0","description":"ICD-CIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC106","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCB1","description":"ICD-NDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUD1","description":"ICD-CFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDB0","description":"ICD-OIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99343","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos air press adhere no perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8855","description":"Pos air press adhere no perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPD1","description":"ICD-FGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove bilat space maintain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1525","description":"Remove bilat space maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recement supp crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6092","description":"Recement supp crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAF0","description":"ICD-EFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEF1","description":"ICD-NIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB245","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00940","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","description":"CPT-00940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGE0","description":"ICD-NEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYA1","description":"ICD-DGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pilonidal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10081","description":"Drainage of pilonidal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGA0","description":"ICD-NJGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPD0","description":"ICD-KIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHC0","description":"ICD-GIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBD1","description":"ICD-OCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGE0","description":"ICD-CAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIC0","description":"ICD-BIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9687","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht musc image planar mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78454","description":"Ht musc image planar mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQC1","description":"ICD-HIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69660","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBB1","description":"ICD-NBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87591","description":"N.gonorrhoeae dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPF1","description":"ICD-NAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWB0","description":"ICD-CDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin pedicle flap trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15570","description":"Skin pedicle flap trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBA1","description":"ICD-NKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAD0","description":"ICD-KAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22A","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22841","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACD1","description":"ICD-MACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFED0","description":"ICD-OFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ear protector evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92596","description":"Ear protector evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL54","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUF0","description":"ICD-OKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol carb > 50%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4180","description":"Parenteral sol carb > 50%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUA0","description":"ICD-IAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sterile gauze>16 <= 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6403","description":"Sterile gauze>16 <= 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATE1","description":"ICD-FATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intranasal reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30620","description":"Intranasal reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXA0","description":"ICD-NAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient is not dysarthric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3763F","description":"Patient is not dysarthric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINA1","description":"ICD-NINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPE0","description":"ICD-CCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHB1","description":"ICD-GDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc_ l/r_ cmv-neg_ irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9058","description":"Rbc_ l/r_ cmv-neg_ irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth eye exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14851","description":"Anesth eye exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSB0","description":"ICD-GGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm system_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5281","description":"Ald fm/dm system_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clean out mastoid cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69222","description":"Clean out mastoid cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ retifanlimab-dlwr_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9345","description":"Injection_ retifanlimab-dlwr_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGB1","description":"ICD-OIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIA1","description":"ICD-EFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt rsk death w/in 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1150F","description":"Doc pt rsk death w/in 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cabg w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56751","description":"Anesth cabg w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILD1","description":"ICD-FILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARB0","description":"ICD-KARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17282","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRE0","description":"ICD-GDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIB1","description":"ICD-JFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-77438","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","description":"CPT-77438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKC0","description":"ICD-KFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRB1","description":"ICD-HIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manipulate wrist w/anesthes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25259","description":"Manipulate wrist w/anesthes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVE0","description":"ICD-CFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16075","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16075","description":"CPT-16075","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder flexion-abduction j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6645","description":"Shoulder flexion-abduction j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBC1","description":"ICD-JHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVC1","description":"ICD-JEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood methemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83045","description":"Blood methemoglobin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph optical endomicroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43206","description":"Esoph optical endomicroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISD0","description":"ICD-KISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWA0","description":"ICD-PJWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of vulva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56620","description":"Partial removal of vulva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUA0","description":"ICD-MIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOE1","description":"ICD-KEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSC1","description":"ICD-GHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCC1","description":"ICD-NBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cauterization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57510","description":"Cauterization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKF0","description":"ICD-CFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29900","description":"Mcp joint arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENA0","description":"ICD-OENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDD0","description":"ICD-NEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVE0","description":"ICD-NAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7570","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7570","description":"HCPCS-C7570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVF1","description":"ICD-NHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyoscyamine sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1980","description":"Hyoscyamine sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDA1","description":"ICD-BEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28299","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLD1","description":"ICD-OJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anal/urinary muscle study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51785","description":"Anal/urinary muscle study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","description":"HCPCS-J3391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUF1","description":"ICD-KDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Management of a new patient with dementia_ moderate to high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0523","description":"Management of a new patient with dementia_ moderate to high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGE1","description":"ICD-OGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYA1","description":"ICD-PAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42500","description":"Repair salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0268T","description":"Implt/rpl crtd sns dev gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove femur lesion/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27356","description":"Remove femur lesion/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPB0","description":"ICD-BFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRC1","description":"ICD-CCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test presump not opt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0479","description":"Drug test presump not opt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88147","description":"Cytopath c/v automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKB1","description":"ICD-GEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVC0","description":"ICD-CCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYB1","description":"ICD-PJYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAA1","description":"ICD-OHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAB0","description":"ICD-ODAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOA1","description":"ICD-HEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: low complexity_ requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97161","description":"Physical therapy evaluation: low complexity_ requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microslide consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88323","description":"Microslide consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55801","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNF0","description":"ICD-FDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACB0","description":"ICD-AACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWE1","description":"ICD-DBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDA1","description":"ICD-FHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEA1","description":"ICD-FFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQF1","description":"ICD-LCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVC1","description":"ICD-NJVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proton treatment complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77525","description":"Proton treatment complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnioexcel or biodexcel_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4137","description":"Amnioexcel or biodexcel_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUA1","description":"ICD-ECUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pamidronate disodium /30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2430","description":"Pamidronate disodium /30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67105","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOB1","description":"ICD-GHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx esophag t1-t3 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9096","description":"Onc dx esophag t1-t3 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Full Gene Sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81351","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Full Gene Sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amp reqd w/in 48h ieler proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9641","description":"Amp reqd w/in 48h ieler proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUD0","description":"ICD-MFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOE0","description":"ICD-OHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1188","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below knee acrylic socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5629","description":"Below knee acrylic socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHC1","description":"ICD-OIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYC0","description":"ICD-DGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37241","description":"Vasc embolize/occlude venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCID0","description":"ICD-MCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILA0","description":"ICD-NILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABED0","description":"ICD-ABED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXC1","description":"ICD-NBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBA1","description":"ICD-FGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9944","description":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUB0","description":"ICD-OIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of left heart vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33988","description":"Insertion of left heart vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28495","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ingest challenge addl 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95079","description":"Ingest challenge addl 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAD0","description":"ICD-CAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTC0","description":"ICD-ACTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELE1","description":"ICD-JELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9610","description":"HCPCS-C9610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mycobacteria dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87550","description":"Mycobacteria dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMF0","description":"ICD-GDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAE1","description":"ICD-FFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10A","description":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUB1","description":"ICD-GAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28D","description":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC31","description":"ICD-3DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAE0","description":"ICD-JGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBA1","description":"ICD-IHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac shunt imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78428","description":"Cardiac shunt imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELE1","description":"ICD-CELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTA0","description":"ICD-KHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHB1","description":"ICD-BCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV and VV delays_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0225T","description":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV and VV delays_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92230","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD151","description":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAD1","description":"ICD-NGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair uro sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53449","description":"Repair uro sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYC1","description":"ICD-CBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aortic dysfunction/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81411","description":"Aortic dysfunction/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICF1","description":"ICD-EICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPB1","description":"ICD-CCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLF1","description":"ICD-OGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGA0","description":"ICD-FCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCME1","description":"ICD-GCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHE1","description":"ICD-MEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8X","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87389","description":"IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGC0","description":"ICD-NIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9993","description":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRF0","description":"ICD-KIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory traction device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0830","description":"Ambulatory traction device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNB1","description":"ICD-FGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETF1","description":"ICD-FETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPA1","description":"ICD-NLPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colectomy w/neo-rectum pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44158","description":"Colectomy w/neo-rectum pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMD0","description":"ICD-IAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHB1","description":"ICD-CAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCF1","description":"ICD-MDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision orbitofacial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21275","description":"Revision orbitofacial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHE0","description":"ICD-OBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuromuscular stim for shock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0745","description":"Neuromuscular stim for shock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj arthroscopy debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7877","description":"Tmj arthroscopy debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53220","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aortobi-iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35638","description":"Art byp aortobi-iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-70473","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","description":"CPT-70473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42107","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fistula cannulation set_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4730","description":"Fistula cannulation set_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAD0","description":"ICD-IGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye/insert implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65103","description":"Remove eye/insert implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATC1","description":"ICD-OATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ppps_ initial visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0438","description":"Ppps_ initial visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peridontal medicament","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5994","description":"Peridontal medicament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJE0","description":"ICD-JAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24640","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMC0","description":"ICD-MCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDB1","description":"ICD-EEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of small int","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2053","description":"Transplantation of small int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMB0","description":"ICD-CCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAB1","description":"ICD-NBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37606","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGE1","description":"ICD-GCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leishmania antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86717","description":"Leishmania antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJD1","description":"ICD-KBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWA1","description":"ICD-ODWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maxilla open reduct simple","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7610","description":"Maxilla open reduct simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKME0","description":"ICD-NKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVA1","description":"ICD-JIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA106","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDF1","description":"ICD-FHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Follow-Up And Mrs Score Not Assessed At 90 Days Following Endovascular Stroke Intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0046","description":"Clinical Follow-Up And Mrs Score Not Assessed At 90 Days Following Endovascular Stroke Intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEF1","description":"ICD-MDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMA1","description":"ICD-OEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No tob assess or cess inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9460","description":"No tob assess or cess inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22843","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOB0","description":"ICD-OIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYC1","description":"ICD-ODYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWA1","description":"ICD-HGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWF1","description":"ICD-CAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27516","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Residual limb support system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1020","description":"Residual limb support system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15A","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX50","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA44","description":"Medium Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJB1","description":"ICD-OJJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE124","description":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (vivimusta)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9056","description":"Injection_ bendamustine hydrochloride (vivimusta)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23800","description":"Fusion of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDB1","description":"ICD-NLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fem/popl revasc stnt & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37227","description":"Fem/popl revasc stnt & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auditor evoke potent compre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92585","description":"Auditor evoke potent compre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABA0","description":"ICD-CABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision gum each quadrant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41820","description":"Excision gum each quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFA1","description":"ICD-CHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJF0","description":"ICD-BGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRA0","description":"ICD-DDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harvest art for cabg add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35600","description":"Harvest art for cabg add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKE1","description":"ICD-GGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chronic care management services_ provided personally by a physician or other qualified health care professional_ at least 30 minutes of physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99491","description":"Chronic care management services_ provided personally by a physician or other qualified health care professional_ at least 30 minutes of physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0539T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHD1","description":"ICD-KFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINF1","description":"ICD-NINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q9999","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","description":"HCPCS-Q9999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNC1","description":"ICD-JCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Euflexxa inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7323","description":"Euflexxa inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38382","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMF0","description":"ICD-MDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pinworm exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87172","description":"Pinworm exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24C","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRF1","description":"ICD-GIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSC1","description":"ICD-GCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIA0","description":"ICD-ECIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSC1","description":"ICD-HBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGA1","description":"ICD-FEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKD0","description":"ICD-NKKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAF0","description":"ICD-FHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADB0","description":"ICD-AADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert epicard eltrd endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33203","description":"Insert epicard eltrd endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ full gene sequence (List separately in addition to code for primary procedu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ full gene sequence (List separately in addition to code for primary procedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINE1","description":"ICD-KINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trg gene rearrangement anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81342","description":"Trg gene rearrangement anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBC0","description":"ICD-FFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSA1","description":"ICD-CGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAC0","description":"ICD-AIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blastomyces antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86612","description":"Blastomyces antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGE1","description":"ICD-KEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza a ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87276","description":"Influenza a ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98011","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","description":"CPT-98011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPA0","description":"ICD-JAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA42","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Injection/Nerve Block Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0620","description":"Hospital Special Treatment Room Support Component (Hstrsc) Injection/Nerve Block Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autonomic nrv adrenrg inervj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95922","description":"Autonomic nrv adrenrg inervj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEB0","description":"ICD-MDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFE1","description":"ICD-OKFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDB1","description":"ICD-EGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETF0","description":"ICD-GETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95170","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22C","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETA1","description":"ICD-BETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapy activation of implanted phrenic nerve stimulator system_ including all interrogation and programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93150","description":"Therapy activation of implanted phrenic nerve stimulator system_ including all interrogation and programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block_ with frozen section(s)_ single specimen (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0841T","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block_ with frozen section(s)_ single specimen (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ref to outpt card rehab prog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4500F","description":"Ref to outpt card rehab prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEC0","description":"ICD-ODEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXA0","description":"ICD-BCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepc gn tstng docd b/4txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3266F","description":"Hepc gn tstng docd b/4txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37615","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBA0","description":"ICD-JHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUC0","description":"ICD-JGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAF0","description":"ICD-MEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFD1","description":"ICD-CEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAE0","description":"ICD-KGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93245","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB255","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0402","description":"HCPCS-B0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDA0","description":"ICD-NBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUD0","description":"ICD-NGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJF0","description":"ICD-BHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFF1","description":"ICD-JAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJE1","description":"ICD-GEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RFC1 (replication factor C subunit 1)_ repeat expansion variant analysis by traditional and repeat-primed PCR_ blood_ saliva_ or buccal swab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0378U","description":"RFC1 (replication factor C subunit 1)_ repeat expansion variant analysis by traditional and repeat-primed PCR_ blood_ saliva_ or buccal swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX20","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMB0","description":"ICD-JDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional electric stim nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0770","description":"Functional electric stim nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66930","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX20","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLF1","description":"ICD-NJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAA1","description":"ICD-FCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Soft protect helmet custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8002","description":"Soft protect helmet custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24675","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSF1","description":"ICD-HBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIA1","description":"ICD-JBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81445","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ pmkr_ transvenous vdd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1779","description":"Lead_ pmkr_ transvenous vdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport lodgng recip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0180","description":"Noner transport lodgng recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQA1","description":"ICD-DAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interferential stim 2 chan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8130","description":"Interferential stim 2 chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dalteparin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1645","description":"Dalteparin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"D&c of cervical stump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57558","description":"D&c of cervical stump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKC1","description":"ICD-OFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKB1","description":"ICD-FGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXC0","description":"ICD-NAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB11","description":"ICD-1KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYF0","description":"ICD-KCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair iris & ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66680","description":"Repair iris & ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of shoulder cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29055","description":"Application of shoulder cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bedside drainage bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4357","description":"Bedside drainage bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVA0","description":"ICD-KHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXB0","description":"ICD-CAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA21","description":"ICD-4DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33406","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALB1","description":"ICD-MALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVF1","description":"ICD-CCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg monitoring/computer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95953","description":"Eeg monitoring/computer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC105","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB31","description":"ICD-4JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNF0","description":"ICD-BCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJF0","description":"ICD-FFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGD0","description":"ICD-NLGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQB1","description":"ICD-OKQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNC1","description":"ICD-KFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m oxidronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9561","description":"Tc99m oxidronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBD0","description":"ICD-JBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29883","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0143","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gross pulpal debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3221","description":"Gross pulpal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No pharm ther osteo rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8635","description":"No pharm ther osteo rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65273","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTB0","description":"ICD-AGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQA0","description":"ICD-DCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLA1","description":"ICD-OGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31235","description":"Nasal/sinus endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEB0","description":"ICD-GGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Molecular Fluorescent Imaging Of Suspicious Nevus; First Lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0700T","description":"Molecular Fluorescent Imaging Of Suspicious Nevus; First Lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transducer protect/fld bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1575","description":"Transducer protect/fld bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood ketone test or strip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4252","description":"Blood ketone test or strip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coagulation time otr method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85348","description":"Coagulation time otr method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXE1","description":"ICD-FCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62190","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plastic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4027","description":"Plastic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6563","description":"Gradient compression stocking_ waist length_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGB0","description":"ICD-GEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hand bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26200","description":"Remove hand bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of fluoride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82735","description":"Assay of fluoride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Capillary blood draw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36416","description":"Capillary blood draw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLD1","description":"ICD-OGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWB1","description":"ICD-HIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE140","description":"Reduced Physical Function _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJC1","description":"ICD-FEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHB1","description":"ICD-OIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYE0","description":"ICD-GDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20D","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special casting material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4590","description":"Special casting material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Admin + supply_ tositumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3001","description":"Admin + supply_ tositumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long arm adult plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4005","description":"Cast sup long arm adult plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asp not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9436","description":"Asp not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBB0","description":"ICD-BCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXC0","description":"ICD-JEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXF1","description":"ICD-CGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect/debride pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48105","description":"Resect/debride pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fas/dir ldl 70-189mg/dl mst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9666","description":"Fas/dir ldl 70-189mg/dl mst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQB1","description":"ICD-GGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1092T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1092T","description":"CPT-1092T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKE0","description":"ICD-OBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAC1","description":"ICD-FGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB07","description":"Medium Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Semi-precision attachment - placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6192","description":"Semi-precision attachment - placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Verify pt site pxd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6100F","description":"Verify pt site pxd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cbc without platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0307","description":"Cbc without platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ pharmacogenomic analysis of single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ whole blood or buccal swab_ with variant analysis_ includin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0461U","description":"Oncology_ pharmacogenomic analysis of single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ whole blood or buccal swab_ with variant analysis_ includin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytal_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4166","description":"Cytal_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neck/chest surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21899","description":"Neck/chest surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESD1","description":"ICD-HESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of ankle joint open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27870","description":"Fusion of ankle joint open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLB1","description":"ICD-CDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOE1","description":"ICD-LDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAA0","description":"ICD-JDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0505","description":"HCPCS-B0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens hydrophil bifocl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2522","description":"Cntct lens hydrophil bifocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGD0","description":"ICD-OLGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44960","description":"Appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQB1","description":"ICD-PLQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1101","description":"HCPCS-B1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1025","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOD1","description":"ICD-KDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15944","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAA0","description":"ICD-KFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWC1","description":"ICD-HHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1010","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert abdomen-venous drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49425","description":"Insert abdomen-venous drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50065","description":"Incision of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEND1","description":"ICD-CEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBE0","description":"ICD-NDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIC0","description":"ICD-JBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl tip cane/crutch/walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4637","description":"Repl tip cane/crutch/walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBA1","description":"ICD-JEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cervical pneum trac equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0849","description":"Cervical pneum trac equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01170","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","description":"CPT-01170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYB0","description":"ICD-GAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of methemalbumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83857","description":"Assay of methemalbumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRF0","description":"ICD-OGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; second","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22870","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; second","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVA0","description":"ICD-NFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ includes placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0775T","description":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ includes placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg > 48 in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6236","description":"Hydrocolld drg > 48 in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRB1","description":"ICD-KIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0D","description":"Very High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy_ includes angioplasty within the same vessel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9774","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy_ includes angioplasty within the same vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMD0","description":"ICD-OLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLE1","description":"ICD-EDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trluml perip athrc abd aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0236T","description":"Trluml perip athrc abd aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture othr specimn aerobic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87070","description":"Culture othr specimn aerobic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1022T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","description":"CPT-1022T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOF0","description":"ICD-LCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24125","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cysto w/up stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52342","description":"Cysto w/up stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIF0","description":"ICD-EIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBD1","description":"ICD-IHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTE1","description":"ICD-JFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Typhoid vaccine_ heat- and phenol-inactivated (h-p)_ for subcutaneous orintradermal use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90692","description":"Typhoid vaccine_ heat- and phenol-inactivated (h-p)_ for subcutaneous orintradermal use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEE0","description":"ICD-GHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist/forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25115","description":"Remove wrist/forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise finger tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26055","description":"Incise finger tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast supplies (plaster)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4580","description":"Cast supplies (plaster)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0406","description":"HCPCS-C0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open tx post pelvic fxcture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0415","description":"Open tx post pelvic fxcture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of androstenedione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82157","description":"Assay of androstenedione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33702","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oasis burn matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4103","description":"Oasis burn matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERE1","description":"ICD-DERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thumb dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26641","description":"Treat thumb dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0541","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","description":"HCPCS-G0541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADF1","description":"ICD-OADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy pouch liq deodorant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4394","description":"Ostomy pouch liq deodorant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair nasal stenosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30465","description":"Repair nasal stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech sound lang comprehen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92523","description":"Speech sound lang comprehen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hexa gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81255","description":"Hexa gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy for bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44391","description":"Colonoscopy for bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC23","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99316","description":"Nursing fac discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTB1","description":"ICD-BBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDF0","description":"ICD-GGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUC1","description":"ICD-JHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILD1","description":"ICD-NILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXD1","description":"ICD-KAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB31","description":"ICD-4BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKE1","description":"ICD-JDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA254","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWE1","description":"ICD-CBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJB1","description":"ICD-BGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKED0","description":"ICD-OKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No order for ceph no reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9198","description":"No order for ceph no reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med rsn scope pt >85y","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9660","description":"Doc med rsn scope pt >85y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUC0","description":"ICD-NBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sloughed off bone","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7550","description":"Removal of sloughed off bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC21","description":"ICD-4JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE241","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE240","description":"Special Care Low _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEE1","description":"ICD-IBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide for transfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76941","description":"Echo guide for transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33277","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWA1","description":"ICD-LHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRD0","description":"ICD-KGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQD1","description":"ICD-HFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect leg/ankle tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27616","description":"Resect leg/ankle tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sex offend tx svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2028","description":"Sex offend tx svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMA1","description":"ICD-MBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea sen ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0429T","description":"Rmvl nstim apnea sen ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia)_ genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0237U","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia)_ genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOB0","description":"ICD-OGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWF1","description":"ICD-DFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kneecap bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27340","description":"Removal of kneecap bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBD1","description":"ICD-JHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGB1","description":"ICD-JCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCD1","description":"ICD-GHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of haloperidol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80173","description":"Assay of haloperidol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93985","description":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ureter stent percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50384","description":"Remove ureter stent percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB51","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPB0","description":"ICD-CIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTC1","description":"ICD-AGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHC0","description":"ICD-GFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQA1","description":"ICD-GBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ob us follow-up per fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76816","description":"Ob us follow-up per fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microprcsr cu elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0481","description":"Microprcsr cu elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp pop-tibl-prl-other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35571","description":"Art byp pop-tibl-prl-other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11C","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each additional single probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0852T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each additional single probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28106","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ trans atherectomy_ dir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1714","description":"Cath_ trans atherectomy_ dir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOB0","description":"ICD-LIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABE1","description":"ICD-AABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYE0","description":"ICD-KBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX52","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lwr ext dynamic prosth pylon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5985","description":"Lwr ext dynamic prosth pylon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANF1","description":"ICD-OANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0902","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0902","description":"CDT-D0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKC0","description":"ICD-KCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII/von Willebrand factor complex_ recombinant (Altuviiio)_ per Factor VIII IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7214","description":"Injection_ Factor VIII/von Willebrand factor complex_ recombinant (Altuviiio)_ per Factor VIII IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLE0","description":"ICD-KFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWE1","description":"ICD-DEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBB0","description":"ICD-GIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assessment of aphasia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96105","description":"Assessment of aphasia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58290","description":"Vag hyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28193","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHB0","description":"ICD-IDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64466","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","description":"CPT-64466","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD235","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metaproterenol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7667","description":"Metaproterenol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEF0","description":"ICD-OAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist/elbow bowden cbl dir f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6582","description":"Wrist/elbow bowden cbl dir f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat/graft heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28420","description":"Treat/graft heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE260","description":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX42","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAC1","description":"ICD-KAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMA0","description":"ICD-JHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRD1","description":"ICD-PCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAB1","description":"ICD-MIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and radiotracer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52250","description":"Cystoscopy and radiotracer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25028","description":"Drainage of forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93532","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHD1","description":"ICD-KBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIA1","description":"ICD-JHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA23","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (WG Critical Care)_ not therapeutically equivalent to J0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0687","description":"Injection_ cefazolin sodium (WG Critical Care)_ not therapeutically equivalent to J0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDF0","description":"ICD-GFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vit d 1 25-dihydroxy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82652","description":"Vit d 1 25-dihydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cptr dbs alys car elec dta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0206T","description":"Cptr dbs alys car elec dta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc forearm les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25075","description":"Exc forearm les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01832","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","description":"CPT-01832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67430","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOA0","description":"ICD-DDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (hikma)_ not therapeutically equivalent to j0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0688","description":"Injection_ cefazolin sodium (hikma)_ not therapeutically equivalent to j0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFE0","description":"ICD-FCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18X","description":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAF1","description":"ICD-ABAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt=d(rh)+ or sensitized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3291F","description":"Pt=d(rh)+ or sensitized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQC0","description":"ICD-PBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQE1","description":"ICD-GEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDB1","description":"ICD-CFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMF0","description":"ICD-GCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOE0","description":"ICD-GAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXD1","description":"ICD-BFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33720","description":"Repair of heart defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Newborn metabolic screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3620","description":"Newborn metabolic screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTC1","description":"ICD-BCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Octreotide inj_ non-depot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2354","description":"Octreotide inj_ non-depot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPE0","description":"ICD-JCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIC1","description":"ICD-ABIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydromorphone 250 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0092","description":"Hydromorphone 250 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulm funct test oscillometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94728","description":"Pulm funct test oscillometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conform band s w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6446","description":"Conform band s w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLB0","description":"ICD-JHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUD1","description":"ICD-EDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo prolong infuse w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96416","description":"Chemo prolong infuse w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATD0","description":"ICD-MATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28B","description":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trb@ gene rearrange dirprobe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81341","description":"Trb@ gene rearrange dirprobe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6010","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC241","description":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18X","description":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUC0","description":"ICD-BBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc Lung 5 Clinical Risk Factors Alg Prblty Mal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0080U","description":"Onc Lung 5 Clinical Risk Factors Alg Prblty Mal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Basiliximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0480","description":"Basiliximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1A","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6009","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVC0","description":"ICD-BIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFC0","description":"ICD-JHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIB0","description":"ICD-OAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCF0","description":"ICD-IBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1047T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1047T","description":"CPT-1047T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLE0","description":"ICD-OKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUD0","description":"ICD-KCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUD0","description":"ICD-EAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pharyngeal walls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42892","description":"Revision of pharyngeal walls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21121","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNE1","description":"ICD-NLNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB106","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDC1","description":"ICD-OKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBE1","description":"ICD-BGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recording without 24 hour attended mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0498T","description":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recording without 24 hour attended mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0D","description":"High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implnt/abut remov dent mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6111","description":"Implnt/abut remov dent mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRE0","description":"ICD-LIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85460","description":"Hemoglobin fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFF1","description":"ICD-OHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0944T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","description":"CPT-0944T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy irrig cone/cath w brs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4399","description":"Ostomy irrig cone/cath w brs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGD0","description":"ICD-FDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEC0","description":"ICD-OLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGD1","description":"ICD-GFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGD0","description":"ICD-KGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBF0","description":"ICD-MJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJB1","description":"ICD-ODJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1104","description":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYF1","description":"ICD-LIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRA0","description":"ICD-OFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIB0","description":"ICD-CIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTD1","description":"ICD-EBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMA0","description":"ICD-KCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOA1","description":"ICD-PEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay carboxyhb qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82376","description":"Assay carboxyhb qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXB0","description":"ICD-FFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAA0","description":"ICD-EIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9999","description":"Chemotherapy drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEA0","description":"ICD-NGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIE0","description":"ICD-NBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHC0","description":"ICD-KFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMA1","description":"ICD-CHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXC0","description":"ICD-JGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBB1","description":"ICD-MGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUE1","description":"ICD-KBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOB0","description":"ICD-LCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7d/.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2207","description":"Lens sphcy bifocal 4.25-7d/.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hand bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26034","description":"Treat hand bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIF0","description":"ICD-OBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXE1","description":"ICD-FAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37281","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","description":"CPT-37281","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBE0","description":"ICD-JGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kt/v =/> 1.2 & <1.7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3083F","description":"Kt/v =/> 1.2 & <1.7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ intra echocardiography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1759","description":"Cath_ intra echocardiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAE0","description":"ICD-MAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens hydrophil extend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2523","description":"Cntct lens hydrophil extend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bitolterol mesylate comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7628","description":"Bitolterol mesylate comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt education noc group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9446","description":"Pt education noc group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who received cervical cytology or an HPV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9806","description":"Patients who received cervical cytology or an HPV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13C","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGD1","description":"ICD-GCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Isolation- tooth w rubb dam","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3910","description":"Isolation- tooth w rubb dam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Polysom <6 yrs cpap/bilvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95783","description":"Polysom <6 yrs cpap/bilvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOD0","description":"ICD-HBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogen micrarray copy nmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81228","description":"Cytogen micrarray copy nmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEB1","description":"ICD-MBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUF0","description":"ICD-OIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENF1","description":"ICD-GENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXA0","description":"ICD-NBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYA1","description":"ICD-HCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEA0","description":"ICD-OHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryosurgery penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54056","description":"Cryosurgery penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAB1","description":"ICD-KEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPB0","description":"ICD-NBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBC1","description":"ICD-CEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMA0","description":"ICD-NFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFF0","description":"ICD-NCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLF0","description":"ICD-CDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ana crown exp 4 or> per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4230","description":"Ana crown exp 4 or> per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMA0","description":"ICD-FEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7556","description":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMB0","description":"ICD-BHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIME0","description":"ICD-GIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cranial electrotherapy stimulation (CES) system supplies and accessories_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4596","description":"Cranial electrotherapy stimulation (CES) system supplies and accessories_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo pla sin up w/wo k/a cus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2034","description":"Kafo pla sin up w/wo k/a cus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anti-reflective coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2750","description":"Anti-reflective coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1269","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX42","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Protein western blot tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88371","description":"Protein western blot tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Construction of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57291","description":"Construction of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKF1","description":"ICD-BGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43113","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIF0","description":"ICD-MGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess hghlymalig doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3345F","description":"Mammo assess hghlymalig doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hypoxia response curve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94450","description":"Hypoxia response curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD135","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteopath manj 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98926","description":"Osteopath manj 3-4 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIA1","description":"ICD-ICIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJF1","description":"ICD-FCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0361T","description":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA11","description":"ICD-2KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCB1","description":"ICD-FHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48146","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOC1","description":"ICD-DDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13B","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1260","description":"Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixed wing air mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0435","description":"Fixed wing air mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSC0","description":"ICD-OLSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEID0","description":"ICD-IEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of psa complexed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84152","description":"Assay of psa complexed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKD0","description":"ICD-NCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXF1","description":"ICD-BEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant temple bone w/stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69714","description":"Implant temple bone w/stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1804","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1804","description":"CDT-D1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHB0","description":"ICD-NLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWE1","description":"ICD-OEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIA0","description":"ICD-OJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL32","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUF1","description":"ICD-JCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX54","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFC0","description":"ICD-BIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWF0","description":"ICD-LDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surv score no improv w/tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9605","description":"Surv score no improv w/tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJE1","description":"ICD-BHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAD0","description":"ICD-MEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lingual frenectomy (frenulectomy)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7962","description":"Lingual frenectomy (frenulectomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40654","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain thyroid/tongue cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60000","description":"Drain thyroid/tongue cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ho abduction static plastic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1660","description":"Ho abduction static plastic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Head/extremity control inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2328","description":"Head/extremity control inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ppsv23 vacc 2 yrs+ subq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90732","description":"Ppsv23 vacc 2 yrs+ subq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9805","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHC0","description":"ICD-CDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAB1","description":"ICD-JGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECF1","description":"ICD-KECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIB1","description":"ICD-KGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25D","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic passive restor cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6370","description":"Thoracic passive restor cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAB0","description":"ICD-JHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKA0","description":"ICD-JEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTC0","description":"ICD-IDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0880","description":"Pwc gp4 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUC1","description":"ICD-KGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQA0","description":"ICD-PHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB33","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPD0","description":"ICD-OFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA55","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA26","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIC1","description":"ICD-FCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-rays bone survey limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77074","description":"X-rays bone survey limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tube_ pneumatic caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2385","description":"Tube_ pneumatic caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97129","description":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTB0","description":"ICD-FGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt couns 4 txmnt opt prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4163F","description":"Pt couns 4 txmnt opt prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic appliance full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0665","description":"Pneumatic appliance full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLE0","description":"ICD-OFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPB0","description":"ICD-NFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKB1","description":"ICD-OEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUC0","description":"ICD-GDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFF1","description":"ICD-NIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAA0","description":"ICD-NFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bowel to bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44130","description":"Bowel to bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83655","description":"Assay of lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrin degradation products","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85362","description":"Fibrin degradation products","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral prescrip drug non chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8499","description":"Oral prescrip drug non chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure of salivary fistula","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7983","description":"Closure of salivary fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX17","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC03","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETF1","description":"ICD-NETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMF1","description":"ICD-BFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rails bed side half length","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0305","description":"Rails bed side half length","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC31","description":"ICD-2HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE101","description":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2101","description":"CDT-D2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBA0","description":"ICD-JFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGD0","description":"ICD-FHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVC1","description":"ICD-KFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKC1","description":"ICD-OHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMF0","description":"ICD-GHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special supply_ nos waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2028","description":"Special supply_ nos waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTD1","description":"ICD-BHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHD0","description":"ICD-EAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone a inj prs-free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3300","description":"Triamcinolone a inj prs-free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE131","description":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTB0","description":"ICD-CHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDF0","description":"ICD-NIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Across Major Side Branches","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33894","description":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Across Major Side Branches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOE0","description":"ICD-PDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2041","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","description":"HCPCS-A2041","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SYPHILIS TST ANTB IA QUAN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0210U","description":"SYPHILIS TST ANTB IA QUAN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIB1","description":"ICD-OAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXA0","description":"ICD-JHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLE1","description":"ICD-NKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJA0","description":"ICD-JIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXC0","description":"ICD-CIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARB1","description":"ICD-KARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification of 8 RNA markers (GAPDH_ SMAD4_ ACY1_ AREG_ CDH1_ KRAS_ TNFRSF10B_ EGLN2) and fecal hem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0421U","description":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification of 8 RNA markers (GAPDH_ SMAD4_ ACY1_ AREG_ CDH1_ KRAS_ TNFRSF10B_ EGLN2) and fecal hem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUD0","description":"ICD-OAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTD0","description":"ICD-ECTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHA1","description":"ICD-FIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hf mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8551","description":"Hf mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CT/MRI chest/neck no thy nod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9557","description":"CT/MRI chest/neck no thy nod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2130","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHF1","description":"ICD-NFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYF0","description":"ICD-GCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUB0","description":"ICD-FBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test def 15-21 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0482","description":"Drug test def 15-21 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moveable patient lift system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0639","description":"Moveable patient lift system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye suture during surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67335","description":"Eye suture during surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93224","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACE1","description":"ICD-FACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole (abilify asimtufii)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0402","description":"Injection_ aripiprazole (abilify asimtufii)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37258","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","description":"CPT-37258","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic intern lock elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6350","description":"Thoracic intern lock elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIED1","description":"ICD-GIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pne not given norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9280","description":"Pne not given norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATD0","description":"ICD-IATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metacarp fx orthosis pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3917","description":"Metacarp fx orthosis pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPE1","description":"ICD-FBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93226","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neg press wound tx >50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97606","description":"Neg press wound tx >50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx dprsd malar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21360","description":"Opn tx dprsd malar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable nebulizer sml vol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7004","description":"Disposable nebulizer sml vol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIE0","description":"ICD-NHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec size w foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1221","description":"Wheelchair spec size w foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBC0","description":"ICD-JCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJE1","description":"ICD-JAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch faceplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5053","description":"Clsd ostomy pouch faceplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRC0","description":"ICD-PDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4020","description":"Ophthalmology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixed prosthodontic proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6999","description":"Fixed prosthodontic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0536","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","description":"HCPCS-G0536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair windpipe opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31614","description":"Repair windpipe opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sternal debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21627","description":"Sternal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36262","description":"Removal of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auditory osseointegrated device_ transducer/actuator_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8694","description":"Auditory osseointegrated device_ transducer/actuator_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCE0","description":"ICD-FDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genome","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9032","description":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA244","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24586","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEID1","description":"ICD-EEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX31","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFF1","description":"ICD-CDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJE1","description":"ICD-KEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evoked auditory test limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92587","description":"Evoked auditory test limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILB1","description":"ICD-FILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD205","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFE0","description":"ICD-KBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA110","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair with fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0163","description":"Commode chair with fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFA1","description":"ICD-NEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUA0","description":"ICD-FFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIA0","description":"ICD-GFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALA0","description":"ICD-IALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVF0","description":"ICD-JIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVD0","description":"ICD-FCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUB1","description":"ICD-EBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extrnl counterpulse_ per tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0166","description":"Extrnl counterpulse_ per tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90958","description":"Esrd srv 2-3 vsts p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd demo bundle-level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9014","description":"Esrd demo bundle-level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITA1","description":"ICD-BITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADB0","description":"ICD-GADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNE1","description":"ICD-NHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDED0","description":"ICD-IDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enzyme cell activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82657","description":"Enzyme cell activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25420","description":"Repair/graft radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8H","description":"Medium Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80439","description":"Trh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOE1","description":"ICD-KBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5161","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","description":"HCPCS-Q5161","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22B","description":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECF0","description":"ICD-OECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILA0","description":"ICD-AILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHB0","description":"ICD-MJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHA1","description":"ICD-NAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVE0","description":"ICD-CGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breathing capacity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94010","description":"Breathing capacity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urea nitrogen semi-quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84525","description":"Urea nitrogen semi-quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxford w supinat/pronat inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3201","description":"Oxford w supinat/pronat inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGA0","description":"ICD-OGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid check both ears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92593","description":"Hearing aid check both ears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4B","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral antiplat thx rx dischrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4073F","description":"Oral antiplat thx rx dischrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEA1","description":"ICD-KEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTF1","description":"ICD-JFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHB0","description":"ICD-IHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mandibular denture prosth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5935","description":"Mandibular denture prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo ia push tecnique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96420","description":"Chemo ia push tecnique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAF1","description":"ICD-MGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8X","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amino acid single qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82127","description":"Amino acid single qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNC0","description":"ICD-NCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGF0","description":"ICD-FCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDF1","description":"ICD-IEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKA0","description":"ICD-KBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0604","description":"HCPCS-C0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin test nos antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86486","description":"Skin test nos antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJB1","description":"ICD-CGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELE1","description":"ICD-NELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0702","description":"HCPCS-C0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens spher bifoc plano 4.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2200","description":"Lens spher bifoc plano 4.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEF1","description":"ICD-CAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23630","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRB1","description":"ICD-OGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES146","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATE0","description":"ICD-NATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99325","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sisi hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92564","description":"Sisi hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQB1","description":"ICD-GAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAB0","description":"ICD-OEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAE0","description":"ICD-CHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHE1","description":"ICD-NFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Provide inr test mater/equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0249","description":"Provide inr test mater/equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interleukin-6 (Il-6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83529","description":"Interleukin-6 (Il-6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYA1","description":"ICD-DEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost b/e acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7403","description":"Add ue prost b/e acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0155","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","description":"HCPCS-Q0155","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncoprotein dcp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83951","description":"Oncoprotein dcp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICF0","description":"ICD-GICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGE0","description":"ICD-FIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAC0","description":"ICD-FIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ melphalan (apotex)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9249","description":"Injection_ melphalan (apotex)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii recombinant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7192","description":"Factor viii recombinant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20605","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKED1","description":"ICD-NKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin alfa_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0885","description":"Epoetin alfa_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC125","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23480","description":"Revision of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove femur lesion/fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27358","description":"Remove femur lesion/fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ intraoperative thoracic aorta (eg_ epiaortic)_ diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76984","description":"Ultrasound_ intraoperative thoracic aorta (eg_ epiaortic)_ diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1002T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","description":"CPT-1002T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKE0","description":"ICD-CAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIF0","description":"ICD-JBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBF1","description":"ICD-JHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tezepelumab-ekko_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2356","description":"Injection_ tezepelumab-ekko_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2198","description":"Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressants class 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80333","description":"Antidepressants class 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMD0","description":"ICD-IGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA25","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKF0","description":"ICD-JIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEME0","description":"ICD-OEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIA1","description":"ICD-IBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUF0","description":"ICD-BAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEE1","description":"ICD-NJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIB0","description":"ICD-CCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","description":"CPT-92638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIA1","description":"ICD-NHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE214","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNB0","description":"ICD-NBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLC1","description":"ICD-EFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1064T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1064T","description":"CPT-1064T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mwc acc_ wheelchair brake","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2228","description":"Mwc acc_ wheelchair brake","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl cushions for jaw motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1701","description":"Repl cushions for jaw motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hfo without joints pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3923","description":"Hfo without joints pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOB0","description":"ICD-OAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUC0","description":"ICD-MGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLA0","description":"ICD-EHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWA1","description":"ICD-PGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analysis nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88356","description":"Analysis nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB124","description":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXD1","description":"ICD-OGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRE1","description":"ICD-HGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic_ pectus carinatum orthosis_ sternal compression_ rigid circumferential frame with anterior and posterior rigid pads_ custom fabricated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1320","description":"Thoracic_ pectus carinatum orthosis_ sternal compression_ rigid circumferential frame with anterior and posterior rigid pads_ custom fabricated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albuterol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7611","description":"Albuterol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVF0","description":"ICD-FHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE154","description":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE151","description":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9962","description":"Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFF0","description":"ICD-BFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBB0","description":"ICD-FFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4A","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPA0","description":"ICD-BHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of foot at ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27888","description":"Amputation of foot at ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo molded to patient plasti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1940","description":"Afo molded to patient plasti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Probe/needle_ cryo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2618","description":"Probe/needle_ cryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cefotaxime sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0698","description":"Cefotaxime sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98003","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","description":"CPT-98003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMD1","description":"ICD-CBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEC0","description":"ICD-NLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at 12 months as demons","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1020","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at 12 months as demons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Direct refer hospital observ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0379","description":"Direct refer hospital observ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure of salivary fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42600","description":"Closure of salivary fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amb infusion pump mechanical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0779","description":"Amb infusion pump mechanical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGB0","description":"ICD-CIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy eyelid & lid margin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67810","description":"Biopsy eyelid & lid margin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt immunity to hep a docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3215F","description":"Pt immunity to hep a docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHB1","description":"ICD-CHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMF1","description":"ICD-IGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB106","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ melphalan (Evomela)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9246","description":"Injection_ melphalan (Evomela)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32480","description":"Partial removal of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIA0","description":"ICD-FDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJB1","description":"ICD-BCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCB1","description":"ICD-JFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQE0","description":"ICD-KDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0201","description":"HCPCS-B0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRE0","description":"ICD-PHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable liner/shield/pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4535","description":"Disposable liner/shield/pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of clot in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35876","description":"Removal of clot in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo-vag hyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58553","description":"Laparo-vag hyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDF0","description":"ICD-IHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch drain w bar & filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4424","description":"Ost pch drain w bar & filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sub pt/ot goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8994","description":"Sub pt/ot goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wireless pressure sensor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2624","description":"Wireless pressure sensor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (Xellia)_ unrefrigerated_ not therapeutically equivalent to J0878 or J0873_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0872","description":"Injection_ daptomycin (Xellia)_ unrefrigerated_ not therapeutically equivalent to J0878 or J0873_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Macroscopic exam parasite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87169","description":"Macroscopic exam parasite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOE0","description":"ICD-CIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLF0","description":"ICD-KDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL53","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC104","description":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA12","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fresh frozen plasma_ high titer COVID-19 convalescent_ frozen within 8 hours of collection_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9507","description":"Fresh frozen plasma_ high titer COVID-19 convalescent_ frozen within 8 hours of collection_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA05","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLA1","description":"ICD-KHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGB0","description":"ICD-KHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0969T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","description":"CPT-0969T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA154","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ground mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0425","description":"Ground mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDE0","description":"ICD-JEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak/knee disartic pelvic band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5697","description":"Ak/knee disartic pelvic band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ ep_ 20 or more elec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1731","description":"Cath_ ep_ 20 or more elec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLA0","description":"ICD-BDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELB1","description":"ICD-MELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antineutrophil Cytoplasmic Antibody (Anca); Titer_ Each Antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86037","description":"Antineutrophil Cytoplasmic Antibody (Anca); Titer_ Each Antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd us transmural injxn/mark","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43253","description":"Egd us transmural injxn/mark","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWC0","description":"ICD-OJWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFE0","description":"ICD-JFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMF0","description":"ICD-OJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQA1","description":"ICD-GEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telehealth facility fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3014","description":"Telehealth facility fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scaling and debridement in the presence of inflammation or mucositis of a single implant_ including cleaning of the implant surfaces_ without flap entry and closure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6081","description":"Scaling and debridement in the presence of inflammation or mucositis of a single implant_ including cleaning of the implant surfaces_ without flap entry and closure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impr med time edarr pain med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9426","description":"Impr med time edarr pain med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC12","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rebond/cement/repair retain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8693","description":"Rebond/cement/repair retain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQC0","description":"ICD-HDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx gastric recurrent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9103","description":"Onc dx gastric recurrent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCE1","description":"ICD-GHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUC1","description":"ICD-NHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tamoxifen 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0187","description":"Tamoxifen 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00522","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","description":"CPT-00522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose with potassium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5012","description":"5% dextrose with potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNB0","description":"ICD-NHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNF0","description":"ICD-KFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with biopsy(ies) with adjuctive blue light cystoscopy with fluorescent imaging agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7550","description":"Cystourethroscopy_ with biopsy(ies) with adjuctive blue light cystoscopy with fluorescent imaging agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQE1","description":"ICD-PHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11301","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01430","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","description":"CPT-01430","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBD0","description":"ICD-MCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15C","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe metatarsal bar wedge ro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3400","description":"Shoe metatarsal bar wedge ro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNC1","description":"ICD-FGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAE1","description":"ICD-OEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBB1","description":"ICD-MHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Statin presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9441","description":"Statin presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDC0","description":"ICD-FEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDC0","description":"ICD-FDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGF0","description":"ICD-OJGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31295","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nfct agent detection gi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87505","description":"Nfct agent detection gi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3d-crt/imrt received","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4165F","description":"3d-crt/imrt received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Irinotecan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9206","description":"Irinotecan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOB0","description":"ICD-GHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITC1","description":"ICD-EITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orbital prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5915","description":"Orbital prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8762","description":"Pd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22A","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUC1","description":"ICD-KEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKD1","description":"ICD-CEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p day 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90970","description":"Esrd home pt serv p day 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5245","description":"Hearing aid_ prog_ mon_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 8.1 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9983","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 8.1 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIF0","description":"ICD-MJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC35","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAF0","description":"ICD-BCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDD1","description":"ICD-OBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meprobamate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6052","description":"Meprobamate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXB0","description":"ICD-FGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB204","description":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0529U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","description":"CPT-0529U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"One way chest drain valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7040","description":"One way chest drain valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATE1","description":"ICD-EATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKB1","description":"ICD-NDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1183","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHB1","description":"ICD-AAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMF1","description":"ICD-ACMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise urethra stage 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53400","description":"Revise urethra stage 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFD0","description":"ICD-OCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e._ patient has an abnormal neurological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9536","description":"Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e._ patient has an abnormal neurological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAC0","description":"ICD-NKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC11","description":"ICD-1CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anti-inhibitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7198","description":"Anti-inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Functionality And Deformity As A Function Of Shear Stress_ Whole Blood_ Reported As A Maximum Elongation Index","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0305U","description":"Hematology_ Red Blood Cell (Rbc) Functionality And Deformity As A Function Of Shear Stress_ Whole Blood_ Reported As A Maximum Elongation Index","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sec art thrombectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37186","description":"Sec art thrombectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty tricuspid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33463","description":"Valvuloplasty tricuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUA1","description":"ICD-EDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOD1","description":"ICD-KAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWF1","description":"ICD-OHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD125","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in wheelch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9721","description":"Patient not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in wheelch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv rna vrl ldnot<lmts quntf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3503F","description":"Hiv rna vrl ldnot<lmts quntf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath cell enhance tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88112","description":"Cytopath cell enhance tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sagit rigid panel prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0635","description":"Lso sagit rigid panel prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC151","description":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2099","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine culture/colony count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87086","description":"Urine culture/colony count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOF0","description":"ICD-DFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA31","description":"ICD-2LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle(s) add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67320","description":"Revise eye muscle(s) add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ infliximab-qbtx_ biosimilar_ (Ixifi)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5109","description":"Injection_ infliximab-qbtx_ biosimilar_ (Ixifi)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARE1","description":"ICD-CARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUF1","description":"ICD-KEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMA0","description":"ICD-OFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coagulation time lee & white","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85345","description":"Coagulation time lee & white","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28575","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21600","description":"Partial removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNB0","description":"ICD-NDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRD1","description":"ICD-HHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METF1","description":"ICD-METF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lovotibeglogene autotemcel_ per treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3394","description":"Injection_ lovotibeglogene autotemcel_ per treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJF1","description":"ICD-GBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom shape cvr hip disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5707","description":"Custom shape cvr hip disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27455","description":"Realignment of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUA1","description":"ICD-FFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNF1","description":"ICD-OLNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14D","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63045","description":"Remove spine lamina 1 crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATD0","description":"ICD-KATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0230T","description":"Njx tfrml eprl w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNA0","description":"ICD-BDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTC0","description":"ICD-KFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0005","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25B","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC215","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBC0","description":"ICD-MBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCB1","description":"ICD-CDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRA1","description":"ICD-DDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOB0","description":"ICD-DHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor intestine/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44720","description":"Prep donor intestine/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJA0","description":"ICD-OFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTA1","description":"ICD-MLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29887","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap inc hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49654","description":"Lap inc hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUA0","description":"ICD-OKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA21","description":"ICD-2HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9852","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSB0","description":"ICD-OFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHA0","description":"ICD-NIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYC0","description":"ICD-KFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCD1","description":"ICD-GFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28X","description":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUE1","description":"ICD-BFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNB1","description":"ICD-NJNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEA0","description":"ICD-BIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine reagent strips/tablets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4250","description":"Urine reagent strips/tablets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of gland abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56420","description":"Drainage of gland abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA31","description":"ICD-1BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB126","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBB0","description":"ICD-BIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13D","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVA0","description":"ICD-BHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18E","description":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic resorbable wound dressing_ sterile_ pad size more than 16 sq in but less than or equal to 48 sq in_ without adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6461","description":"Synthetic resorbable wound dressing_ sterile_ pad size more than 16 sq in but less than or equal to 48 sq in_ without adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00352","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","description":"CPT-00352","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cbt 1st hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94644","description":"Cbt 1st hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraabdominal pressure test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51797","description":"Intraabdominal pressure test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBA0","description":"ICD-OIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc t cabg b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9605","description":"Perc d-e cor revasc t cabg b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA50","description":"Ultra High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES121","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYE1","description":"ICD-GBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMA0","description":"ICD-FDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOC0","description":"ICD-PKOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHD0","description":"ICD-OIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITF1","description":"ICD-NITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCB1","description":"ICD-NJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 25 MCG/0.25 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91314","description":"SARSCOV2 VACCINE BIVALENT 25 MCG/0.25 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBF0","description":"ICD-NIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurobehavioral status exam (clinical assessment of thinking_ reasoning and judgment_ [eg_ acquired knowledge_ attention_ language_ memory_ planning and problem solving_ and v","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96121","description":"Neurobehavioral status exam (clinical assessment of thinking_ reasoning and judgment_ [eg_ acquired knowledge_ attention_ language_ memory_ planning and problem solving_ and v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLA1","description":"ICD-IGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUE1","description":"ICD-GBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJE0","description":"ICD-CAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEND1","description":"ICD-OEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUB0","description":"ICD-MAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUC0","description":"ICD-FEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWF0","description":"ICD-DFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYC1","description":"ICD-HBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mast simple complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19303","description":"Mast simple complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28G","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXC1","description":"ICD-NDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA22","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO lumbar intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an ade","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9733","description":"Patient unable to complete the FOTO lumbar intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an ade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQE0","description":"ICD-HAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Misc vision item or service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2799","description":"Misc vision item or service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18H","description":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64837","description":"Repair nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nitroglycerin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2305","description":"Injection_ nitroglycerin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Actin (Smooth Muscle) Antibody (Asma)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86015","description":"Actin (Smooth Muscle) Antibody (Asma)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9465","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove lung catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32552","description":"Remove lung catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDA1","description":"ICD-ICDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKE0","description":"ICD-NJKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95718","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCF1","description":"ICD-OCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB120","description":"Special Care Low _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLF0","description":"ICD-CCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gi/renal risk assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1008F","description":"Gi/renal risk assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair anti-tipping devi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0971","description":"Wheelchair anti-tipping devi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No hcv infect srn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9454","description":"No hcv infect srn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUB1","description":"ICD-CHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEA0","description":"ICD-OIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHC0","description":"ICD-CBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compounded drug not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9977","description":"Compounded drug not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISA0","description":"ICD-DISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDE1","description":"ICD-EGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTD0","description":"ICD-OGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc recpt counsl vit d/calc+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4019F","description":"Doc recpt counsl vit d/calc+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCA0","description":"ICD-CGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX05","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES211","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Create tear sac drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68720","description":"Create tear sac drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15018","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","description":"CPT-15018","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Igk rearrangeabn clonal pop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81264","description":"Igk rearrangeabn clonal pop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCE0","description":"ICD-AHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0614","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","description":"HCPCS-J0614","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/orogastric w/tube plmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43752","description":"Nasal/orogastric w/tube plmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8D","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Guided tiss regen nonresorb","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4267","description":"Guided tiss regen nonresorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj iron dextran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1750","description":"Inj iron dextran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Services performed by a occupational therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2169","description":"Services performed by a occupational therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB106","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0513","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNF0","description":"ICD-BHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEC0","description":"ICD-IEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for bladder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51610","description":"Injection for bladder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC11","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABA0","description":"ICD-MABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mental/Behavioral Health Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4013","description":"Mental/Behavioral Health Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBE0","description":"ICD-FDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANA0","description":"ICD-OANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate unknwn nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9083","description":"Onc dx prostate unknwn nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICF0","description":"ICD-FICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHB0","description":"ICD-ABHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1048T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1048T","description":"CPT-1048T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLD0","description":"ICD-OFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEB1","description":"ICD-FIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPC1","description":"ICD-CAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAE0","description":"ICD-EEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEB0","description":"ICD-OJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBA0","description":"ICD-GEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMD0","description":"ICD-FDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/1-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34804","description":"Endovas aaa repr w/1-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7553","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31600","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHF0","description":"ICD-AAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE216","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAE0","description":"ICD-BBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9583","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFE0","description":"ICD-NHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRC0","description":"ICD-OLRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bronchus add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32501","description":"Repair bronchus add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWE1","description":"ICD-PFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temporal artery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37609","description":"Temporal artery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBA1","description":"ICD-ADBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPE0","description":"ICD-BHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSC1","description":"ICD-PKSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1395","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","description":"HCPCS-M1395","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERD0","description":"ICD-PERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTC0","description":"ICD-FGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHB1","description":"ICD-KGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1702","description":"HCPCS-A1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEF1","description":"ICD-KCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria w/bypass add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33259","description":"Ablate atria w/bypass add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alloskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4115","description":"Alloskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIA0","description":"ICD-BFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enlarge breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19324","description":"Enlarge breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1480","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","description":"HCPCS-M1480","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOD1","description":"ICD-HAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLD0","description":"ICD-CHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10B","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDA0","description":"ICD-BCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRE0","description":"ICD-HIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","description":"HCPCS-J9382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOA1","description":"ICD-DGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occlusive device in vein art","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0269","description":"Occlusive device in vein art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQA1","description":"ICD-DEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJC0","description":"ICD-KCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93931","description":"Upper extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Segmentectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32484","description":"Segmentectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIA1","description":"ICD-EGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTF0","description":"ICD-JHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4400","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","description":"HCPCS-Q4400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth neck vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35051","description":"Anesth neck vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis b dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87516","description":"Hepatitis b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc no pt rsk death w/in 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1151F","description":"Doc no pt rsk death w/in 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calcium gluconate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0610","description":"Calcium gluconate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5A","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ethylene glycol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82693","description":"Assay of ethylene glycol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELF0","description":"ICD-MELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sildenafil citrate_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0090","description":"Sildenafil citrate_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGB1","description":"ICD-CHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ischm stroke symp lt3 hrsb/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1065F","description":"Ischm stroke symp lt3 hrsb/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILE0","description":"ICD-BILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis_ solid organ neoplasm_ DNA analysis of 324 genes_ interrogation for sequence variants_ gene copy number amplifications_ gene rearrangements_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0037U","description":"Targeted genomic sequence analysis_ solid organ neoplasm_ DNA analysis of 324 genes_ interrogation for sequence variants_ gene copy number amplifications_ gene rearrangements_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63287","description":"Bx/exc idrl imed lesn thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3A","description":"Default_ /PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGB1","description":"ICD-JDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJC1","description":"ICD-CDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gr24 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2363","description":"Gr24 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med nutrition indiv subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97803","description":"Med nutrition indiv subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95926","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thorac cont paraspinal uprig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2670","description":"Thorac cont paraspinal uprig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEA1","description":"ICD-BFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAB1","description":"ICD-NFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pm phone r-strip device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93293","description":"Pm phone r-strip device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBF0","description":"ICD-OCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEA1","description":"ICD-AGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ elastic medium stretch_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6598","description":"Gradient compression bandage roll_ elastic medium stretch_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABD0","description":"ICD-BABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADA0","description":"ICD-AADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPA0","description":"ICD-JHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27472","description":"Repair/graft of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95983","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVE0","description":"ICD-CEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE121","description":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth for liver biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70251","description":"Anesth for liver biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML10","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NEURO ALZHEIMER CELL AGGREGJ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0206U","description":"NEURO ALZHEIMER CELL AGGREGJ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQA0","description":"ICD-CAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAF1","description":"ICD-OGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLA1","description":"ICD-IDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSC1","description":"ICD-GBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHB0","description":"ICD-BHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA23","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELC0","description":"ICD-MELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer w/ compressor & he","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0585","description":"Nebulizer w/ compressor & he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2211","description":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are breastfeeding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9779","description":"Patients who are breastfeeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTD0","description":"ICD-FBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIF1","description":"ICD-NDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl bifo 7.25-12/4.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2213","description":"Lens sphcyl bifo 7.25-12/4.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28B","description":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX33","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sinus augmentation vertical","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7952","description":"Sinus augmentation vertical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tenecteplase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3101","description":"Tenecteplase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20C","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYF0","description":"ICD-PEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWB1","description":"ICD-DDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mold socket bent knee shin s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5160","description":"Mold socket bent knee shin s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transverse Aortic Arch Graft_ With Cardiopulmonary Bypass_ With Profound Hypothermia_ Total Circulatory Arrest And Isolated Cerebral Perfusion With Reimplantation Of Arch Vess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33871","description":"Transverse Aortic Arch Graft_ With Cardiopulmonary Bypass_ With Profound Hypothermia_ Total Circulatory Arrest And Isolated Cerebral Perfusion With Reimplantation Of Arch Vess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0492","description":"Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB51","description":"Low Rehab_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Needle localization by xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77002","description":"Needle localization by xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPE1","description":"ICD-OCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration_ with single automated_ standardized instrument via electronic platform_ with automated result only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96146","description":"Psychological or neuropsychological test administration_ with single automated_ standardized instrument via electronic platform_ with automated result only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVD1","description":"ICD-JAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair elbow deb/attch open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24359","description":"Repair elbow deb/attch open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJB0","description":"ICD-NJJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLE1","description":"ICD-MDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Measure kidney pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50396","description":"Measure kidney pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Direct advanced life support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99288","description":"Direct advanced life support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIB1","description":"ICD-EBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEB0","description":"ICD-AGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBF1","description":"ICD-OJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYB1","description":"ICD-KCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mosunetuzumab-axgb_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9350","description":"Injection_ mosunetuzumab-axgb_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55714","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","description":"CPT-55714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Christian sci nurse visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9901","description":"Christian sci nurse visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext amb infusn pump insulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0784","description":"Ext amb infusn pump insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prenatal vitamins 30 day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0197","description":"Prenatal vitamins 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak univ multiplex sys frict","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5616","description":"Ak univ multiplex sys frict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWA0","description":"ICD-PDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB120","description":"Special Care High _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGC1","description":"ICD-OIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Draw blood off venous device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36591","description":"Draw blood off venous device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xm archive tissue molec anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88363","description":"Xm archive tissue molec anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES255","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJD0","description":"ICD-OLJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18X","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2208","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temozolomide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9328","description":"Temozolomide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of breast capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19371","description":"Removal of breast capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smear complex stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87209","description":"Smear complex stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen one/mult class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80304","description":"Drug screen one/mult class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBF1","description":"ICD-GCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ob us limited fetus(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76815","description":"Ob us limited fetus(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Most recent BP is greater than 140/90 mm Hg_ or blood pressure not documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9790","description":"Most recent BP is greater than 140/90 mm Hg_ or blood pressure not documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXE1","description":"ICD-NDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGD1","description":"ICD-BCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC216","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9979","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 2 shl symphys-stern cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0460","description":"Tlso 2 shl symphys-stern cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTD1","description":"ICD-NFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0703","description":"HCPCS-A0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDF1","description":"ICD-FFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8D","description":"Medium Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11423","description":"Exc h-f-nk-sp b9+marg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRA1","description":"ICD-GGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADF0","description":"ICD-EADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28B","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remv/repl penis contain pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54416","description":"Remv/repl penis contain pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLC1","description":"ICD-CGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ binaural_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5248","description":"Hearing aid_ binaural_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQE0","description":"ICD-GFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pin finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26756","description":"Pin finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNF0","description":"ICD-ODNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy flex dx brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43197","description":"Esophagoscopy flex dx brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1high risk no ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9366","description":"1high risk no ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQA0","description":"ICD-GBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB11","description":"ICD-3KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped complete intact nut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4158","description":"Ef ped complete intact nut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemolysins/agglutinins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86941","description":"Hemolysins/agglutinins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMF1","description":"ICD-OKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20665","description":"Removal of fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAE0","description":"ICD-GGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQB0","description":"ICD-GCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMF1","description":"ICD-GHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of face wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15828","description":"Removal of face wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEF1","description":"ICD-OLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93152","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0545","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","description":"HCPCS-G0545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIA0","description":"ICD-MBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23B","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKB0","description":"ICD-BFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFA1","description":"ICD-NKFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINB1","description":"ICD-BINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ot re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97004","description":"Ot re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTD1","description":"ICD-NJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETA1","description":"ICD-OETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye photodynamic ther add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67225","description":"Eye photodynamic ther add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHD0","description":"ICD-FIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRE0","description":"ICD-LDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1482","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","description":"HCPCS-M1482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5B","description":"Default_ /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFB1","description":"ICD-JEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4349","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","description":"HCPCS-Q4349","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair fixed retainers","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8694","description":"Repair fixed retainers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3C","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ep & ablate ventric tachy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93654","description":"Ep & ablate ventric tachy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCB1","description":"ICD-KCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2698","description":"Brachytx_ stranded_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjustment of custom sleep apnea appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9948","description":"Adjustment of custom sleep apnea appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBE1","description":"ICD-GBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj intercost mlt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64421","description":"N block inj intercost mlt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLA0","description":"ICD-FHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4014","description":"Nephrology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00790","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","description":"CPT-00790","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration for testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54560","description":"Exploration for testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOD0","description":"ICD-KGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQA1","description":"ICD-OBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQA1","description":"ICD-KCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21010","description":"Incision of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21255","description":"Reconstruct lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Day habil waiver per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2021","description":"Day habil waiver per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSF1","description":"ICD-DDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPC0","description":"ICD-OJPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEB0","description":"ICD-GCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQD1","description":"ICD-HGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYA0","description":"ICD-HCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXE1","description":"ICD-JGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBA0","description":"ICD-GHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (fungi)_ fungal pathogen identification_ DNA (15 fungal targets)_ blood culture_ amplified probe technique_ each target reported as detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0140U","description":"Infectious disease (fungi)_ fungal pathogen identification_ DNA (15 fungal targets)_ blood culture_ amplified probe technique_ each target reported as detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA215","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMC0","description":"ICD-MJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gauze >16 <=48 sq in w/bordr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6220","description":"Gauze >16 <=48 sq in w/bordr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1160","description":"Wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMF1","description":"ICD-NJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSA0","description":"ICD-GBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGB1","description":"ICD-BGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBF1","description":"ICD-CDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24560","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANB0","description":"ICD-FANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAE1","description":"ICD-EFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone cutting body mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7945","description":"Bone cutting body mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOB1","description":"ICD-HHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETC1","description":"ICD-BETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSB1","description":"ICD-PDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLC1","description":"ICD-GGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJC0","description":"ICD-GGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preventive Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4029","description":"Preventive Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMA1","description":"ICD-KEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFB0","description":"ICD-BGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWD1","description":"ICD-LIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reposition pacing-defib lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33215","description":"Reposition pacing-defib lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIE1","description":"ICD-JDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5916","description":"Ocular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTC1","description":"ICD-OGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKB0","description":"ICD-NCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of tonsil abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42700","description":"Drainage of tonsil abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hd shck absrber for hd powwc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1018","description":"Hd shck absrber for hd powwc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCC1","description":"ICD-NLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ methotrexate (accord) not therapeutically equivalent to j9250 and j9260_ 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9255","description":"Injection_ methotrexate (accord) not therapeutically equivalent to j9250 and j9260_ 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYD0","description":"ICD-DFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art pancreas ext transmitter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1036","description":"Art pancreas ext transmitter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHA1","description":"ICD-KAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo radical prostatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55866","description":"Laparo radical prostatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFB0","description":"ICD-JDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVD1","description":"ICD-OIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPC0","description":"ICD-FDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTA1","description":"ICD-BGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper ext fx orthosis rad/ul","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3982","description":"Upper ext fx orthosis rad/ul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pros sock single ply upper l","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8485","description":"Pros sock single ply upper l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDE0","description":"ICD-NCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87494","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","description":"CPT-87494","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYA0","description":"ICD-KFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUC1","description":"ICD-OFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOE1","description":"ICD-OBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAE0","description":"ICD-NBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2177","description":"Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46761","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28490","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9703","description":"Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intro/sheath_ fixed_non-peel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1893","description":"Intro/sheath_ fixed_non-peel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDD0","description":"ICD-CBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision malig lesion<=1.25c","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7413","description":"Excision malig lesion<=1.25c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cysto/uretero w/lithotripsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52356","description":"Cysto/uretero w/lithotripsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBD1","description":"ICD-IIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHB1","description":"ICD-EFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRD0","description":"ICD-PLRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig neg scrn depres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8510","description":"Pt inelig neg scrn depres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87634","description":"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLF0","description":"ICD-KBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRF0","description":"ICD-LIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEF1","description":"ICD-EFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15A","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELF1","description":"ICD-CELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMB1","description":"ICD-MKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39000","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLC1","description":"ICD-EGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLC1","description":"ICD-EHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMD0","description":"ICD-FEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68500","description":"Removal of tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEA1","description":"ICD-NGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFA1","description":"ICD-OFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0856","description":"Pwc gp3 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of quinidine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80194","description":"Assay of quinidine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of floor of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41108","description":"Biopsy of floor of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNB0","description":"ICD-GGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tcranial magn stim tx plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90867","description":"Tcranial magn stim tx plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAC1","description":"ICD-NGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFD0","description":"ICD-CFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3A","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00921","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","description":"CPT-00921","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"P2y inhib presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9438","description":"P2y inhib presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2005","description":"Extensive (75 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIB0","description":"ICD-NCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCB0","description":"ICD-OBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPD1","description":"ICD-OCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPF0","description":"ICD-FDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFED0","description":"ICD-NFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair stomach-bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43880","description":"Repair stomach-bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILE0","description":"ICD-OILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee lift loop drop lock rin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2492","description":"Knee lift loop drop lock rin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46607","description":"Diagnostic anoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMC0","description":"ICD-JEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE110","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABE0","description":"ICD-BABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDF0","description":"ICD-FDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrical stimulator supplies (external) for use with implantable neurostimulator_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8678","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53665","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCC1","description":"ICD-OCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIE1","description":"ICD-NLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysat sol fld vol > 249cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4720","description":"Dialysat sol fld vol > 249cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMB1","description":"ICD-MLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIE1","description":"ICD-FIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10A","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDF1","description":"ICD-MEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPF0","description":"ICD-GHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0971T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","description":"CPT-0971T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 15-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86300","description":"Immunoassay tumor ca 15-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimpanzee adenovirus Oxford 1 (ChAdOx1) vector_ pre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91302","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimpanzee adenovirus Oxford 1 (ChAdOx1) vector_ pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLA0","description":"ICD-MJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact layer <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6206","description":"Contact layer <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop ea cast chg & realign","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6386","description":"Postop ea cast chg & realign","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKD1","description":"ICD-NKKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5654","description":"Socket insert symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPC0","description":"ICD-NDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Consultation with a medical health care professional","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9311","description":"Consultation with a medical health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33690","description":"Reinforce pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEE1","description":"ICD-ODEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUB1","description":"ICD-OKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRA0","description":"ICD-KFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHF1","description":"ICD-NAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNA1","description":"ICD-ODNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj dexamethasone acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1094","description":"Inj dexamethasone acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAA0","description":"ICD-MIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6782","description":"Crown 3/4 cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shldr disar prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6550","description":"Shldr disar prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDC1","description":"ICD-KEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHA0","description":"ICD-GHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47000","description":"Needle biopsy of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPE0","description":"ICD-JAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flebogamma injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1572","description":"Flebogamma injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amantadine hcl 100mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9017","description":"Amantadine hcl 100mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0454U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human Papillomavirus vaccine types 6_ 11_ 16_ 18_ 31_ 33_ 45_ 52_ 58_ nonavalent (9vHPV)_ 2 or 3 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90651","description":"Human Papillomavirus vaccine types 6_ 11_ 16_ 18_ 31_ 33_ 45_ 52_ 58_ nonavalent (9vHPV)_ 2 or 3 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct sft tsue nck w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70492","description":"Ct sft tsue nck w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0405","description":"HCPCS-B0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLC1","description":"ICD-ADLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; each additional wound (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0513T","description":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; each additional wound (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parkinsons disease mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8903","description":"Parkinsons disease mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICF1","description":"ICD-JICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFF1","description":"ICD-CHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAF1","description":"ICD-BIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLC0","description":"ICD-FFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","description":"HCPCS-L6028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIA1","description":"ICD-MHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALF0","description":"ICD-EALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","description":"HCPCS-L1006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11B","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mechlorethamine hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9230","description":"Mechlorethamine hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSB1","description":"ICD-KGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLA0","description":"ICD-IGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Review patient spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94016","description":"Review patient spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHA0","description":"ICD-MIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45384","description":"Colonoscopy w/lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIE1","description":"ICD-AEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWA0","description":"ICD-PFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUD0","description":"ICD-JCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplt allo lymphocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38242","description":"Transplt allo lymphocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIC1","description":"ICD-IIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manipulat palm cord post inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26341","description":"Manipulat palm cord post inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKA0","description":"ICD-CBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXC1","description":"ICD-GAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHF0","description":"ICD-EEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0203","description":"HCPCS-C0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artificial larynx_ accessory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8505","description":"Artificial larynx_ accessory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXA0","description":"ICD-NKXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentur repr broken compl bas","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5510","description":"Dentur repr broken compl bas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33478","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEB0","description":"ICD-MEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIB1","description":"ICD-CFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neox 100 or Clarix 100_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4156","description":"Neox 100 or Clarix 100_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALE1","description":"ICD-GALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27654","description":"Repair of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWD1","description":"ICD-DEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAA1","description":"ICD-JGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Io anal gast n-stim subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95981","description":"Io anal gast n-stim subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 5-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99441","description":"Phone e/m phys/qhp 5-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJA0","description":"ICD-GDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX02","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37145","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHD1","description":"ICD-MGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE145","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXD1","description":"ICD-NCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28606","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit longterm infusion diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9347","description":"Hit longterm infusion diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB11","description":"ICD-2IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8E","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 3 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64492","description":"Inj paravert f jnt c/t 3 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOA1","description":"ICD-HCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIF1","description":"ICD-NEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23660","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBF1","description":"ICD-AGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFD0","description":"ICD-OEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAF0","description":"ICD-GBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ metronidazole_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1836","description":"Injection_ metronidazole_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28476","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXF0","description":"ICD-GEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETC1","description":"ICD-CETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1551","description":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00144","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","description":"CPT-00144","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26775","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19000","description":"Drainage of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic appliance full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0660","description":"Pneumatic appliance full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eps Gast Cardia Plic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9724","description":"Eps Gast Cardia Plic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41800","description":"Drainage of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPD0","description":"ICD-CEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABF0","description":"ICD-MABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE135","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Hypotensive Patients Who Are At Immediate Risk Of Cardiogenic Shock_ Hospita","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2093","description":"Documentation Of Medical Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Hypotensive Patients Who Are At Immediate Risk Of Cardiogenic Shock_ Hospita","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainable pch w st wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4389","description":"Drainable pch w st wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYA1","description":"ICD-CDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teclistamab-cqyv_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9380","description":"Injection_ teclistamab-cqyv_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCE1","description":"ICD-FCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9176","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9176","description":"HCPCS-C9176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fentanyl citrate injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3010","description":"Fentanyl citrate injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Community health integration services performed by certified or trained auxiliary personnel_ including a community health worker_ under the direction of a physician or other p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0019","description":"Community health integration services performed by certified or trained auxiliary personnel_ including a community health worker_ under the direction of a physician or other p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEED0","description":"ICD-EEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGF1","description":"ICD-JGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of astigmatism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65775","description":"Correction of astigmatism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virus inoculation tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87252","description":"Virus inoculation tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wedge resect of lung initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32505","description":"Wedge resect of lung initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPB1","description":"ICD-GCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWB1","description":"ICD-OHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD117","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKE0","description":"ICD-FIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSA0","description":"ICD-HDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADF0","description":"ICD-IADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEA1","description":"ICD-AEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHME0","description":"ICD-FHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEF1","description":"ICD-EAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFC1","description":"ICD-OAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc death after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9260","description":"Doc death after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICC1","description":"ICD-OICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gen use back cush wdth>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2612","description":"Gen use back cush wdth>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part removal hip bone deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27071","description":"Part removal hip bone deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDE1","description":"ICD-GCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVA0","description":"ICD-OGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMD0","description":"ICD-IDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28005","description":"Treat foot bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fall risk assessment docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3288F","description":"Fall risk assessment docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1 (breast cancer 1) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie_ exon 13 del 3.835kb_ exo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81214","description":"BRCA1 (breast cancer 1) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie_ exon 13 del 3.835kb_ exo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shorten radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25392","description":"Shorten radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AmnioBand_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4168","description":"AmnioBand_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADA0","description":"ICD-GADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOF0","description":"ICD-LFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy remove myoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58561","description":"Hysteroscopy remove myoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ prothrombin complex concentrate_ human-lans_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7165","description":"Injection_ prothrombin complex concentrate_ human-lans_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0667U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0667U","description":"CPT-0667U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKD1","description":"ICD-JIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGF0","description":"ICD-JFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27637","description":"Remove/graft leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis equipment noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1699","description":"Dialysis equipment noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14D","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documented reason for not screening or recommending a follow-up for high blood pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9745","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMB0","description":"ICD-MBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJC1","description":"ICD-NLJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Pasireotide Long Acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9454","description":"Injection_ Pasireotide Long Acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJF0","description":"ICD-JIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); open_ from cadaver donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0664T","description":"Donor hysterectomy (including cold preservation); open_ from cadaver donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYA1","description":"ICD-OCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31292","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABF1","description":"ICD-EABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUB0","description":"ICD-GGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo molded ankle gauntlet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1904","description":"Afo molded ankle gauntlet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01486","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","description":"CPT-01486","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVC1","description":"ICD-GIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61891","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fistula repair & colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57307","description":"Fistula repair & colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 4 visits p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90960","description":"Esrd srv 4 visits p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMD1","description":"ICD-JBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUC0","description":"ICD-CAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth heart surg w/o pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56051","description":"Anesth heart surg w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0C","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart first pass add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78496","description":"Heart first pass add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYF0","description":"ICD-DAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMD1","description":"ICD-KIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28B","description":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress forearm 2 spaces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25025","description":"Decompress forearm 2 spaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2782","description":"Crown 3/4 cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney dialysate delivry sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1510","description":"Kidney dialysate delivry sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intrvasc us noncoronary addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37253","description":"Intrvasc us noncoronary addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA124","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27740","description":"Repair of leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8X","description":"Medium Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYD1","description":"ICD-PFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJA1","description":"ICD-OGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVB1","description":"ICD-BIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKE1","description":"ICD-JAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXB1","description":"ICD-FHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12001","description":"Rpr s/n/ax/gen/trnk 2.5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQE0","description":"ICD-OLQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient is undergoing palliative dialysis with a catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9749","description":"Patient is undergoing palliative dialysis with a catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Power bone marrow bx needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1830","description":"Power bone marrow bx needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35206","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chem/antisept solution_ 8oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4674","description":"Chem/antisept solution_ 8oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27715","description":"Revision of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGA1","description":"ICD-NLGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQA0","description":"ICD-LIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9748","description":"Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No pt cat and  pt1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9431","description":"No pt cat and  pt1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVD0","description":"ICD-JCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m tetrofosmin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9502","description":"Tc99m tetrofosmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27536","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Minoxidil_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0139","description":"Minoxidil_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYB1","description":"ICD-KHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHA0","description":"ICD-EBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human ig sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90284","description":"Human ig sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with one patie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97153","description":"Adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with one patie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 10 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP10","description":"Auto.test pane pricing code_ 10 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54015","description":"Drain penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High strength ltwt whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0004","description":"High strength ltwt whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUE1","description":"ICD-BIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2132","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYF1","description":"ICD-PCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEB0","description":"ICD-IGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBED1","description":"ICD-FBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9834","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD215","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection Nusinersen 0.1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9489","description":"Injection Nusinersen 0.1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVA0","description":"ICD-JEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLED1","description":"ICD-NLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bp sys <140 and dias <90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8476","description":"Bp sys <140 and dias <90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB11","description":"ICD-4HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ IV_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5138","description":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ IV_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMB1","description":"ICD-FDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of facial/other nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64868","description":"Fusion of facial/other nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthro_ loose body + chondro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0289","description":"Arthro_ loose body + chondro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35304","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMB1","description":"ICD-NAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0220","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXE0","description":"ICD-NEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4045","description":"Cast sup sht leg splnt plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bactericidal level serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87197","description":"Bactericidal level serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADD1","description":"ICD-GADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct thorax w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71260","description":"Ct thorax w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWA0","description":"ICD-PHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCE0","description":"ICD-IGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens variab asphericity sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2410","description":"Lens variab asphericity sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct head/brain w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70470","description":"Ct head/brain w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14A","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50970","description":"Ureter endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWB0","description":"ICD-PKWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient not eligible due to active diagnosis of hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1290","description":"Patient not eligible due to active diagnosis of hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove lumb artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22865","description":"Remove lumb artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sitz bath/equipment w/faucet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0161","description":"Sitz bath/equipment w/faucet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8912","description":"Mra w/cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCC0","description":"ICD-MKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aztreonam_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0073","description":"Injection_ aztreonam_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUA0","description":"ICD-BEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPC1","description":"ICD-NKPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCA0","description":"ICD-JHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAND0","description":"ICD-JAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug screenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0002","description":"Alcohol and/or drug screenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBB1","description":"ICD-CIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPF0","description":"ICD-JDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASC1","description":"ICD-OASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYF0","description":"ICD-OFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No neuropsych symptoms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8948","description":"No neuropsych symptoms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIED1","description":"ICD-EIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXF0","description":"ICD-BBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBD0","description":"ICD-GDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPF0","description":"ICD-CFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBE0","description":"ICD-NIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX41","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFB0","description":"ICD-KBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTF0","description":"ICD-AGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAD0","description":"ICD-BFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1403","description":"HCPCS-A1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUA0","description":"ICD-MBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKA1","description":"ICD-KBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1036T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1036T","description":"CPT-1036T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC21","description":"ICD-3DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBB1","description":"ICD-GBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supp maint employ_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2025","description":"Supp maint employ_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIF0","description":"ICD-BGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc extend prosth init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34825","description":"Endovasc extend prosth init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain spinal cord cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62268","description":"Drain spinal cord cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvas resp support talk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4550F","description":"Noninvas resp support talk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aortic suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33800","description":"Aortic suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ hydroxocobalamin_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3425","description":"Injection_ hydroxocobalamin_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocyte immune globulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7504","description":"Lymphocyte immune globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tubing with heating element","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4604","description":"Tubing with heating element","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPB0","description":"ICD-OJPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA51","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bortezomib injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9041","description":"Bortezomib injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTF1","description":"ICD-CBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCA1","description":"ICD-KBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJB0","description":"ICD-GEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0C","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAD0","description":"ICD-OGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC115","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colpopexy intraperitoneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57283","description":"Colpopexy intraperitoneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYE0","description":"ICD-HAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVE1","description":"ICD-NLVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQF0","description":"ICD-DEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLF1","description":"ICD-NDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYD0","description":"ICD-OKYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFA0","description":"ICD-GEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEC1","description":"ICD-FFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTD0","description":"ICD-JFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDA0","description":"ICD-KHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNE1","description":"ICD-CHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ldl-c >/= 130 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3050F","description":"Ldl-c >/= 130 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHD0","description":"ICD-ABHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRB1","description":"ICD-PHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJA1","description":"ICD-GBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUF1","description":"ICD-EEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anticonv thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4230F","description":"Anticonv thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEA1","description":"ICD-MAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epidrm autogrft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15110","description":"Epidrm autogrft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE254","description":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sys bp less 140","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8752","description":"Sys bp less 140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14D","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc comm risk calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9317","description":"No doc comm risk calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath indw foley 3 way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4346","description":"Cath indw foley 3 way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fc receptor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86243","description":"Fc receptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNA0","description":"ICD-GDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Most recent hemoblobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3051F","description":"Most recent hemoblobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUF1","description":"ICD-KAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct capture limited","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0380","description":"Cone beam ct capture limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE224","description":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYE1","description":"ICD-GGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX06","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test def 8-14 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0481","description":"Drug test def 8-14 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC11","description":"ICD-2GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVD0","description":"ICD-OAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGB1","description":"ICD-NHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLD1","description":"ICD-CFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE217","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKD0","description":"ICD-BCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast add lesion strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19082","description":"Bx breast add lesion strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q2058","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","description":"HCPCS-Q2058","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemolysins/agglutinins auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86940","description":"Hemolysins/agglutinins auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adoptive immunotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2107","description":"Adoptive immunotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADA0","description":"ICD-IADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFD1","description":"ICD-GDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTC1","description":"ICD-OJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA55","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRF1","description":"ICD-LBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 1-4 ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64643","description":"Chemodenerv 1 extrem 1-4 ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBA1","description":"ICD-GGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1018T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","description":"CPT-1018T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst w/enterocele repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58270","description":"Vag hyst w/enterocele repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPF0","description":"ICD-KGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3C","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLC1","description":"ICD-ECLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla x-math non-cytotoxic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86825","description":"Hla x-math non-cytotoxic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA11","description":"ICD-3EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYD1","description":"ICD-LIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVB0","description":"ICD-NIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMD0","description":"ICD-GFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA02","description":"Low Rehab_ ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDD1","description":"ICD-FIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBE0","description":"ICD-GDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC31","description":"ICD-1AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKA0","description":"ICD-FCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Job Coaching 1:2 to 1:4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1734","description":"Employment - Job Coaching 1:2 to 1:4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28208","description":"Repair of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAF0","description":"ICD-EAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Anifrolumab-Fnia_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9086","description":"Injection_ Anifrolumab-Fnia_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ copy number variants and microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81458","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ copy number variants and microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYC1","description":"ICD-CDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMF1","description":"ICD-JDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10D","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery blockage each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75968","description":"Repair artery blockage each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB01","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sensorineural acuity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92575","description":"Sensorineural acuity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICA0","description":"ICD-FICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDA0","description":"ICD-NGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABB1","description":"ICD-OABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUD0","description":"ICD-OEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHD0","description":"ICD-FCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9945","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLF1","description":"ICD-KDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67966","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auditory Evoked Potentials; For Hearing Status Determination_ Broadband Stimuli_ With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92651","description":"Auditory Evoked Potentials; For Hearing Status Determination_ Broadband Stimuli_ With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap rmvl gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43772","description":"Lap rmvl gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCE0","description":"ICD-JFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUA1","description":"ICD-OJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC21","description":"ICD-4GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLF1","description":"ICD-NBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29345","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJD1","description":"ICD-FGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFC0","description":"ICD-JIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB256","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Posterior Chamber Of Eye_ Medication","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0699T","description":"Injection_ Posterior Chamber Of Eye_ Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUC1","description":"ICD-OJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDE1","description":"ICD-NJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tinzaparin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1655","description":"Tinzaparin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absorp drg >48 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0746","description":"Absorp drg >48 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66989","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev resin rest_ perm tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1352","description":"Prev resin rest_ perm tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Expandable controller_ repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2376","description":"Expandable controller_ repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73020","description":"X-ray exam of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intestine transplant live","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44136","description":"Intestine transplant live","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQB1","description":"ICD-KEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45905","description":"Dilation of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 2 hd 301-450 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0807","description":"Pov group 2 hd 301-450 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counselin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1289","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counselin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGE0","description":"ICD-GIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD240","description":"Reduced Physical Function _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETD1","description":"ICD-JETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCF1","description":"ICD-GFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUB1","description":"ICD-ICUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIA0","description":"ICD-JAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal angioplasty with intravascular ultrasound (initial noncoro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7531","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal angioplasty with intravascular ultrasound (initial noncoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE241","description":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCB0","description":"ICD-OCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33954","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21452","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Canalith repositioning proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95992","description":"Canalith repositioning proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATC0","description":"ICD-CATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-CDC SARS-CoV-2/2019-nCoV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0002","description":"Non-CDC SARS-CoV-2/2019-nCoV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepa vacc ped/adol 3 dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90634","description":"Hepa vacc ped/adol 3 dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPA0","description":"ICD-NCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ue not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8670","description":"Fun stat score ue not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psy evaluation of records","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90885","description":"Psy evaluation of records","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUB1","description":"ICD-EFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27500","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHID1","description":"ICD-FHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0502U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","description":"CPT-0502U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAC1","description":"ICD-OKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHA0","description":"ICD-NKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUF1","description":"ICD-BEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHF0","description":"ICD-NLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDF1","description":"ICD-OFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMD1","description":"ICD-CFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open chest heart massage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32160","description":"Open chest heart massage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTE1","description":"ICD-GHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDE1","description":"ICD-NFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ana crown exp 1-3 per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4231","description":"Ana crown exp 1-3 per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ob us detailed addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76812","description":"Ob us detailed addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80329","description":"Analgesics non-opioid 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHD0","description":"ICD-GBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTB1","description":"ICD-ECTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB216","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture_ Typing; Identification Of Blood Pathogen And Resistance Typing_ When Performed_ By Nucleic Acid (Dna Or Rna) Probe_ Multiplexed Amplified Probe Technique Including Mu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87154","description":"Culture_ Typing; Identification Of Blood Pathogen And Resistance Typing_ When Performed_ By Nucleic Acid (Dna Or Rna) Probe_ Multiplexed Amplified Probe Technique Including Mu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTC0","description":"ICD-FFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21407","description":"Opn tx orbit fx w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 2 vhd 451-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0808","description":"Pov group 2 vhd 451-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular disease_ plasma_ analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019M","description":"Cardiovascular disease_ plasma_ analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSE1","description":"ICD-CFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUB1","description":"ICD-KAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25505","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNC1","description":"ICD-FCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSB0","description":"ICD-PLSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDA1","description":"ICD-MDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESB1","description":"ICD-PESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHB0","description":"ICD-FHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOF0","description":"ICD-DEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ampicillin sodium per 1.5 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0295","description":"Ampicillin sodium per 1.5 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWE1","description":"ICD-PHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay chondroitin sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82485","description":"Assay chondroitin sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ammonia test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4774","description":"Ammonia test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEE1","description":"ICD-BFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathology lab procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89240","description":"Pathology lab procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNC1","description":"ICD-CGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vertebral body tethering_ anterior; 8 or more vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0657T","description":"Vertebral body tethering_ anterior; 8 or more vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","description":"HCPCS-J2804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLF1","description":"ICD-IDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost skn barr extnd >4 sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4410","description":"Ost skn barr extnd >4 sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tongue removal neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41145","description":"Tongue removal neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow imaging ltd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78102","description":"Bone marrow imaging ltd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAD0","description":"ICD-BBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVD1","description":"ICD-CAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHF0","description":"ICD-OIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUC0","description":"ICD-ECUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBC0","description":"ICD-ACBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUD0","description":"ICD-NKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADF0","description":"ICD-CADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICC1","description":"ICD-EICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sialoendoscopy capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0371","description":"Sialoendoscopy capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin w/ base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2721","description":"Crown resin w/ base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA44","description":"High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDD0","description":"ICD-EHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHA1","description":"ICD-GCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKF1","description":"ICD-GFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27562","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJE0","description":"ICD-CBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22840","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Specimen fat stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89125","description":"Specimen fat stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUF0","description":"ICD-IEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Promazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2950","description":"Promazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRD0","description":"ICD-CFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0608U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","description":"CPT-0608U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYB1","description":"ICD-DBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/density","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86972","description":"Rbc pretx incubatj w/density","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluocinol acet intravit imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7313","description":"Fluocinol acet intravit imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELD1","description":"ICD-IELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRD0","description":"ICD-OGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0B","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo drain lymphocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49323","description":"Laparo drain lymphocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl oral cushion combo mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7028","description":"Repl oral cushion combo mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAA1","description":"ICD-ECAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRD1","description":"ICD-PLRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXA1","description":"ICD-FGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPA0","description":"ICD-GIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSC1","description":"ICD-HHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD134","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTE0","description":"ICD-JGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHID0","description":"ICD-FHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15946","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYC0","description":"ICD-PFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8I","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolytic antiplasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85410","description":"Fibrinolytic antiplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of major vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37660","description":"Revision of major vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDA0","description":"ICD-IFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50957","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using posttransplant peripheral blood_ algorithm reported as a risk score for acute cellular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0320U","description":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using posttransplant peripheral blood_ algorithm reported as a risk score for acute cellular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMD1","description":"ICD-AAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKE1","description":"ICD-CGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUF0","description":"ICD-NDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lamellar bdy fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83664","description":"Lamellar bdy fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetics 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88272","description":"Cytogenetics 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAC1","description":"ICD-NHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8610","description":"Ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gr27 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2371","description":"Gr27 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 5_ gene duplication/multiplication) (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0075U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 5_ gene duplication/multiplication) (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDME1","description":"ICD-IDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATB0","description":"ICD-CATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGF0","description":"ICD-CCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGB0","description":"ICD-FIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht inj hormone diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9560","description":"Ht inj hormone diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penile vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93981","description":"Penile vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0494","description":"Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPB0","description":"ICD-OEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNB0","description":"ICD-FHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coccidioides antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86635","description":"Coccidioides antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"C-reactive protein hs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86141","description":"C-reactive protein hs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1042T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1042T","description":"CPT-1042T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8I","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release forearm/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26449","description":"Release forearm/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cholera vaccine for injectable use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90725","description":"Cholera vaccine for injectable use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE135","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESD1","description":"ICD-CESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mobilization of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44139","description":"Mobilization of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAE0","description":"ICD-FBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open aortic tube prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34830","description":"Open aortic tube prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAD1","description":"ICD-GDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem oct rta techl sprt min 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0605T","description":"Rem oct rta techl sprt min 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psytx crisis initial 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90839","description":"Psytx crisis initial 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mumps antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86735","description":"Mumps antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOA0","description":"ICD-PEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAA0","description":"ICD-FIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKF0","description":"ICD-JCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKD0","description":"ICD-KIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE245","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso full corset","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0974","description":"Tlso full corset","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSC1","description":"ICD-KCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKE1","description":"ICD-NEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIND1","description":"ICD-KIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFE0","description":"ICD-FFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQE1","description":"ICD-GFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQC0","description":"ICD-LBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYB1","description":"ICD-KDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEF0","description":"ICD-BBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62326","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUF1","description":"ICD-JFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPD1","description":"ICD-GFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Halo cervical into jckt vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0810","description":"Halo cervical into jckt vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBID0","description":"ICD-NBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVA1","description":"ICD-GIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA146","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACC1","description":"ICD-MACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8F","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mastectomy form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8020","description":"Mastectomy form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAF1","description":"ICD-CEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sbsq nb em per day hosp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99462","description":"Sbsq nb em per day hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKF0","description":"ICD-KGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin sub graft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15272","description":"Skin sub graft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelets_ irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9032","description":"Platelets_ irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBC0","description":"ICD-FEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCB0","description":"ICD-CHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEA1","description":"ICD-GBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRF0","description":"ICD-KBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYB0","description":"ICD-OGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVB1","description":"ICD-BFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBA1","description":"ICD-EBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levalbuterol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7612","description":"Levalbuterol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18G","description":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIF1","description":"ICD-KBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUB1","description":"ICD-MGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening barbiturates","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80345","description":"Drug screening barbiturates","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILA1","description":"ICD-CILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYF0","description":"ICD-PJYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHE1","description":"ICD-GGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE250","description":"Reduced Physical Function _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBD0","description":"ICD-MEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplant palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26485","description":"Transplant palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSD1","description":"ICD-OHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILE1","description":"ICD-NILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dicom format image data availability not documented in final report due to medical reasons (eg_CT studies performed for radiation treatment planning or image-guided radiation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9328","description":"Dicom format image data availability not documented in final report due to medical reasons (eg_CT studies performed for radiation treatment planning or image-guided radiation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUB0","description":"ICD-ADUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQA0","description":"ICD-CHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spring-ass rot wrst w/ latch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6623","description":"Spring-ass rot wrst w/ latch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC12","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ olanzapine_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2359","description":"Injection_ olanzapine_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx med space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32606","description":"Thoracoscopy w/bx med space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place cath thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36221","description":"Place cath thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6075","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cr51 chromate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9553","description":"Cr51 chromate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB113","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPC0","description":"ICD-JGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair rotator cuff chronic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23412","description":"Repair rotator cuff chronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTC0","description":"ICD-CDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVD1","description":"ICD-FAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUA1","description":"ICD-MGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIF1","description":"ICD-NHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIF1","description":"ICD-CEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC31","description":"ICD-3AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQC0","description":"ICD-DFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region infection at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1039","description":"Patients with a diagnosis of lumbar spine region infection at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIE0","description":"ICD-AGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1809","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","description":"HCPCS-J1809","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ configuration of wave form_ battery status_ elect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95973","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ configuration of wave form_ battery status_ elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligate leg veins radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37760","description":"Ligate leg veins radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy for treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31527","description":"Laryngoscopy for treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGE1","description":"ICD-KCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHE0","description":"ICD-KHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAE1","description":"ICD-ADAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWB1","description":"ICD-PLWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKD0","description":"ICD-NLKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skull base/brainstem surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61575","description":"Skull base/brainstem surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Children who were not screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9967","description":"Children who were not screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25909","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid check one ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92592","description":"Hearing aid check one ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv trunk musc 1-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64646","description":"Chemodenerv trunk musc 1-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ashkenazi jewish assoc dis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81412","description":"Ashkenazi jewish assoc dis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVC1","description":"ICD-JDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37268","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","description":"CPT-37268","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDC1","description":"ICD-MCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ank symes mold sckt sach ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5050","description":"Ank symes mold sckt sach ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLB1","description":"ICD-BGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1400","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","description":"HCPCS-M1400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft subclav-vertbrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35515","description":"Art byp grft subclav-vertbrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0506U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","description":"CPT-0506U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYD0","description":"ICD-LEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ torso and shoulder_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6568","description":"Gradient compression garment_ torso and shoulder_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEE1","description":"ICD-KAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25574","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGD1","description":"ICD-CAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47051","description":"Anesth removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67975","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQC1","description":"ICD-LGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation of wheezing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94060","description":"Evaluation of wheezing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped home apnea rec compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94774","description":"Ped home apnea rec compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES221","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syph scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3512F","description":"Syph scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFC0","description":"ICD-JEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96203","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES206","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid imaging w/blood flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78014","description":"Thyroid imaging w/blood flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSB0","description":"ICD-KDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQE0","description":"ICD-OKQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSD0","description":"ICD-LCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","description":"HCPCS-E1807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQE1","description":"ICD-CCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKB1","description":"ICD-NBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLD1","description":"ICD-MCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJE0","description":"ICD-NAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD234","description":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eyelid lining surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68399","description":"Eyelid lining surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEF1","description":"ICD-BBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed fixed ht w/ mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0250","description":"Hosp bed fixed ht w/ mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: headache radiating to the neck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2190","description":"Patients with clinical indications for imaging of the head: headache radiating to the neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rhythm ecg with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93040","description":"Rhythm ecg with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGD0","description":"ICD-GCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin splt grft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15101","description":"Skin splt grft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test for porphobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84106","description":"Test for porphobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8544","description":"Cabg measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXD1","description":"ICD-BDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFE1","description":"ICD-FAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB31","description":"ICD-1LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIA0","description":"ICD-MFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTB0","description":"ICD-OKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBF1","description":"ICD-AFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMD0","description":"ICD-OBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nb resuscitation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99465","description":"Nb resuscitation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENE1","description":"ICD-KENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of phenobarbital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80184","description":"Assay of phenobarbital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIF0","description":"ICD-CDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASE0","description":"ICD-HASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8I","description":"Very High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Felbamate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80167","description":"Felbamate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBF0","description":"ICD-FEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXE1","description":"ICD-BCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antepartum management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1001","description":"Antepartum management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repositioning of teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7290","description":"Repositioning of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRD1","description":"ICD-DDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMB1","description":"ICD-EFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prim art m-thrmbc 1st vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37184","description":"Prim art m-thrmbc 1st vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXB1","description":"ICD-KHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYA0","description":"ICD-CGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNC0","description":"ICD-GBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNB0","description":"ICD-CFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cephalin floculation test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2028","description":"Cephalin floculation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSE0","description":"ICD-LDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14C","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0604","description":"HCPCS-B0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBA0","description":"ICD-FFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAC0","description":"ICD-OAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB111","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27257","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX21","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHF0","description":"ICD-EFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ra meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8499","description":"Ra meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Care plan hgb docd esa pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0514F","description":"Care plan hgb docd esa pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFB1","description":"ICD-JIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUD1","description":"ICD-KEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEF1","description":"ICD-MKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetaminophen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6039","description":"Acetaminophen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1166","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50290","description":"Removal of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB121","description":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ Pressure-Generating_ One-Way Valve_ Intermittently Occlusive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1982","description":"Catheter_ Pressure-Generating_ One-Way Valve_ Intermittently Occlusive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative screen metals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83018","description":"Quantitative screen metals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phentolaine mesylate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2760","description":"Phentolaine mesylate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen crosslinking cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0402T","description":"Collagen crosslinking cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8I","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBC0","description":"ICD-CBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMB0","description":"ICD-OKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3386","description":"HCPCS-J3386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAD1","description":"ICD-NFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36014","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOA1","description":"ICD-CFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 1 hd 301-450 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0801","description":"Pov group 1 hd 301-450 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTC0","description":"ICD-GHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay duodenal fluid trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84485","description":"Assay duodenal fluid trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBD1","description":"ICD-KHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flt3 gene analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81246","description":"Flt3 gene analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJID0","description":"ICD-MJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFE0","description":"ICD-GDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcv <10mg daily predniso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4193F","description":"Pt rcv <10mg daily predniso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt care icu&vent w/in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4168F","description":"Pt care icu&vent w/in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ear impression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5275","description":"Ear impression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0769T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted to a SPU or and ASC for a procedure which could not be certified as medically necessary for that place of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0596","description":"Patient admitted to a SPU or and ASC for a procedure which could not be certified as medically necessary for that place of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spec gene test hyp cardiomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3866","description":"Spec gene test hyp cardiomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA CRYPTOCOCCUS NEOFORMANS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87327","description":"IAAD IA CRYPTOCOCCUS NEOFORMANS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWB1","description":"ICD-OBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc (ovarian) biocheml assays of five proteins (apolipoprotein A-1_ CA 125 II_ follicle stimulating hormone_ human epididymis protein 4_ transferrin)_ utilizing serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003U","description":"Onc (ovarian) biocheml assays of five proteins (apolipoprotein A-1_ CA 125 II_ follicle stimulating hormone_ human epididymis protein 4_ transferrin)_ utilizing serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC11","description":"ICD-2KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42970","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUE0","description":"ICD-NKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOB1","description":"ICD-PKOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Toe loop/holder_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0952","description":"Toe loop/holder_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSE1","description":"ICD-LFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCB0","description":"ICD-MKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMA1","description":"ICD-MLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOC1","description":"ICD-DEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol (ethanol); any specimen except breath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6040","description":"Alcohol (ethanol); any specimen except breath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWA1","description":"ICD-LIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0803T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLB0","description":"ICD-GDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEB1","description":"ICD-IAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSB1","description":"ICD-GFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAF0","description":"ICD-IFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDE1","description":"ICD-CGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICB1","description":"ICD-NICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGE1","description":"ICD-GBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQD1","description":"ICD-GEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBD0","description":"ICD-FIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNF0","description":"ICD-GDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise thumb tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26496","description":"Revise thumb tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICME1","description":"ICD-ICME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUE1","description":"ICD-BCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGED1","description":"ICD-IGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBF0","description":"ICD-FIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Identify sperm tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89264","description":"Identify sperm tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor liver lobe split","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47145","description":"Prep donor liver lobe split","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHA0","description":"ICD-ODHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA236","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCF1","description":"ICD-GHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADB1","description":"ICD-BADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impression casting ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0395","description":"Impression casting ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUD1","description":"ICD-CEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0321","description":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL22","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRA1","description":"ICD-KHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Durolane_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9465","description":"Hyaluronan or derivative_ Durolane_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERA0","description":"ICD-CERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRE1","description":"ICD-LHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEA0","description":"ICD-EAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDA0","description":"ICD-AGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84233","description":"Assay of estrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNA1","description":"ICD-FGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adults currently taking pharmacotherapy for OUD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1032","description":"Adults currently taking pharmacotherapy for OUD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBF0","description":"ICD-JDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice routine home care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2042","description":"Hospice routine home care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDID0","description":"ICD-MDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No knee joint with artic ali","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5220","description":"No knee joint with artic ali","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; requiring revision of gastrostomy tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43763","description":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; requiring revision of gastrostomy tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lactation class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9443","description":"Lactation class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Cutaneous Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81529","description":"Oncology (Cutaneous Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTB1","description":"ICD-JCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBA0","description":"ICD-CEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAA1","description":"ICD-JHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIC1","description":"ICD-BAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVE0","description":"ICD-OFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWF0","description":"ICD-KCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVE1","description":"ICD-CGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Humidifier for use w/ regula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0555","description":"Humidifier for use w/ regula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0682T","description":"Removal Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATA1","description":"ICD-MATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extraoral first film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0250","description":"Extraoral first film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including CT guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10009","description":"Fine needle aspiration biopsy_ including CT guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIB1","description":"ICD-EFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLE1","description":"ICD-BDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYA1","description":"ICD-OKYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst nbl mtl >=3 surfac","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6615","description":"Onlay cst nbl mtl >=3 surfac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKD1","description":"ICD-OFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOE0","description":"ICD-GCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIE1","description":"ICD-KGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-97008","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","description":"CPT-97008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99224","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAE0","description":"ICD-FFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALA1","description":"ICD-NALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIE1","description":"ICD-EGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEB1","description":"ICD-CDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerv collar supp adj cerv ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0190","description":"Cerv collar supp adj cerv ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEB1","description":"ICD-CGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shingrix vaccine documented as administered or previously received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1064","description":"Shingrix vaccine documented as administered or previously received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOE1","description":"ICD-PDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNC0","description":"ICD-GGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUA1","description":"ICD-KHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWD0","description":"ICD-PDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFB0","description":"ICD-BBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXD1","description":"ICD-OBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQB1","description":"ICD-LGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ire abltj 1+tum organ perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0600T","description":"Ire abltj 1+tum organ perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFF1","description":"ICD-CEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTA1","description":"ICD-AFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair special seat heig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1296","description":"Wheelchair special seat heig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMF0","description":"ICD-EAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42845","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDA0","description":"ICD-MEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10D","description":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microsomal antibody each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86376","description":"Microsomal antibody each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAF1","description":"ICD-KHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCE0","description":"ICD-EBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABE1","description":"ICD-FABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBF1","description":"ICD-NFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect apical lung tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32503","description":"Resect apical lung tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9750","description":"Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transport chair pt wt<=300lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1038","description":"Transport chair pt wt<=300lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC250","description":"Clinically Complex _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral everolimus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7527","description":"Oral everolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRB0","description":"ICD-OJRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin fluid swing p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5824","description":"Endo knee-shin fluid swing p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNA0","description":"ICD-JGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQC0","description":"ICD-OLQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENE1","description":"ICD-OENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64580","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDE0","description":"ICD-BBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXF1","description":"ICD-BGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI w/o fol w/cont_ brst_ un","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8905","description":"MRI w/o fol w/cont_ brst_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJE0","description":"ICD-OBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Disease Other Than Dissection (Eg_ Aneurysm)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33859","description":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Disease Other Than Dissection (Eg_ Aneurysm)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUF1","description":"ICD-GBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hbv assess&results intrp 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3517F","description":"Hbv assess&results intrp 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBC0","description":"ICD-BEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Above knee cushion socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5648","description":"Above knee cushion socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLA1","description":"ICD-FFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of toes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29550","description":"Strapping of toes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aztreonam_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0457","description":"Injection_ aztreonam_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTD1","description":"ICD-IGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21182","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot external keel sach foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5970","description":"Foot external keel sach foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand restoration no fingers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6910","description":"Hand restoration no fingers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41113","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCC1","description":"ICD-NHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Longevity And Mortality Risk_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 18 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0294U","description":"Longevity And Mortality Risk_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 18 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Preparation And Transmission Of Data For Analysis To Be Performed Elsewhere","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77090","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Preparation And Transmission Of Data For Analysis To Be Performed Elsewhere","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-43889","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","description":"CPT-43889","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plastic mod low ext pad/line","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2275","description":"Plastic mod low ext pad/line","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81234","description":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX41","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14C","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Induction of vomiting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99175","description":"Induction of vomiting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYF0","description":"ICD-OGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Paricalcitol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2501","description":"Paricalcitol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTA1","description":"ICD-NDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIB1","description":"ICD-OEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI pelvis w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72196","description":"MRI pelvis w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAA1","description":"ICD-GGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCD0","description":"ICD-KHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Follow-Up And Mrs Score Assessed At 90 Days Following Endovascular Stroke Intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0045","description":"Clinical Follow-Up And Mrs Score Assessed At 90 Days Following Endovascular Stroke Intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23A","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE245","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEA1","description":"ICD-CEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGA1","description":"ICD-FGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE113","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove part lumbar vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22114","description":"Remove part lumbar vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neg press wound therapy pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2402","description":"Neg press wound therapy pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLC1","description":"ICD-IHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Variable concentration mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4620","description":"Variable concentration mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAME1","description":"ICD-EAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBA1","description":"ICD-AHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 50NCG/0.25ML IM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91306","description":"SARSCOV2 VAC 50NCG/0.25ML IM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBC0","description":"ICD-OLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJA1","description":"ICD-KFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA51","description":"Medium Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBND1","description":"ICD-BBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHD1","description":"ICD-BEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8931","description":"Mra_ w/dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB02","description":"Very High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O shoe add felt w leath insl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3520","description":"O shoe add felt w leath insl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28060","description":"Partial removal foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEC1","description":"ICD-CDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDE0","description":"ICD-NKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy retro balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43213","description":"Esophagoscopy retro balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81289","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","description":"HCPCS-A2028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPB0","description":"ICD-KDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCD0","description":"ICD-NGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No syst antimicrobial thx rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4132F","description":"No syst antimicrobial thx rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64832","description":"Repair nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCE0","description":"ICD-IHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDC1","description":"ICD-KCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUE1","description":"ICD-NDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACF1","description":"ICD-MACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion identification_ characterizatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0865T","description":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion identification_ characterizatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No pt care icu/vent in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4169F","description":"No pt care icu/vent in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPE0","description":"ICD-KAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of finger jnt add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26861","description":"Fusion of finger jnt add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVF1","description":"ICD-JIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28B","description":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28320","description":"Repair of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair special seat dept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1297","description":"Wheelchair special seat dept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19380","description":"Revise breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJE1","description":"ICD-FFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51555","description":"Partial removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKA1","description":"ICD-NHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9300","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9300","description":"HCPCS-C9300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTE1","description":"ICD-OLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep b vac injxn admin/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4149F","description":"Hep b vac injxn admin/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWF1","description":"ICD-KGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSC0","description":"ICD-DBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWE0","description":"ICD-OJWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4030","description":"Pulmonology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Expiratory positive airway pressure intranasal resistance valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7049","description":"Expiratory positive airway pressure intranasal resistance valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGF0","description":"ICD-NLGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablation Of Malignant Prostate Tissue_ Transrectal_ With High Intensity-Focused Ultrasound (Hifu)_ Including Ultrasound Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55880","description":"Ablation Of Malignant Prostate Tissue_ Transrectal_ With High Intensity-Focused Ultrasound (Hifu)_ Including Ultrasound Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGD1","description":"ICD-BFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spirom fev/fvc <70% w/copd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3025F","description":"Spirom fev/fvc <70% w/copd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressant rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4064F","description":"Antidepressant rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd pneum dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87485","description":"Chylmd pneum dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIA1","description":"ICD-KEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPE1","description":"ICD-KCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSF1","description":"ICD-LHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOA0","description":"ICD-OFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMC1","description":"ICD-OHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lev 4 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0383","description":"Lev 4 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXD1","description":"ICD-JIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECD1","description":"ICD-AECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB16","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abut support crown titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6094","description":"Abut support crown titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dysphagia screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5364","description":"Dysphagia screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVF0","description":"ICD-NDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDA0","description":"ICD-EGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXA1","description":"ICD-JEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87636","description":"IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQC1","description":"ICD-OJQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc esrd dia trans preg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9231","description":"Doc esrd dia trans preg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Outer ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69399","description":"Outer ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBD0","description":"ICD-OEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHC0","description":"ICD-JEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWD0","description":"ICD-OBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAF1","description":"ICD-JDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDF0","description":"ICD-KEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACE0","description":"ICD-AACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVA0","description":"ICD-JHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0302T","description":"Icar ischm mntrng sys compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC21","description":"ICD-3CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diast bp <80 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3078F","description":"Diast bp <80 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWE0","description":"ICD-KHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA21","description":"ICD-3IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemotx admn prtl cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96446","description":"Chemotx admn prtl cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine chloride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82436","description":"Assay of urine chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPB1","description":"ICD-NFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDE1","description":"ICD-NEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGE0","description":"ICD-BCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0945T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","description":"CPT-0945T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Atten d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9167","description":"Atten d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23D","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCC1","description":"ICD-OLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIA1","description":"ICD-NCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Azathioprine parenteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7501","description":"Azathioprine parenteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJC0","description":"ICD-OFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB30","description":"High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Femoral endovas graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34813","description":"Femoral endovas graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0013","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLF1","description":"ICD-OCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLE0","description":"ICD-CGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1x scrn hcv infect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9451","description":"1x scrn hcv infect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial exam involved joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2004F","description":"Initial exam involved joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB41","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIA1","description":"ICD-CDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4370","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","description":"HCPCS-Q4370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (papillary thyroid cancer)_ gene-expression profiling via targeted hybrid capture–enrichment RNA sequencing of 82 content genes and 10 housekeeping genes_ formalin-fi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0362U","description":"Oncology (papillary thyroid cancer)_ gene-expression profiling via targeted hybrid capture–enrichment RNA sequencing of 82 content genes and 10 housekeeping genes_ formalin-fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; thin layer_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82489","description":"Chromatography_ qualitative; thin layer_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95925","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter_ including recording_ with interpretation and written report_ up to 30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95836","description":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter_ including recording_ with interpretation and written report_ up to 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWB1","description":"ICD-CCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJF0","description":"ICD-CBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optx post ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27769","description":"Optx post ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNE1","description":"ICD-GBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWE0","description":"ICD-DFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo partial colectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44204","description":"Laparo partial colectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dtap-hep b-ipv vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90723","description":"Dtap-hep b-ipv vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKD0","description":"ICD-KEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDE1","description":"ICD-BHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAC1","description":"ICD-NDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSE0","description":"ICD-DCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIA1","description":"ICD-KDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXD0","description":"ICD-CFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NEURO INH ATAXIA DNA 12 COM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0216U","description":"NEURO INH ATAXIA DNA 12 COM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACA1","description":"ICD-MACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKE1","description":"ICD-BHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNF0","description":"ICD-OBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNA1","description":"ICD-OLNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACE1","description":"ICD-CACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC240","description":"Reduced Physical Function _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEE0","description":"ICD-IAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMD1","description":"ICD-MLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUE0","description":"ICD-ODUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGB1","description":"ICD-JFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/.25-2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2111","description":"Spherocylindr 7.25d/.25-2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intro/sheath_ laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2629","description":"Intro/sheath_ laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBE0","description":"ICD-FGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFD1","description":"ICD-GHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6060","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9191","description":"Pt reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AmnioCyte Plus_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4242","description":"AmnioCyte Plus_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTF0","description":"ICD-ACTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acp discuss/dscn mkr docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1123F","description":"Acp discuss/dscn mkr docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enfuvirtide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1324","description":"Enfuvirtide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCC1","description":"ICD-BBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYD0","description":"ICD-KCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00541","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","description":"CPT-00541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKF1","description":"ICD-BBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGF0","description":"ICD-BAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMD1","description":"ICD-FAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sinusitis intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9463","description":"Sinusitis intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYB1","description":"ICD-GEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHB0","description":"ICD-AHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUA0","description":"ICD-GHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCD0","description":"ICD-CCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAA1","description":"ICD-CHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPD0","description":"ICD-OAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not disch to home day#7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8825","description":"Pt not disch to home day#7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYE0","description":"ICD-HCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Term dev mech hook vol close","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6707","description":"Term dev mech hook vol close","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUE0","description":"ICD-EGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEF1","description":"ICD-AIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21083","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGC0","description":"ICD-CHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUC0","description":"ICD-MAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUB0","description":"ICD-FCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOC1","description":"ICD-PHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoluminal bx urtr rnl plvs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50606","description":"Endoluminal bx urtr rnl plvs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLE1","description":"ICD-CFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIA0","description":"ICD-CIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ra disease activity low","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3470F","description":"Ra disease activity low","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18X","description":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWE1","description":"ICD-HGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSA1","description":"ICD-HBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD144","description":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1396","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","description":"HCPCS-M1396","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECE1","description":"ICD-GECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUE0","description":"ICD-MFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHB1","description":"ICD-AEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXF1","description":"ICD-GGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine&cord 2 trx crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63196","description":"Incise spine&cord 2 trx crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTA0","description":"ICD-CGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBB0","description":"ICD-NGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental panoramic film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0330","description":"Dental panoramic film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCD1","description":"ICD-OCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUF0","description":"ICD-EIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYB0","description":"ICD-OJYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD156","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHE1","description":"ICD-OKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68760","description":"Close tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1136","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKA0","description":"ICD-CGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWC1","description":"ICD-KDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maxilla or mandible resectio","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7490","description":"Maxilla or mandible resectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOD0","description":"ICD-DCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair prosth valve clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33496","description":"Repair prosth valve clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9292","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","description":"HCPCS-J9292","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0612U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","description":"CPT-0612U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYD1","description":"ICD-LCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCC1","description":"ICD-ABCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOE1","description":"ICD-PBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64902","description":"Nerve graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneuma compresor non-segment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0650","description":"Pneuma compresor non-segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJF0","description":"ICD-KCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC201","description":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMD0","description":"ICD-MIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDC0","description":"ICD-GGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67825","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic prop tire insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2213","description":"Pneumatic prop tire insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTB1","description":"ICD-JGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAC1","description":"ICD-CGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHC0","description":"ICD-JFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRD0","description":"ICD-GFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKE0","description":"ICD-FGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10B","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLD0","description":"ICD-MGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25C","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGE0","description":"ICD-NJGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQE1","description":"ICD-HAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pelvic fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57020","description":"Drainage of pelvic fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIC1","description":"ICD-JEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHID0","description":"ICD-BHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIE1","description":"ICD-KEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cataract measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8906","description":"Cataract measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHC1","description":"ICD-GCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethro w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52441","description":"Cystourethro w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBD0","description":"ICD-GEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep b scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3513F","description":"Hep b scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Singlay_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4329","description":"Singlay_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc repair abdom aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75952","description":"Endovasc repair abdom aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pin finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26776","description":"Pin finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDC0","description":"ICD-NKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITE1","description":"ICD-EITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGD0","description":"ICD-OBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQA1","description":"ICD-HBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96113","description":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBA0","description":"ICD-FHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVD0","description":"ICD-NKVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHC0","description":"ICD-IGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9278","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","description":"HCPCS-J9278","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replc tth&acrlc on mtl frmwk","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5670","description":"Replc tth&acrlc on mtl frmwk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILE1","description":"ICD-OILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67903","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQE1","description":"ICD-GGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ gold-198","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1716","description":"Brachytx_ non-str_ gold-198","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFA1","description":"ICD-BDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXB0","description":"ICD-CEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMB1","description":"ICD-OBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALD1","description":"ICD-JALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARD0","description":"ICD-HARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAF1","description":"ICD-IBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE221","description":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHB0","description":"ICD-EGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCE0","description":"ICD-ACCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aoe comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9466","description":"Aoe comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; Birth Through 5 Years Of Age Or Any","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33018","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; Birth Through 5 Years Of Age Or Any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB145","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDF1","description":"ICD-AEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENA0","description":"ICD-JENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Guidance for radiaj tx dlvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77387","description":"Guidance for radiaj tx dlvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0402","description":"HCPCS-A0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYB1","description":"ICD-HGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bckdhb gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81205","description":"Bckdhb gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rear whl compl pneum tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0070","description":"Rear whl compl pneum tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 13.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7301","description":"Levonorgestrel iu 13.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0526","description":"Management of established patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replc tth&acrlc mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5671","description":"Replc tth&acrlc mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vbac delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59612","description":"Vbac delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB31","description":"ICD-3JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam knee 4 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73564","description":"X-ray exam knee 4 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of spermatic ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54900","description":"Fusion of spermatic ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL44","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL41","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOB0","description":"ICD-KGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9351","description":"Doc >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWC1","description":"ICD-KBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MSH6 (mutS homolog 6) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0160U","description":"MSH6 (mutS homolog 6) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQA1","description":"ICD-PKQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cancer treatment plan change","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0354","description":"Cancer treatment plan change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGF0","description":"ICD-FAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPA0","description":"ICD-CGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged service inpatient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99356","description":"Prolonged service inpatient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKC1","description":"ICD-CEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace socket brim cust fit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4030","description":"Replace socket brim cust fit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45520","description":"Treatment of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flexion/extension wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6620","description":"Flexion/extension wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCB0","description":"ICD-JCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper arm/elbow surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24999","description":"Upper arm/elbow surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64567","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","description":"CPT-64567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chiropract manj xtrspinl 1/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98943","description":"Chiropract manj xtrspinl 1/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHE1","description":"ICD-MAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0521","description":"Management of new patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCID1","description":"ICD-CCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0974T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","description":"CPT-0974T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAC1","description":"ICD-ICAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSB1","description":"ICD-LDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin (fiasp) for administration through dme (i.e._ insulin pump) per 50 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1811","description":"Insulin (fiasp) for administration through dme (i.e._ insulin pump) per 50 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Order for ceph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9197","description":"Order for ceph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triptorelin extended release_ 3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9016","description":"Injection_ triptorelin extended release_ 3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AmnioArmor_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4188","description":"AmnioArmor_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy accessory convex inse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5093","description":"Ostomy accessory convex inse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD255","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKE1","description":"ICD-KHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGC1","description":"ICD-OCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLA1","description":"ICD-GHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc skin abd add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15847","description":"Exc skin abd add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEE1","description":"ICD-NHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit new age 12-17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99384","description":"Prev visit new age 12-17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAA0","description":"ICD-BDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF)_ derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0900T","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF)_ derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKA1","description":"ICD-OKKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMF1","description":"ICD-FEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGE1","description":"ICD-CIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAF0","description":"ICD-MCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEF0","description":"ICD-JIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA33","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33813","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPB1","description":"ICD-CGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMC1","description":"ICD-GHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLC0","description":"ICD-ODLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No improve visual funct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0915","description":"No improve visual funct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrafiltration monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9007","description":"Ultrafiltration monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthr0 w/debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29862","description":"Hip arthr0 w/debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAB1","description":"ICD-IDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSA1","description":"ICD-GFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPE1","description":"ICD-BGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin w/ high noble me","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2720","description":"Crown resin w/ high noble me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUC1","description":"ICD-BEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27808","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIC1","description":"ICD-FIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTD0","description":"ICD-IBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54660","description":"Revision of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nras gene variants exon 2&3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81311","description":"Nras gene variants exon 2&3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFF1","description":"ICD-OAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMD0","description":"ICD-KCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFND1","description":"ICD-BFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECF1","description":"ICD-MECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L7406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","description":"HCPCS-L7406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pentostatin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9268","description":"Pentostatin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLE0","description":"ICD-KGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADE1","description":"ICD-FADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enteral ng tubing w/o stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4082","description":"Enteral ng tubing w/o stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDB1","description":"ICD-IGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx duod intub w/asp spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43756","description":"Dx duod intub w/asp spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4208","description":"3 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGE1","description":"ICD-JBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemical peel nonfacial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15792","description":"Chemical peel nonfacial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary service/procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94799","description":"Pulmonary service/procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat tail bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27200","description":"Treat tail bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB14","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDE1","description":"ICD-NCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDB0","description":"ICD-IGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ Response To Radiation_ Cell-Free Dna_ Quantitative Branched Chain Dna Amplification_ Plasma_ Reported As A Radiation Toxicity Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0285U","description":"Oncology_ Response To Radiation_ Cell-Free Dna_ Quantitative Branched Chain Dna Amplification_ Plasma_ Reported As A Radiation Toxicity Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-emer transport wait time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2007","description":"Non-emer transport wait time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens/es other type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2599","description":"Contact lens/es other type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUE0","description":"ICD-MBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; reducibl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49621","description":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; reducibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADB1","description":"ICD-GADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLF0","description":"ICD-JDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74250","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXB0","description":"ICD-NEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Estradiol valerate 10 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1380","description":"Estradiol valerate 10 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable sensor_ cgm sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9276","description":"Disposable sensor_ cgm sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETF1","description":"ICD-IETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYD0","description":"ICD-KAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sio rig pnl pelv/sac pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0623","description":"Sio rig pnl pelv/sac pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHD0","description":"ICD-KGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56634","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYB1","description":"ICD-KFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethral lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57230","description":"Repair of urethral lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28D","description":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQB1","description":"ICD-PKQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEF0","description":"ICD-BCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBID0","description":"ICD-BBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKC1","description":"ICD-FAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHED1","description":"ICD-JHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES240","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29355","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEC1","description":"ICD-AGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext ecg recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0296T","description":"Ext ecg recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQF0","description":"ICD-HHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDD1","description":"ICD-NKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Surveillance Center Technical Support Including Data Transmission With Analysis_ With A Minimum Of 18 Training Hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0705T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Surveillance Center Technical Support Including Data Transmission With Analysis_ With A Minimum Of 18 Training Hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22C","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no abx therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9559","description":"Doc med reas no abx therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHE0","description":"ICD-BIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37288","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","description":"CPT-37288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allergen specific igg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86001","description":"Allergen specific igg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTF0","description":"ICD-ECTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKB1","description":"ICD-CDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA25","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB221","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Predominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6086","description":"Implant Supported Crown - Predominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg arterial single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33533","description":"Cabg arterial single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFC1","description":"ICD-NCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99 tilmanocept diag 0.5mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9520","description":"Tc99 tilmanocept diag 0.5mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIC1","description":"ICD-IDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUB0","description":"ICD-JEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-82234","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","description":"CPT-82234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEID0","description":"ICD-FEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCA0","description":"ICD-ADCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAB0","description":"ICD-JFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPC1","description":"ICD-GEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0749T","description":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVB0","description":"ICD-OLVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARF0","description":"ICD-OARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc rectal tumor endoscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0184T","description":"Exc rectal tumor endoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rho d immune globulin 50 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2788","description":"Rho d immune globulin 50 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76827","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIA1","description":"ICD-JFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology tum unknown origin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81540","description":"Oncology tum unknown origin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTA1","description":"ICD-ACTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation by ocularist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9150","description":"Evaluation by ocularist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0695T","description":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99315","description":"Nursing fac discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bamlanivimab and etesevimab_ 2100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0245","description":"Injection_ bamlanivimab and etesevimab_ 2100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13D","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFB0","description":"ICD-ODFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23C","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMF0","description":"ICD-OCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIF1","description":"ICD-JIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYB0","description":"ICD-OEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIE0","description":"ICD-BCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy soft tissue of back","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21925","description":"Biopsy soft tissue of back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEE0","description":"ICD-KBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ intradiscal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1754","description":"Catheter_ intradiscal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXE0","description":"ICD-KDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD255","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTE1","description":"ICD-GCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHD0","description":"ICD-FDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst t/o & repair compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58292","description":"Vag hyst t/o & repair compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCF0","description":"ICD-MKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBE0","description":"ICD-BFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHC0","description":"ICD-CFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYF1","description":"ICD-PLYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMA1","description":"ICD-OKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAB0","description":"ICD-FIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRC1","description":"ICD-CIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gluc monitor purchase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1030","description":"Gluc monitor purchase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANA1","description":"ICD-JANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQB0","description":"ICD-HIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21A","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYC0","description":"ICD-LHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3405","description":"HCPCS-J3405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTC0","description":"ICD-OJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTE1","description":"ICD-EGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27826","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETF1","description":"ICD-JETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autochondrocyte implant knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27412","description":"Autochondrocyte implant knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTE1","description":"ICD-EFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUD0","description":"ICD-OHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pp eval/edu perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9357","description":"Pp eval/edu perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE160","description":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84583","description":"Assay of urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHD1","description":"ICD-CAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abd paracentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49082","description":"Abd paracentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHF0","description":"ICD-ADHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALB1","description":"ICD-BALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHA1","description":"ICD-IFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSF0","description":"ICD-HFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ)_ targeted genomic sequence analysis_ formalin-fixed paraffin-embedded (FFPE) tumor tissue_ DNA analysis_ 84 or more genes_ interrogation for sequence va","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0334U","description":"Oncology (solid organ)_ targeted genomic sequence analysis_ formalin-fixed paraffin-embedded (FFPE) tumor tissue_ DNA analysis_ 84 or more genes_ interrogation for sequence va","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHA0","description":"ICD-JHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHA0","description":"ICD-BAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0817T","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary pouch w st wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4392","description":"Urinary pouch w st wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBE1","description":"ICD-FIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGF1","description":"ICD-GEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEB1","description":"ICD-IHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31587","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTA0","description":"ICD-NLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQB1","description":"ICD-PEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Borrelia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86619","description":"Borrelia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGB1","description":"ICD-FHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung transplant with bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32854","description":"Lung transplant with bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGF1","description":"ICD-FGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq sacral augmt unilat inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0200T","description":"Perq sacral augmt unilat inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIA0","description":"ICD-MGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Twist drill hole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61105","description":"Twist drill hole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGD1","description":"ICD-NBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair ing hernia reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49520","description":"Rerepair ing hernia reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD211","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replc sockt shldr dis/interc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6885","description":"Replc sockt shldr dis/interc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abortion (mpr)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59866","description":"Abortion (mpr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBA0","description":"ICD-CFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVF1","description":"ICD-CAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFD1","description":"ICD-BDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUF1","description":"ICD-ADUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCE1","description":"ICD-JCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHA0","description":"ICD-JCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0B","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28298","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATB1","description":"ICD-GATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYC1","description":"ICD-GIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of lower eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15820","description":"Revision of lower eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vent mgmt inpat subq day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94003","description":"Vent mgmt inpat subq day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28I","description":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMB1","description":"ICD-CFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIF1","description":"ICD-AAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70558","description":"MRI brain w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10D","description":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPF1","description":"ICD-GFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKE0","description":"ICD-CFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLD1","description":"ICD-FGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHC1","description":"ICD-AGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABA0","description":"ICD-IABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMD0","description":"ICD-OIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Who nontorsion jnts pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3915","description":"Who nontorsion jnts pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8913","description":"Mra w/o cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0986T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","description":"CPT-0986T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDF0","description":"ICD-JEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24C","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJB0","description":"ICD-FHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGD0","description":"ICD-FCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTE0","description":"ICD-JDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Torsion straight knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2380","description":"Torsion straight knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKB0","description":"ICD-JGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGE0","description":"ICD-JFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Haloperidol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1630","description":"Haloperidol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inflamation (eosinophilic esophagitis)_ ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2_ pro eosinophil major","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0095U","description":"Inflamation (eosinophilic esophagitis)_ ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2_ pro eosinophil major","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQF1","description":"ICD-DFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enterovirus probe&revrs trns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87498","description":"Enterovirus probe&revrs trns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPF0","description":"ICD-JBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5255","description":"Hearing aid_ digit_ mon_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMD1","description":"ICD-NFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo fluid swing ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5724","description":"Knee-shin exo fluid swing ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMF1","description":"ICD-GDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOF1","description":"ICD-KEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYF0","description":"ICD-CGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ arm_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6588","description":"Gradient pressure wrap with adjustable straps_ arm_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQD1","description":"ICD-CFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJME0","description":"ICD-MJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabergoline_ oral 0.25mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8515","description":"Cabergoline_ oral 0.25mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anter chamber intraocul lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2630","description":"Anter chamber intraocul lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNA0","description":"ICD-KHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Guide wire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1769","description":"Guide wire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQA0","description":"ICD-KHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28485","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44144","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88020","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFB0","description":"ICD-JIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBD0","description":"ICD-JCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUE0","description":"ICD-GFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urgent care center global","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9083","description":"Urgent care center global","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAE1","description":"ICD-BEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx multi myeloma unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9130","description":"Onc dx multi myeloma unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD245","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNA1","description":"ICD-FBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAD0","description":"ICD-CEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegcetacoplan_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9151","description":"Injection_ pegcetacoplan_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remis 12m not phq-9 score <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9510","description":"Remis 12m not phq-9 score <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDF1","description":"ICD-BBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21243","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysate solution_ non-dex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4728","description":"Dialysate solution_ non-dex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extremity 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64642","description":"Chemodenerv 1 extremity 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were deceased when the hu survey reached them","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1254","description":"Patients who were deceased when the hu survey reached them","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLD0","description":"ICD-BDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breath tube kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2326","description":"Breath tube kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC13","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3398","description":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2A","description":"Default_ /PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28308","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPB0","description":"ICD-NGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGE0","description":"ICD-KDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgigraft-dual_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4219","description":"Surgigraft-dual_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJB0","description":"ICD-CCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir and rilpivirine_ 2 mg/3 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0741","description":"Injection_ cabotegravir and rilpivirine_ 2 mg/3 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQA0","description":"ICD-PBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIF1","description":"ICD-JDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYD1","description":"ICD-HCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE240","description":"Special Care High _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFD1","description":"ICD-GIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHD1","description":"ICD-FCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITA1","description":"ICD-OITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak/knee disartic silesian ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5698","description":"Ak/knee disartic silesian ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUB1","description":"ICD-MKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEB0","description":"ICD-BDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUA0","description":"ICD-GFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJB1","description":"ICD-FAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood_ l/r_ irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9056","description":"Blood_ l/r_ irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKA0","description":"ICD-FBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc thigh/knee tum dep 5cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27339","description":"Exc thigh/knee tum dep 5cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIE0","description":"ICD-MEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop applicat rigid dsg on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6388","description":"Postop applicat rigid dsg on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13A","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"F9 (coagulation factor IX) (eg_ hemophilia B)_ full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81238","description":"F9 (coagulation factor IX) (eg_ hemophilia B)_ full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCF1","description":"ICD-NHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYE1","description":"ICD-LAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alarm symp assessed-absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1070F","description":"Alarm symp assessed-absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKC1","description":"ICD-NBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMC0","description":"ICD-NIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTB0","description":"ICD-NFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revis reconst shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23474","description":"Revis reconst shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAME1","description":"ICD-MAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prefab glove for term device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6890","description":"Prefab glove for term device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXC0","description":"ICD-FFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA221","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYF1","description":"ICD-CCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLF1","description":"ICD-BFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIB0","description":"ICD-OIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX44","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAA0","description":"ICD-GFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand held low vision aids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2600","description":"Hand held low vision aids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHID0","description":"ICD-AHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cemiplimab-rwlc_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9044","description":"Injection_ cemiplimab-rwlc_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPB0","description":"ICD-NHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUE0","description":"ICD-GGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBF0","description":"ICD-BFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLD0","description":"ICD-GBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHD1","description":"ICD-BHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59140","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ FISH analysis of 4 genes (ASAP1_ HDAC9_ CHD1 and PTEN)_ needle biopsy specimen_ algorithm reported as probability of higher tumor grade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053U","description":"Oncology (prostate cancer)_ FISH analysis of 4 genes (ASAP1_ HDAC9_ CHD1 and PTEN)_ needle biopsy specimen_ algorithm reported as probability of higher tumor grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18C","description":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJC1","description":"ICD-OKJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATD0","description":"ICD-CATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harvest auto stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38206","description":"Harvest auto stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXC1","description":"ICD-NCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE234","description":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy removal of clots","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52001","description":"Cystoscopy removal of clots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart flow reserve measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93571","description":"Heart flow reserve measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJC1","description":"ICD-JCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQB1","description":"ICD-GDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit20.1-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12046","description":"Intmd rpr n-hf/genit20.1-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES324","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGC1","description":"ICD-GHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIB1","description":"ICD-BFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2361","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2361","description":"HCPCS-J2361","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUC1","description":"ICD-GCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ft prosth multiaxial ankl/ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5978","description":"Ft prosth multiaxial ankl/ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth pharyngeal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17451","description":"Anesth pharyngeal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEA1","description":"ICD-CHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj cervical plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64413","description":"N block inj cervical plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place po breast cath for rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19296","description":"Place po breast cath for rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQE1","description":"ICD-HEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens fitting for tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92071","description":"Contact lens fitting for tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise bladder & ureter(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51565","description":"Revise bladder & ureter(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn cervl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63285","description":"Bx/exc idrl imed lesn cervl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUF1","description":"ICD-MCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc abdl tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22900","description":"Exc abdl tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-35602","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","description":"CPT-35602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKC1","description":"ICD-BHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEC0","description":"ICD-AGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection Tocilizumab for COVID-19 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0249","description":"Injection Tocilizumab for COVID-19 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDF1","description":"ICD-ICDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intercep dental tx primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8050","description":"Intercep dental tx primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mediastinoscpy w/lmph nod bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39402","description":"Mediastinoscpy w/lmph nod bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHB1","description":"ICD-NIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKF0","description":"ICD-OKKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-38228","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","description":"CPT-38228","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQB1","description":"ICD-DEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","description":"CPT-00474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDF1","description":"ICD-OGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch drain/barr lk flng/f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4427","description":"Ost pch drain/barr lk flng/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDA1","description":"ICD-EFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0549","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","description":"HCPCS-G0549","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEC0","description":"ICD-NDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXA1","description":"ICD-GAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKC0","description":"ICD-OEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX51","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYB1","description":"ICD-OGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQC0","description":"ICD-ODQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILB1","description":"ICD-BILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWE1","description":"ICD-HIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHA1","description":"ICD-EHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKE1","description":"ICD-FAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDA1","description":"ICD-KIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBC0","description":"ICD-CCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); multiple analytes_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82492","description":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); multiple analytes_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD131","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHC1","description":"ICD-IAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iop measurement not documented_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1226","description":"Iop measurement not documented_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ bra_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6589","description":"Gradient pressure wrap with adjustable straps_ bra_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15956","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18E","description":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove uterus after cesarean","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59525","description":"Remove uterus after cesarean","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41112","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Av fistula revision open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36832","description":"Av fistula revision open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reusable rectal thermometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4932","description":"Reusable rectal thermometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of triglycerides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84478","description":"Assay of triglycerides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOC1","description":"ICD-LHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAA1","description":"ICD-ACAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEB1","description":"ICD-BIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNB1","description":"ICD-CGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIE0","description":"ICD-GDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interferon alfa-2b inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9214","description":"Interferon alfa-2b inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Image cath fluid trns/vgnl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49407","description":"Image cath fluid trns/vgnl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiographic procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76499","description":"Radiographic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ infliximab-abda_ biosimilar_ (Renflexis)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5104","description":"Injection_ infliximab-abda_ biosimilar_ (Renflexis)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99327","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of rbc galactokinase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82759","description":"Assay of rbc galactokinase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intermittent urinary cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4353","description":"Intermittent urinary cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB35","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA140","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA21","description":"Low Rehab_ ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESB0","description":"ICD-DESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYB0","description":"ICD-CAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBF1","description":"ICD-OBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Calculation Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77091","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Calculation Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTF0","description":"ICD-MJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCA1","description":"ICD-IBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Viper venom prothrombin time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85612","description":"Viper venom prothrombin time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 80 or more drugs or metabolites_ urine_ by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0146U","description":"Drug assay_ definitive_ 80 or more drugs or metabolites_ urine_ by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQE1","description":"ICD-PJQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retinal prosth int/ext comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1841","description":"Retinal prosth int/ext comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score hip pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8653","description":"Fun stat score hip pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGD1","description":"ICD-NCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Provisional splint extracoro","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4321","description":"Provisional splint extracoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBD1","description":"ICD-AFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUA1","description":"ICD-EBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84446","description":"Assay of vitamin e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAB0","description":"ICD-FBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27818","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat recline pwr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1005","description":"Pwr seat recline pwr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILC0","description":"ICD-JILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIF0","description":"ICD-MEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28E","description":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVA0","description":"ICD-FBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15933","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL15","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj vocal cord bulking agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8607","description":"Inj vocal cord bulking agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefiderocol_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0699","description":"Injection_ cefiderocol_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQE1","description":"ICD-HBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEE0","description":"ICD-MGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metatarsal joint implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8641","description":"Metatarsal joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWE1","description":"ICD-PEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of ureter & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50810","description":"Fusion of ureter & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32310","description":"Removal of chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystometrogram w/vp&up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51729","description":"Cystometrogram w/vp&up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBB1","description":"ICD-IDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUB0","description":"ICD-EAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDB0","description":"ICD-KBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBB0","description":"ICD-ABBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATA0","description":"ICD-AATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPB0","description":"ICD-NJPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cross-over vein graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34520","description":"Cross-over vein graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBF1","description":"ICD-JCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNB0","description":"ICD-BBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0661","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","description":"HCPCS-G0661","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXE0","description":"ICD-BHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6527","description":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNF1","description":"ICD-KHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5C","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOB0","description":"ICD-PIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWC1","description":"ICD-CEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXC1","description":"ICD-NKXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHB1","description":"ICD-IFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23A","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTF0","description":"ICD-KCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE126","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIND1","description":"ICD-CIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDC0","description":"ICD-OLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCC1","description":"ICD-MFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPB1","description":"ICD-KAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx bronchoscope/brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31623","description":"Dx bronchoscope/brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBE1","description":"ICD-GDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36566","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAF0","description":"ICD-CBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOA1","description":"ICD-PDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKA0","description":"ICD-NHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXC0","description":"ICD-OFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cftr gene intron poly t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81224","description":"Cftr gene intron poly t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNE0","description":"ICD-FDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEF0","description":"ICD-GAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMF0","description":"ICD-GIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull for surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61460","description":"Incise skull for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15D","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCB1","description":"ICD-EDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Porfimer sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9600","description":"Porfimer sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetoscop laser ther ttts","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2411","description":"Fetoscop laser ther ttts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations_ orders or referrals for positive screen (e.g._ patient in pal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9924","description":"Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations_ orders or referrals for positive screen (e.g._ patient in pal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEB1","description":"ICD-OEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27759","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAF0","description":"ICD-KHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHD0","description":"ICD-FEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92019","description":"Eye exam & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coronary artery graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33504","description":"Coronary artery graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25400","description":"Repair radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens bifocal add over 3.25d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2220","description":"Lens bifocal add over 3.25d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFE1","description":"ICD-GDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLF0","description":"ICD-NGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient transfer to practice after initiation of chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9833","description":"Patient transfer to practice after initiation of chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGD0","description":"ICD-OAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7515","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Burr hole for puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61120","description":"Burr hole for puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBD0","description":"ICD-EGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHC0","description":"ICD-AIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHF1","description":"ICD-GHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABD0","description":"ICD-NABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAE1","description":"ICD-KCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52265","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMD1","description":"ICD-FGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMB1","description":"ICD-KIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIA1","description":"ICD-OIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOA1","description":"ICD-KDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUB1","description":"ICD-JDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAD1","description":"ICD-GCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thromboxane urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84431","description":"Thromboxane urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for cholangiogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47531","description":"Injection for cholangiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB144","description":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ob us detailed sngl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76811","description":"Ob us detailed sngl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC11","description":"ICD-3CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGA0","description":"ICD-KAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g._ allergy_ intolerance_ infectious etiology_ pancrea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1184","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g._ allergy_ intolerance_ infectious etiology_ pancrea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6548","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","description":"HCPCS-A6548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOE0","description":"ICD-LAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34001","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 1 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90381","description":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 1 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTE0","description":"ICD-ADTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hfo without joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3924","description":"Hfo without joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative assay drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80299","description":"Quantitative assay drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDB0","description":"ICD-NDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAC1","description":"ICD-GBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQF0","description":"ICD-LAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Sequence Analysis_ Exon 10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81339","description":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Sequence Analysis_ Exon 10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87534","description":"Hiv-1 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASF1","description":"ICD-KASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neoxflo or clarixflo 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4155","description":"Neoxflo or clarixflo 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILB0","description":"ICD-AILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastro/jejuno tube_ low-pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4088","description":"Gastro/jejuno tube_ low-pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKE1","description":"ICD-JCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUB0","description":"ICD-FIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrde addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61868","description":"Implant neuroelectrde addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70260","description":"X-ray exam of skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMD0","description":"ICD-KFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightweight det a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1088","description":"Wheelchair lightweight det a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFD1","description":"ICD-BGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQD0","description":"ICD-LGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","description":"HCPCS-Q4379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O shoe add horseshoe toe tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3560","description":"O shoe add horseshoe toe tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Administration of home sleep apnea test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9956","description":"Administration of home sleep apnea test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOB1","description":"ICD-KCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACB0","description":"ICD-EACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHE1","description":"ICD-AHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKF1","description":"ICD-FDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARC1","description":"ICD-DARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conz of cervix w/scope leep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57461","description":"Conz of cervix w/scope leep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 mins) home care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2015","description":"Comprehensive (60 mins) home care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Access thoracic lymph duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38794","description":"Access thoracic lymph duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLD0","description":"ICD-OCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRA1","description":"ICD-HBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8E","description":"High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8B","description":"Low Rehab_ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (CT) ima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0808T","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (CT) ima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWD0","description":"ICD-OFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytomegalovirus dfa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87271","description":"Cytomegalovirus dfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKC1","description":"ICD-FHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous vertebral augmentations_ first thoracic and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7507","description":"Percutaneous vertebral augmentations_ first thoracic and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCE1","description":"ICD-FDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visual evoked potential_ testing for glaucoma_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0464T","description":"Visual evoked potential_ testing for glaucoma_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFME1","description":"ICD-GFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNA0","description":"ICD-GFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIC0","description":"ICD-NCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPF1","description":"ICD-KDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDA1","description":"ICD-KGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Granisetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1626","description":"Granisetron hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDD0","description":"ICD-NJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFB0","description":"ICD-KDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0505F","description":"Hemodialysis plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRA1","description":"ICD-PDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13D","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAB0","description":"ICD-CHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seat lift incorp lift-chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0627","description":"Seat lift incorp lift-chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lev 5 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0384","description":"Lev 5 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct bronchus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31775","description":"Reconstruct bronchus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXD1","description":"ICD-OJXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARC0","description":"ICD-DARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20B","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3310","description":"Anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Portable oxygen contents_ liquid_ 1 month_s supply = 1 unit_ prescribed amount at rest or nighttime exceeds 4 liters per minute","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0447","description":"Portable oxygen contents_ liquid_ 1 month_s supply = 1 unit_ prescribed amount at rest or nighttime exceeds 4 liters per minute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11B","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0D","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6083","description":"Implant Supported Crown - Porcelain Fused To Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo frct swg & sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5718","description":"Knee-shin exo frct swg & sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMA0","description":"ICD-MCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQF0","description":"ICD-DAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Delay flap f/c/c/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15620","description":"Delay flap f/c/c/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25B","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPE0","description":"ICD-OLPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRD0","description":"ICD-GGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69720","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00218","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","description":"CPT-00218","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ bandage liner_ lower extremity_ any size or length_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6594","description":"Gradient compression bandaging supply_ bandage liner_ lower extremity_ any size or length_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUD0","description":"ICD-NBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHD0","description":"ICD-ADHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAE0","description":"ICD-EIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXD1","description":"ICD-OHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip wall fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27226","description":"Treat hip wall fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Palliative care services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1309","description":"Palliative care services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lamination collar w/ couplin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6629","description":"Lamination collar w/ couplin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILD0","description":"ICD-MILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMB1","description":"ICD-IBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Analysis_ Review And Report By A Physician Or Othe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0576T","description":"Interrogation Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Analysis_ Review And Report By A Physician Or Othe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRC0","description":"ICD-GDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGC1","description":"ICD-BDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISC1","description":"ICD-DISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cutting ramus open w/graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7943","description":"Cutting ramus open w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQD0","description":"ICD-GDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy face plate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4361","description":"Ostomy face plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor viii vw ristoctn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85245","description":"Clot factor viii vw ristoctn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAB1","description":"ICD-GCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prfrmnc docd 2 wks b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3328F","description":"Prfrmnc docd 2 wks b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTB0","description":"ICD-MGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove int/ext hem 1 group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46255","description":"Remove int/ext hem 1 group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRA1","description":"ICD-OLRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 2","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1782","description":"vaccine administration-human papillomavirus - Dose 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD260","description":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEE0","description":"ICD-IEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office visit during hours","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9430","description":"Office visit during hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKB0","description":"ICD-NLKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFID0","description":"ICD-NFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDC1","description":"ICD-EHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFND0","description":"ICD-NFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXE0","description":"ICD-KHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFB1","description":"ICD-GEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDE1","description":"ICD-BEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1028","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMF0","description":"ICD-FFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXB0","description":"ICD-NHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise lesion skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61615","description":"Resect/excise lesion skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5913","description":"Nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENB0","description":"ICD-CENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","description":"HCPCS-J1164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sargramostim injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2820","description":"Sargramostim injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nutritional counseling_ diet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9470","description":"Nutritional counseling_ diet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQE1","description":"ICD-LHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYA0","description":"ICD-PCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAA0","description":"ICD-KCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWC1","description":"ICD-KEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFD1","description":"ICD-KAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJC0","description":"ICD-JAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRB1","description":"ICD-OKRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEB0","description":"ICD-AHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFE0","description":"ICD-KEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOB0","description":"ICD-HEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBC1","description":"ICD-EIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33951","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2049","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2049","description":"HCPCS-A2049","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull for brain wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61571","description":"Incise skull for brain wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Prostate)_ Mrna_ Microarray Gene Expression Profiling Of 22 Content Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported As Metastasis Risk S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81542","description":"Oncology (Prostate)_ Mrna_ Microarray Gene Expression Profiling Of 22 Content Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported As Metastasis Risk S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBB1","description":"ICD-IBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMB0","description":"ICD-OIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAA1","description":"ICD-NAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABE0","description":"ICD-EABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARC0","description":"ICD-GARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICME0","description":"ICD-ICME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIC0","description":"ICD-NBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinogen antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85385","description":"Fibrinogen antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-62330","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","description":"CPT-62330","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDC0","description":"ICD-ADDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having records of negative or managed positive TB screen (e.g._ patient does not return for Mantoux (PPD) skin test evaluation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9932","description":"Documentation of patient reason(s) for not having records of negative or managed positive TB screen (e.g._ patient does not return for Mantoux (PPD) skin test evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQF0","description":"ICD-LHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3D","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerv col sr foam 2pc pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0172","description":"Cerv col sr foam 2pc pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8X","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27722","description":"Repair/graft of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen dua non","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8688","description":"Implt nrostm pls gen dua non","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARB0","description":"ICD-DARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38571","description":"Laparoscopy lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat forearm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25035","description":"Treat forearm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection Hpc 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9986","description":"Injection Hpc 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6077","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat dental ridge fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21445","description":"Treat dental ridge fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spin/brain pump refil & main","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95991","description":"Spin/brain pump refil & main","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTC0","description":"ICD-CBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCC1","description":"ICD-AFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Renal biopsy perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50200","description":"Renal biopsy perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous laser vein addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36479","description":"Endovenous laser vein addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDC0","description":"ICD-ECDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJA1","description":"ICD-KBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reshaping bone orthognathic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7940","description":"Reshaping bone orthognathic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCE0","description":"ICD-CBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain bag/bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4911","description":"Drain bag/bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTB1","description":"ICD-NKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPB1","description":"ICD-BEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTF1","description":"ICD-KDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE205","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch clsd w barrier/filtr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4416","description":"Ost pch clsd w barrier/filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJC1","description":"ICD-NHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder/vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51900","description":"Repair bladder/vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDE0","description":"ICD-BCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISC1","description":"ICD-OISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITD0","description":"ICD-EITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/ov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2210","description":"Lens sphcy bifocal 4.25-7/ov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELC0","description":"ICD-IELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ctrl dose inh drug deliv sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0730","description":"Ctrl dose inh drug deliv sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHC1","description":"ICD-MBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI joint lwr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73723","description":"MRI joint lwr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDID1","description":"ICD-BDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg <=16 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6251","description":"Absorpt drg <=16 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFC0","description":"ICD-OGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33684","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTB0","description":"ICD-JCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48551","description":"Prep donor pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYB0","description":"ICD-DDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDB1","description":"ICD-BBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJB1","description":"ICD-NIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUA0","description":"ICD-NDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rigid ped w/c tilt-in-space","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1231","description":"Rigid ped w/c tilt-in-space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Back Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2138","description":"Back Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0608","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","description":"HCPCS-J0608","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRD0","description":"ICD-PHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHC0","description":"ICD-GCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RARE DS GEN DNA ALYS PROBAND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0212U","description":"RARE DS GEN DNA ALYS PROBAND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2209","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01462","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","description":"CPT-01462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUC0","description":"ICD-JDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC31","description":"ICD-1KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFD0","description":"ICD-OKFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANE1","description":"ICD-KANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","description":"HCPCS-J9003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOE0","description":"ICD-DHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8C","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic elbow hosmer swit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7170","description":"Electronic elbow hosmer swit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21462","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELC0","description":"ICD-JELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWD1","description":"ICD-CIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo fem fx cast semi-rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2134","description":"Kafo fem fx cast semi-rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3A","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAB1","description":"ICD-NIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair hallux rigidus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28289","description":"Repair hallux rigidus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLD0","description":"ICD-MLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPB1","description":"ICD-CDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0663","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","description":"HCPCS-G0663","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDE0","description":"ICD-MCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth tympanotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12651","description":"Anesth tympanotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1052T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1052T","description":"CPT-1052T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDE0","description":"ICD-JBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIF0","description":"ICD-BCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX41","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject for lymphatic x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38790","description":"Inject for lymphatic x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supplies for maintenance of insulin infusion catheter_ per week","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4224","description":"Supplies for maintenance of insulin infusion catheter_ per week","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCB1","description":"ICD-NKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2221","description":"Solid caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Serpina1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81332","description":"Serpina1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOF0","description":"ICD-LBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-dkst_ biosimilar_ (Ogivri)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5114","description":"Injection_ trastuzumab-dkst_ biosimilar_ (Ogivri)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients Who Receive Palliative Care Services Any Time During The Intake Period Through The End Of The Measurement Year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0048","description":"Patients Who Receive Palliative Care Services Any Time During The Intake Period Through The End Of The Measurement Year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEC1","description":"ICD-KIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETE0","description":"ICD-GETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx chron care w/o pt vsit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99487","description":"Cmplx chron care w/o pt vsit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRD1","description":"ICD-GDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical foods for inborn err","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9435","description":"Medical foods for inborn err","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore abdominal vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35840","description":"Explore abdominal vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAD0","description":"ICD-GHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9906","description":"Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Toc dur aneth to icu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9657","description":"Toc dur aneth to icu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVA0","description":"ICD-BCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Receiver/transmitter_ neuro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1816","description":"Receiver/transmitter_ neuro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMC0","description":"ICD-GIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBD1","description":"ICD-JCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28X","description":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj protirelin per 250 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2725","description":"Inj protirelin per 250 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCF0","description":"ICD-ABCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIF0","description":"ICD-NDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther/diag concurrent inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96368","description":"Ther/diag concurrent inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCA0","description":"ICD-MJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient transferred to practice after initiation of chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9826","description":"Patient transferred to practice after initiation of chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHE1","description":"ICD-ICHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMA0","description":"ICD-JDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECA1","description":"ICD-GECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1348","description":"Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunohisto antb 1st stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88342","description":"Immunohisto antb 1st stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYA0","description":"ICD-KBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special stains group 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88313","description":"Special stains group 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTD1","description":"ICD-ACTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2101","description":"HCPCS-A2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBD1","description":"ICD-NGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq cardiac angioplast 1 art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92920","description":"Prq cardiac angioplast 1 art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0562","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","description":"HCPCS-G0562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQC0","description":"ICD-PGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUC1","description":"ICD-GDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63011","description":"Remove spine lamina 1/2 scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXC1","description":"ICD-CGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp cont lens eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0592","description":"Comp cont lens eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove unilat space maintain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1520","description":"Remove unilat space maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEF0","description":"ICD-BGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTF1","description":"ICD-ECTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYD0","description":"ICD-DCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3C","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36558","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens aniseikonic trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2318","description":"Lens aniseikonic trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJA0","description":"ICD-BHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIA0","description":"ICD-BAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc sinus ct 28d or dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9350","description":"No doc sinus ct 28d or dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27828","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGB1","description":"ICD-NEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFA1","description":"ICD-OHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPA0","description":"ICD-FEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27394","description":"Lengthening of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28072","description":"Removal of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJF1","description":"ICD-GHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADE0","description":"ICD-IADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYC0","description":"ICD-OCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACE0","description":"ICD-CACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Male vacuum erection system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7900","description":"Male vacuum erection system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I & d vaginal hematoma pp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57022","description":"I & d vaginal hematoma pp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELB1","description":"ICD-BELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cataract surg w/iol 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66984","description":"Cataract surg w/iol 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQD1","description":"ICD-DBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18E","description":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXD1","description":"ICD-FHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Belinostat_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9442","description":"Injection_ Belinostat_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMF0","description":"ICD-CDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJD0","description":"ICD-OKJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gatifloxacin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1590","description":"Gatifloxacin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ single analyte_ quantitative_ single st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82543","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ single analyte_ quantitative_ single st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKC0","description":"ICD-KAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRE1","description":"ICD-DBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINB0","description":"ICD-FINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstr lwr jaw w/advance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21199","description":"Reconstr lwr jaw w/advance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00410","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","description":"CPT-00410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATF1","description":"ICD-JATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPE1","description":"ICD-JGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELB0","description":"ICD-BELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin pinch graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15050","description":"Skin pinch graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60252","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0692U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692U","description":"CPT-0692U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHF0","description":"ICD-NCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; First 2 Vertebral Bodies_ Lumbar Or Sacral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64628","description":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; First 2 Vertebral Bodies_ Lumbar Or Sacral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl girdle milwaukee orth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4000","description":"Repl girdle milwaukee orth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTB1","description":"ICD-OLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVC0","description":"ICD-NJVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemical peel nonfacial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15793","description":"Chemical peel nonfacial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cltx post ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27767","description":"Cltx post ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decalcification procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0475","description":"Decalcification procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evasc prlng admn rx agnt 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61650","description":"Evasc prlng admn rx agnt 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB220","description":"Special Care High _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCF0","description":"ICD-KDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVA0","description":"ICD-GHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES212","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHME1","description":"ICD-OHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIA0","description":"ICD-CAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLE1","description":"ICD-FGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55881","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","description":"CPT-55881","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISA1","description":"ICD-OISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0801","description":"HCPCS-C0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv rna vrl ld <lmts quantif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3502F","description":"Hiv rna vrl ld <lmts quantif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (central nervous system)_ analysis of 30000 DNA methylation loci by methylation array_ utilizing DNA extracted from tumor tissue_ diagnostic algorithm reported as pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0020M","description":"Oncology (central nervous system)_ analysis of 30000 DNA methylation loci by methylation array_ utilizing DNA extracted from tumor tissue_ diagnostic algorithm reported as pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPF1","description":"ICD-GCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary reflex study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51792","description":"Urinary reflex study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fremanezumab-vfrm_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9040","description":"Injection_ fremanezumab-vfrm_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fats/lipids feces quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82710","description":"Fats/lipids feces quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1904","description":"HCPCS-C1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24582","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid sup/access/dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5267","description":"Hearing aid sup/access/dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKA1","description":"ICD-NKKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLE0","description":"ICD-ODLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36585","description":"Replace picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCF1","description":"ICD-KCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDD0","description":"ICD-NHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8E","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEA0","description":"ICD-KDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal leg bone(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27360","description":"Partial removal leg bone(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Av dialysis shunt imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75791","description":"Av dialysis shunt imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQD0","description":"ICD-OKQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBB0","description":"ICD-KIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pediatrics (vasculitis_ Kawasaki disease [KD])_ analysis of 3 biomarkers (NT-proBNP_ C-reactive protein_ and T-uptake)_ plasma_ algorithm reported as a risk score for KD","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0310U","description":"Pediatrics (vasculitis_ Kawasaki disease [KD])_ analysis of 3 biomarkers (NT-proBNP_ C-reactive protein_ and T-uptake)_ plasma_ algorithm reported as a risk score for KD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOB0","description":"ICD-PCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLE0","description":"ICD-JDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ toripalimab-tpzi_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3263","description":"Injection_ toripalimab-tpzi_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99282","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no sleep apnea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8840","description":"Doc reas no sleep apnea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95060","description":"Eye allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise two eye muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67312","description":"Revise two eye muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWA0","description":"ICD-KGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQF0","description":"ICD-GIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALD1","description":"ICD-AALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16076","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAE0","description":"ICD-BEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOD1","description":"ICD-DIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial exchange transfusion_ blood_ plasma or crystalloid necessitating the skill of a physician or other qualified health care professional_ newborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36456","description":"Partial exchange transfusion_ blood_ plasma or crystalloid necessitating the skill of a physician or other qualified health care professional_ newborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"V-band gastroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43842","description":"V-band gastroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEC1","description":"ICD-AAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQA1","description":"ICD-HEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOC1","description":"ICD-GDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23680","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open reduc compd alveolus fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7770","description":"Open reduc compd alveolus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie_ external genitalia_ perineum_ abdominal wall) due to soft tissue infection or trauma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15778","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie_ external genitalia_ perineum_ abdominal wall) due to soft tissue infection or trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBD1","description":"ICD-IFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled breath condensate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83987","description":"Exhaled breath condensate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRA0","description":"ICD-OBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quality care in mental health and substance use disorders mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1369","description":"Quality care in mental health and substance use disorders mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOA0","description":"ICD-DEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTD0","description":"ICD-MGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEC0","description":"ICD-BBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body-worn binaur hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5120","description":"Body-worn binaur hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sterile saline or water","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4218","description":"Sterile saline or water","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIA1","description":"ICD-CIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pp eval/edu not perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9358","description":"Pp eval/edu not perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1097","description":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine infusion device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62360","description":"Insert spine infusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMB0","description":"ICD-CGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA210","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAB1","description":"ICD-KFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of foot infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28003","description":"Treatment of foot infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct orbit/forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21175","description":"Reconstruct orbit/forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01482","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","description":"CPT-01482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exchange nephrostomy catheter_ percutaneous_ with ureteral stricture balloon dilation_ including diagnostic nephrostogram and/or ureterogram when performed_ imaging guidance (","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7548","description":"Exchange nephrostomy catheter_ percutaneous_ with ureteral stricture balloon dilation_ including diagnostic nephrostogram and/or ureterogram when performed_ imaging guidance (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCA1","description":"ICD-FCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQE0","description":"ICD-HGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLB0","description":"ICD-JFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD121","description":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAB1","description":"ICD-CFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFA0","description":"ICD-NDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen quan lamotrigine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80175","description":"Drug screen quan lamotrigine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42800","description":"Biopsy of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEE0","description":"ICD-KHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADE0","description":"ICD-MADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEC1","description":"ICD-MHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCB0","description":"ICD-MLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCE1","description":"ICD-MBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54318","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flex thermoplastic collar mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0130","description":"Flex thermoplastic collar mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe sole wedge between sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3370","description":"Shoe sole wedge between sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOA1","description":"ICD-CCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement Of Lost Or Broken Retainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8704","description":"Replacement Of Lost Or Broken Retainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAE1","description":"ICD-OAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDC1","description":"ICD-CDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYB1","description":"ICD-CBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA11","description":"ICD-4BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99204","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAF0","description":"ICD-FCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20A","description":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49428","description":"Ligation of shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEF1","description":"ICD-JIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPC1","description":"ICD-GDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYD1","description":"ICD-KGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACD0","description":"ICD-AACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ tubular protective absorption layer_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6607","description":"Gradient compression bandaging supply_ tubular protective absorption layer_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHC1","description":"ICD-EEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1942","description":"Injection_ aripiprazole lauroxil_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardioassist internal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92970","description":"Cardioassist internal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIND1","description":"ICD-JIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental film skull/facial bon","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0290","description":"Dental film skull/facial bon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64898","description":"Nerve graft arm/leg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUB1","description":"ICD-BFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5250","description":"Hearing aid_ prog_ bin_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJD1","description":"ICD-JAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMD0","description":"ICD-BEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSF0","description":"ICD-CDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJB1","description":"ICD-OFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Musculoskeletal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20999","description":"Musculoskeletal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA21","description":"ICD-3EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKD1","description":"ICD-CDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC30","description":"Ultra High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEE0","description":"ICD-JBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tongue jaw & neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41155","description":"Tongue jaw & neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHA1","description":"ICD-OFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removable unilateral partial denture - one piece cast metal_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5283","description":"Removable unilateral partial denture - one piece cast metal_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ spheroid cell culture_ poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib_ olaparib_ rucaparib_ velparib)_ tumor response prediction for each drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0325U","description":"Oncology (ovarian)_ spheroid cell culture_ poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib_ olaparib_ rucaparib_ velparib)_ tumor response prediction for each drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMC0","description":"ICD-NLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQA1","description":"ICD-ODQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEB1","description":"ICD-FEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28F","description":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIE0","description":"ICD-JEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1501","description":"HCPCS-A1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNB1","description":"ICD-FDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harvesting of donor multivis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2055","description":"Harvesting of donor multivis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUC1","description":"ICD-EFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHF0","description":"ICD-OEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIE1","description":"ICD-CEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of support implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20680","description":"Removal of support implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDC1","description":"ICD-NBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILD1","description":"ICD-GILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRE1","description":"ICD-OFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJC1","description":"ICD-JBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ortho dvc repair per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4205","description":"Ortho dvc repair per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEF1","description":"ICD-EDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYA1","description":"ICD-GFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQA0","description":"ICD-KBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kras gene variants exon 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81275","description":"Kras gene variants exon 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEB1","description":"ICD-MGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIC0","description":"ICD-MKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILA1","description":"ICD-BILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUA1","description":"ICD-FDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kt/v >/= 1.7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3084F","description":"Kt/v >/= 1.7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sympt show clin import drop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1451F","description":"Sympt show clin import drop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parainfluenza ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87279","description":"Parainfluenza ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGME1","description":"ICD-BGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLE0","description":"ICD-NDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69645","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX60","description":"Low Rehab plus Extensive _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22C","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUE1","description":"ICD-KHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPE1","description":"ICD-KAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNF0","description":"ICD-NBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive Care Management For A Single High-Risk Disease Services_ E.G. Principal Care Management_ At Least 30 Minutes Of Clinical Staff Time Directed By A Physician Or Ot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2065","description":"Comprehensive Care Management For A Single High-Risk Disease Services_ E.G. Principal Care Management_ At Least 30 Minutes Of Clinical Staff Time Directed By A Physician Or Ot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electron elbow child switch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7186","description":"Electron elbow child switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch w bar/bltinconv/fltr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4417","description":"Ost pch w bar/bltinconv/fltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36572","description":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFE0","description":"ICD-CIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBA1","description":"ICD-KFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percut bx lung/mediastinum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32405","description":"Percut bx lung/mediastinum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18I","description":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGF1","description":"ICD-JCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj dobutamine hcl/250 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1250","description":"Inj dobutamine hcl/250 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28A","description":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0676","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0676","description":"HCPCS-G0676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVE0","description":"ICD-ODVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHED0","description":"ICD-MHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group psychotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90853","description":"Group psychotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDF1","description":"ICD-IGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFC1","description":"ICD-NHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No rev_ comm_ track biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8885","description":"No rev_ comm_ track biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Membrane graft or membrane wrap_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4205","description":"Membrane graft or membrane wrap_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thyroidectomy_ total or complete with parathyroid autotransplantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7555","description":"Thyroidectomy_ total or complete with parathyroid autotransplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJB1","description":"ICD-NDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_ automated sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0147","description":"Scr c/v cyto_ automated sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmi not calculated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8421","description":"Bmi not calculated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFE1","description":"ICD-JGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ntrk2 (Neurotrophic Receptor Tyrosine Kinase 2) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81192","description":"Ntrk2 (Neurotrophic Receptor Tyrosine Kinase 2) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethro w/addl implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52442","description":"Cystourethro w/addl implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUE1","description":"ICD-CIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDED1","description":"ICD-FDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of scapula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23190","description":"Partial removal of scapula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEND1","description":"ICD-BEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUE1","description":"ICD-ABUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTE1","description":"ICD-JCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHE1","description":"ICD-ACHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUE0","description":"ICD-KDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sub pt/ot d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8995","description":"Sub pt/ot d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEC0","description":"ICD-FAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGA1","description":"ICD-OHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCC1","description":"ICD-MCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ age 12 years or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31554","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ age 12 years or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55862","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECE0","description":"ICD-CECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXB0","description":"ICD-FCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDA1","description":"ICD-IBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMA1","description":"ICD-NJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy cleaning brush","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4626","description":"Tracheostomy cleaning brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of catheter-delivered prosthetic pulmonary valve_ endovascular approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0262T","description":"Implantation of catheter-delivered prosthetic pulmonary valve_ endovascular approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDA0","description":"ICD-BEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0494U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","description":"CPT-0494U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDC0","description":"ICD-BIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63101","description":"Remove vert body dcmprn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAB0","description":"ICD-FAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of corticosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82528","description":"Assay of corticosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHC1","description":"ICD-OFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch clsd for bar w lk fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4420","description":"Ost pch clsd for bar w lk fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray guide gu dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74485","description":"X-ray guide gu dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78433","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAC0","description":"ICD-ACAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIC1","description":"ICD-MLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBD1","description":"ICD-OLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIC0","description":"ICD-ICIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLA1","description":"ICD-FHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHF0","description":"ICD-GBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect phalanx of toe tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28175","description":"Resect phalanx of toe tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDME0","description":"ICD-JDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGE0","description":"ICD-BEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body fluid specific gravity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84315","description":"Body fluid specific gravity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brca1&2 seq & full dup/del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81162","description":"Brca1&2 seq & full dup/del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCA0","description":"ICD-GFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLB1","description":"ICD-OLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACE0","description":"ICD-JACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fludarabine phosphate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9185","description":"Fludarabine phosphate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt ed re ft care inspct rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4305F","description":"Pt ed re ft care inspct rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTB0","description":"ICD-MLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRB1","description":"ICD-OJRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carbonic anhydrase VI (CA VI)_ parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG_ IgM_ and IgA antibodies_ enzyme-linked immunosorbent assay (ELISA)_ sem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0472U","description":"Carbonic anhydrase VI (CA VI)_ parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG_ IgM_ and IgA antibodies_ enzyme-linked immunosorbent assay (ELISA)_ sem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5B","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUB1","description":"ICD-JGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy chemodenervation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52287","description":"Cystoscopy chemodenervation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ruptured uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58520","description":"Repair of ruptured uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32663","description":"Thoracoscopy w/lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0849","description":"Pwc gp 3 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGE0","description":"ICD-NDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPA0","description":"ICD-JGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spinal orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1499","description":"Spinal orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tibial arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29855","description":"Tibial arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFA0","description":"ICD-NCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJA1","description":"ICD-NLJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA31","description":"ICD-4FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13B","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE206","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23D","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB210","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUB1","description":"ICD-AHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBE0","description":"ICD-CBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIC0","description":"ICD-CCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLD0","description":"ICD-AGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFF0","description":"ICD-KIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSD0","description":"ICD-DHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAA1","description":"ICD-MDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio lwr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73706","description":"Ct angio lwr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermatology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4000","description":"Dermatology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYE1","description":"ICD-OEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIB0","description":"ICD-FBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQA0","description":"ICD-OJQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX06","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELC1","description":"ICD-KELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert multi-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54405","description":"Insert multi-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUD0","description":"ICD-IAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiokymography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0035","description":"Cardiokymography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLB1","description":"ICD-IGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ ado-trastuzumab emt 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9354","description":"Inj_ ado-trastuzumab emt 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLB0","description":"ICD-BFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient receiving an anti-TNF agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9914","description":"Patient receiving an anti-TNF agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTA1","description":"ICD-NFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scap thorac prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6570","description":"Scap thorac prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sedation (non-iv)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9248","description":"Sedation (non-iv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise knuckle with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26531","description":"Revise knuckle with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01829","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","description":"CPT-01829","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVA0","description":"ICD-OBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable pack w/bowel syst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0352","description":"Disposable pack w/bowel syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFD0","description":"ICD-FCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKME1","description":"ICD-MKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIB1","description":"ICD-JGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQB1","description":"ICD-KAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove femur lesion/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27357","description":"Remove femur lesion/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAD0","description":"ICD-IIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie_ ELISA)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0085U","description":"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie_ ELISA)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mrgfus strtctc les abltj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0398T","description":"Mrgfus strtctc les abltj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAF0","description":"ICD-FIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCB0","description":"ICD-ICCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHF1","description":"ICD-KEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJD1","description":"ICD-OEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASD1","description":"ICD-PASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0084U","description":"Red blood cell antigen typing_ DNA_ genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQD0","description":"ICD-DHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKD0","description":"ICD-KHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decalcify tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88311","description":"Decalcify tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAC0","description":"ICD-NEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYF0","description":"ICD-KDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGC0","description":"ICD-OKGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cartilage for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20910","description":"Remove cartilage for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHD1","description":"ICD-FFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTD0","description":"ICD-ADTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20D","description":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAF1","description":"ICD-JCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of scleral staphyloma; without graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66220","description":"Repair of scleral staphyloma; without graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB07","description":"Ultra High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee orthosis (KO)_ double upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1852","description":"Knee orthosis (KO)_ double upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOB0","description":"ICD-LEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision and repair of eyelid_ involving lid margin_ tarsus_ conjunctiva_ canthus_ or full thickness_ may include preparation for skin graft or pedicle flap with adjacent tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67961","description":"Excision and repair of eyelid_ involving lid margin_ tarsus_ conjunctiva_ canthus_ or full thickness_ may include preparation for skin graft or pedicle flap with adjacent tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHF0","description":"ICD-IGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBC1","description":"ICD-BDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cryofibrinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82585","description":"Assay of cryofibrinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGA0","description":"ICD-OKGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSA0","description":"ICD-OGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHC0","description":"ICD-BEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunofluorescence_ per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0845T","description":"Digitization of glass microscope slides for immunofluorescence_ per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asth controlled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9432","description":"Asth controlled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMC0","description":"ICD-ICMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCD0","description":"ICD-NDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0A","description":"Very High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTE0","description":"ICD-ABTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMB0","description":"ICD-EHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKC1","description":"ICD-NGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVE0","description":"ICD-NDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body fluid cell count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89051","description":"Body fluid cell count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multiple surgery abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49220","description":"Multiple surgery abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of corneal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65450","description":"Treatment of corneal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAC0","description":"ICD-NDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5100","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","description":"HCPCS-Q5100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXF0","description":"ICD-FIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQC1","description":"ICD-PHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc surv no stroke after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9259","description":"Doc surv no stroke after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24126","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRB1","description":"ICD-DBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reloc skin pocket pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0416T","description":"Reloc skin pocket pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUE0","description":"ICD-NLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIB1","description":"ICD-GBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Frequency Ultrasonic Diathermy Treatment Device For Home Use_ Includes All Components And Accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1004","description":"Low Frequency Ultrasonic Diathermy Treatment Device For Home Use_ Includes All Components And Accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBB1","description":"ICD-NGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPF1","description":"ICD-KEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEA1","description":"ICD-OKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0917T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","description":"CPT-0917T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVF0","description":"ICD-CDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHC1","description":"ICD-OCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEC0","description":"ICD-BEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0823T","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXD1","description":"ICD-OEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMD0","description":"ICD-JEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko supracondylar socket mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1860","description":"Ko supracondylar socket mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE241","description":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44620","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMD1","description":"ICD-CGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harvest allogeneic stem cell","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38205","description":"Harvest allogeneic stem cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA11","description":"ICD-4DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove stent via transureth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50386","description":"Remove stent via transureth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATA1","description":"ICD-NATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFND0","description":"ICD-GFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp5 ped mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0891","description":"Pwc gp5 ped mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPF0","description":"ICD-FBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain open retroperi abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49060","description":"Drain open retroperi abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGD1","description":"ICD-JCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body mass index docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3008F","description":"Body mass index docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMC0","description":"ICD-JBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (non-small cell lung cancer)_ cell-free DNA from plasma_ targeted sequence analysis of at least 109 genes_ including sequence variants_ substitutions_ insertions_ del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0397U","description":"Oncology (non-small cell lung cancer)_ cell-free DNA from plasma_ targeted sequence analysis of at least 109 genes_ including sequence variants_ substitutions_ insertions_ del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMC1","description":"ICD-NFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20962","description":"Other bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXC1","description":"ICD-FHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus and fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43305","description":"Repair esophagus and fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQF0","description":"ICD-CEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","description":"HCPCS-J1414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUC1","description":"ICD-AAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQB1","description":"ICD-GHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fungi identification yeast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87106","description":"Fungi identification yeast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLC0","description":"ICD-KHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUF1","description":"ICD-ABUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD116","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPD1","description":"ICD-BDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81457","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blinded administration of convulsive therapy procedure_ either electroconvulsive therapy (ect_ current covered gold standard) or magnetic seizure therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2000","description":"Blinded administration of convulsive therapy procedure_ either electroconvulsive therapy (ect_ current covered gold standard) or magnetic seizure therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTB1","description":"ICD-BFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tubular dressing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6457","description":"Tubular dressing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCF1","description":"ICD-JGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove iris and lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66600","description":"Remove iris and lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAB0","description":"ICD-AAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAC0","description":"ICD-CHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGA0","description":"ICD-BIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped term dev_ hook_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6711","description":"Ped term dev_ hook_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - periapical radiographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0374","description":"intraoral tomosynthesis - periapical radiographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSA1","description":"ICD-GDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ini phq9 >9 no remiss >=5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9395","description":"Ini phq9 >9 no remiss >=5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe lift elev heel/sole neo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3310","description":"Shoe lift elev heel/sole neo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMB1","description":"ICD-BIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIB1","description":"ICD-FBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGB0","description":"ICD-JHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ntsty modul rad tx dlvr smpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77385","description":"Ntsty modul rad tx dlvr smpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTA0","description":"ICD-EFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTE1","description":"ICD-IBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1602","description":"HCPCS-A1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93018","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLC0","description":"ICD-FHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67314","description":"Revise eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOD0","description":"ICD-GBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Matristem burn matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4120","description":"Matristem burn matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWD0","description":"ICD-DBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1032","description":"Nonpneumatic sequential compression garment_ full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGC0","description":"ICD-NLGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPF0","description":"ICD-CIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC55","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJC0","description":"ICD-CAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician_ including a written report to the patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99451","description":"Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician_ including a written report to the patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4288","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","description":"HCPCS-A4288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28X","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total disc arthrp ant appr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0375T","description":"Total disc arthrp ant appr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHC0","description":"ICD-JAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOE1","description":"ICD-PAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Th/wght bear nar m-l brim mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2525","description":"Th/wght bear nar m-l brim mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIA1","description":"ICD-NKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSD1","description":"ICD-DGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOE0","description":"ICD-ODOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAE1","description":"ICD-CHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1602","description":"HCPCS-B1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC11","description":"ICD-2DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMA0","description":"ICD-FFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOA1","description":"ICD-HGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB117","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUB0","description":"ICD-FEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEA1","description":"ICD-BGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35351","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNE0","description":"ICD-CHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD204","description":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flow cyto done b/4 tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3170F","description":"Flow cyto done b/4 tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFA0","description":"ICD-NFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68040","description":"Treatment of eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diathermy eg microwave","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97024","description":"Diathermy eg microwave","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGC1","description":"ICD-JBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4412","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","description":"HCPCS-Q4412","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVC0","description":"ICD-JGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd lesion ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43270","description":"Egd lesion ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAC0","description":"ICD-NGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped crit care age 2-5 init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99475","description":"Ped crit care age 2-5 init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ca screen;flexi sigmoidscope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0104","description":"Ca screen;flexi sigmoidscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFB1","description":"ICD-GCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJA0","description":"ICD-FHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stent placemt retro carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37217","description":"Stent placemt retro carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64585","description":"Revise/remove neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cervical cap contraceptive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4261","description":"Cervical cap contraceptive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited motion knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2184","description":"Limited motion knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQF0","description":"ICD-OCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9186","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9186","description":"HCPCS-J9186","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOD1","description":"ICD-PFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRB1","description":"ICD-HBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1074T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1074T","description":"CPT-1074T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0565","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0565","description":"HCPCS-G0565","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped compr care pkg_ per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1026","description":"Ped compr care pkg_ per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc face tum deep < 2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21013","description":"Exc face tum deep < 2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCB0","description":"ICD-JHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ complete joint (ie_ joint space and peri-articular soft tissue structures) real-time with image documentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76881","description":"Ultrasound_ complete joint (ie_ joint space and peri-articular soft tissue structures) real-time with image documentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHF1","description":"ICD-FIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMB0","description":"ICD-JHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22B","description":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGD1","description":"ICD-FHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD146","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEA0","description":"ICD-OFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0476U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","description":"CPT-0476U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alt long-term cntrl med rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4144F","description":"Alt long-term cntrl med rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-97009","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","description":"CPT-97009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0643","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0643","description":"HCPCS-J0643","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assistive technology assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97755","description":"Assistive technology assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSA0","description":"ICD-GHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0596U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","description":"CPT-0596U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIA0","description":"ICD-BBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDA0","description":"ICD-ODDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrics (pre-implantation genetic testing)_ evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray_ embryonic tissue_ algorithm reported as a probabi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0396U","description":"Obstetrics (pre-implantation genetic testing)_ evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray_ embryonic tissue_ algorithm reported as a probabi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9011","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","description":"HCPCS-J9011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWE0","description":"ICD-GFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHD1","description":"ICD-NBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGB1","description":"ICD-OFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIA0","description":"ICD-GHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVC0","description":"ICD-KDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Topical fluoride varnish","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1206","description":"Topical fluoride varnish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21B","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Florbetapir f18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9586","description":"Florbetapir f18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic sock multi ply ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8430","description":"Prosthetic sock multi ply ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0551T","description":"Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Typhoid vaccine_ acetone-killed_ dried (akd)_ for subcutaneous or jetinjection use (u.s. military)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90693","description":"Typhoid vaccine_ acetone-killed_ dried (akd)_ for subcutaneous or jetinjection use (u.s. military)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIF0","description":"ICD-BFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA134","description":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj prohance multipack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9576","description":"Inj prohance multipack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEC1","description":"ICD-OAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHID0","description":"ICD-JHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIE0","description":"ICD-MAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEE1","description":"ICD-EAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0937T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","description":"CPT-0937T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD204","description":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep ak ischial thermo mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5580","description":"Prep ak ischial thermo mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGA0","description":"ICD-OIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIB1","description":"ICD-NFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX32","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRD1","description":"ICD-KHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLD0","description":"ICD-OBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFF0","description":"ICD-FAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct abdomen w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74150","description":"Ct abdomen w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWB0","description":"ICD-HBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUE0","description":"ICD-IAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0546U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","description":"CPT-0546U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0D","description":"Low Rehab_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEF0","description":"ICD-AIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pessary_ disposable_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4564","description":"Pessary_ disposable_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stimulated iui case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4035","description":"Stimulated iui case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza b ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87275","description":"Influenza b ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42844","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1079T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1079T","description":"CPT-1079T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDB1","description":"ICD-KHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB220","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDC1","description":"ICD-NJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBD0","description":"ICD-NKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEE1","description":"ICD-CHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKB1","description":"ICD-CEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFD0","description":"ICD-FDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27030","description":"Drainage of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cell marker study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88182","description":"Cell marker study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEA0","description":"ICD-FFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA30","description":"Very High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA21","description":"ICD-2DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA144","description":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDB1","description":"ICD-AFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1002","description":"HCPCS-B1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Isavuconazonium Sulfate_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9456","description":"Injection_ Isavuconazonium Sulfate_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24C","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRF0","description":"ICD-PDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQF0","description":"ICD-HCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24B","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAE0","description":"ICD-IIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFE0","description":"ICD-BFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prefabricated resin crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2932","description":"Prefabricated resin crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLC1","description":"ICD-JCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph balloon distension tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91040","description":"Esoph balloon distension tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASF0","description":"ICD-OASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA13","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Viral culture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0416","description":"Viral culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXC1","description":"ICD-JFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALA1","description":"ICD-AALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAA0","description":"ICD-ADAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCD1","description":"ICD-MCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Guided tiss regen resorble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4266","description":"Guided tiss regen resorble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFA1","description":"ICD-GCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDF0","description":"ICD-AEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDA0","description":"ICD-OGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00944","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","description":"CPT-00944","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEA1","description":"ICD-KFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGB0","description":"ICD-JAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70488","description":"Ct maxillofacial w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOE0","description":"ICD-LBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysate sol test kit_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4760","description":"Dialysate sol test kit_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain blood from under nail","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11740","description":"Drain blood from under nail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAA1","description":"ICD-GEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tissue for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20926","description":"Removal of tissue for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFE1","description":"ICD-KEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL53","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6100","description":"Removal of implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0508U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0508U","description":"CPT-0508U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29844","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reeva FT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4314","description":"Reeva FT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIE1","description":"ICD-JBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26650","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD254","description":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQD0","description":"ICD-CBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult daycare services 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5100","description":"Adult daycare services 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVD0","description":"ICD-BAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap ing hernia repair recur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49651","description":"Lap ing hernia repair recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLD0","description":"ICD-MCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index cli","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1353","description":"Patients who did not have a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index cli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41006","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv adjuvant vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90653","description":"Iiv adjuvant vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth collar bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45451","description":"Anesth collar bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bed pan standard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0275","description":"Bed pan standard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSA0","description":"ICD-OLSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78499","description":"Cardiovascular nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"A Model Participant (Ambulance Supplier/Provider)_ The Beneficiary Refuses Services Covered Under The Model (Transport To An Alternate Destination/Treatment In Place)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2022","description":"A Model Participant (Ambulance Supplier/Provider)_ The Beneficiary Refuses Services Covered Under The Model (Transport To An Alternate Destination/Treatment In Place)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB50","description":"Ultra High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBE1","description":"ICD-KFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lyse chest fibrin init day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32561","description":"Lyse chest fibrin init day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-123 ioflupane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9584","description":"Iodine i-123 ioflupane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0551U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0551U","description":"CPT-0551U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGE0","description":"ICD-GBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX56","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxford w/ supinator/pronator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3203","description":"Oxford w/ supinator/pronator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD216","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36217","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMA0","description":"ICD-AAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13A","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Init nb em per day non-fac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99461","description":"Init nb em per day non-fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB220","description":"Clinically Complex _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (b braun) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0136","description":"Injection_ acetaminophen (b braun) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAE1","description":"ICD-IFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) Pain At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (V","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2139","description":"Back Pain Measured By The Visual Analog Scale (Vas) Pain At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (V","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEC0","description":"ICD-MDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99203","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ureter calculus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51065","description":"Remove ureter calculus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHD1","description":"ICD-NFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure of windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31820","description":"Closure of windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA213","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNE0","description":"ICD-OGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermabrasion total face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15780","description":"Dermabrasion total face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-81515","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","description":"CPT-81515","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCF0","description":"ICD-OHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUB1","description":"ICD-EEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQC1","description":"ICD-KGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extension drainage tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4331","description":"Extension drainage tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAF0","description":"ICD-MLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBD1","description":"ICD-NFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCD0","description":"ICD-ICCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUB0","description":"ICD-FHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKA0","description":"ICD-BIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIF1","description":"ICD-MGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52300","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recon_ cta for surg plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0288","description":"Recon_ cta for surg plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24363","description":"Replace elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE246","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral periapical first f","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0220","description":"Intraoral periapical first f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Activity therapy_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2032","description":"Activity therapy_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKC0","description":"ICD-FDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCF0","description":"ICD-BCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDA0","description":"ICD-EIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGC1","description":"ICD-GIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2D","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWB1","description":"ICD-CFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAE1","description":"ICD-EIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBC1","description":"ICD-EGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo mnl lock ultra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5711","description":"Knee-shin exo mnl lock ultra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEC1","description":"ICD-GAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq sacral augmt bilat inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0201T","description":"Perq sacral augmt bilat inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIE1","description":"ICD-OEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVA1","description":"ICD-KHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXA0","description":"ICD-OHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEC0","description":"ICD-FGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDA1","description":"ICD-BIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPE1","description":"ICD-NEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCD0","description":"ICD-MKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remov vert idrl bdy lmbr/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63307","description":"Remov vert idrl bdy lmbr/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tumor immunohistochem/comput","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88361","description":"Tumor immunohistochem/comput","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00932","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","description":"CPT-00932","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44120","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92992","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKE0","description":"ICD-BDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKB0","description":"ICD-KIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace strap_ any orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4002","description":"Replace strap_ any orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUD1","description":"ICD-ACUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat shoulder blade fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23570","description":"Treat shoulder blade fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mech amb infusion pump <8hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0780","description":"Mech amb infusion pump <8hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt has resp insufficiency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1504F","description":"Pt has resp insufficiency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7683","description":"Triamcinolone comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBD0","description":"ICD-CBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEE0","description":"ICD-AFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTC0","description":"ICD-NKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJB1","description":"ICD-NBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMB1","description":"ICD-CGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCB0","description":"ICD-NBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs and metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ includes specimen validity and a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0328U","description":"Drug assay_ definitive_ 120 or more drugs and metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ includes specimen validity and a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11B","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCF1","description":"ICD-FHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVA0","description":"ICD-GAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPC1","description":"ICD-BGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ferumoxytol_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0139","description":"Ferumoxytol_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glucagon tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80424","description":"Glucagon tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGD0","description":"ICD-CIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens lenticular trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2315","description":"Lens lenticular trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSF1","description":"ICD-KHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69633","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01610","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","description":"CPT-01610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVF0","description":"ICD-NCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shank ft w vert load pylon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5987","description":"Shank ft w vert load pylon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Principal illness navigation - peer support_ additional 30 minutes per calendar month (list separately in addition to g0140)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0146","description":"Principal illness navigation - peer support_ additional 30 minutes per calendar month (list separately in addition to g0140)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC11","description":"ICD-4IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJA1","description":"ICD-FIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB250","description":"Special Care High _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXE0","description":"ICD-CBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTC0","description":"ICD-GBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopathology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88199","description":"Cytopathology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQB1","description":"ICD-LHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31511","description":"Remove foreign body larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGME0","description":"ICD-KGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAE0","description":"ICD-ICAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Htlv-i antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86687","description":"Htlv-i antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67515","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vasopneumatic device therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97016","description":"Vasopneumatic device therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBD0","description":"ICD-OFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery blockage each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75964","description":"Repair artery blockage each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISB1","description":"ICD-CISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKC1","description":"ICD-NLKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of forearm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25031","description":"Drainage of forearm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive mastoid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69530","description":"Extensive mastoid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3C","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIF1","description":"ICD-NLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ talimogene laherparepvec_ 1 million plaque forming units (PFU) (Imlygic)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9472","description":"Injection_ talimogene laherparepvec_ 1 million plaque forming units (PFU) (Imlygic)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cultr oocyte/embryo <4 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89251","description":"Cultr oocyte/embryo <4 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBD0","description":"ICD-FCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITD1","description":"ICD-JITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLA1","description":"ICD-MGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81343","description":"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"F5 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81241","description":"F5 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJE0","description":"ICD-BDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE150","description":"Special Care High _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUF0","description":"ICD-JEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVC0","description":"ICD-NBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGF0","description":"ICD-OEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFD1","description":"ICD-OJFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures immediat maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5130","description":"Dentures immediat maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBF1","description":"ICD-OKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patch_ lidocaine/tetracaine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9285","description":"Patch_ lidocaine/tetracaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no rh-immuno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8810","description":"Doc reas no rh-immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASA0","description":"ICD-DASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFF1","description":"ICD-BDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFF1","description":"ICD-GFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fna w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10021","description":"Fna w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVE1","description":"ICD-NHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAB0","description":"ICD-OBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo cholangiopancreatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43262","description":"Endo cholangiopancreatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATF1","description":"ICD-EATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBC0","description":"ICD-NGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMF1","description":"ICD-FHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXA1","description":"ICD-GCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOC0","description":"ICD-HHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECE1","description":"ICD-FECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVC1","description":"ICD-GFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj melphalan hydrochl 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9245","description":"Inj melphalan hydrochl 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYD0","description":"ICD-OEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLD1","description":"ICD-KCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"End of life counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0257","description":"End of life counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEE1","description":"ICD-AEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore wound neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20100","description":"Explore wound neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63706","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prednisone ir or dr oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7512","description":"Prednisone ir or dr oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLA0","description":"ICD-OFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDE0","description":"ICD-MBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRB0","description":"ICD-PJRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ho flex frejka w/cov pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1600","description":"Ho flex frejka w/cov pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair heavy duty fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1295","description":"Wheelchair heavy duty fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHA1","description":"ICD-CAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWA1","description":"ICD-LFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ conforming gauze_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6596","description":"Gradient compression bandaging supply_ conforming gauze_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKF0","description":"ICD-GAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIA1","description":"ICD-NLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUE0","description":"ICD-NJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATB1","description":"ICD-NATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot arch supp premold metat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3050","description":"Foot arch supp premold metat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLE1","description":"ICD-OBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair communication device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5336","description":"Repair communication device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBF0","description":"ICD-CFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat recline mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1004","description":"Pwr seat recline mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med reas not incl histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9419","description":"Med reas not incl histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIA0","description":"ICD-KFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFA0","description":"ICD-FGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTD0","description":"ICD-ODTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Natalizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2323","description":"Natalizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXA0","description":"ICD-GHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25624","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDE1","description":"ICD-MIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWA0","description":"ICD-OGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Curette/treat cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65435","description":"Curette/treat cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt surv improv bsline tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9603","description":"Pt surv improv bsline tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx infiltrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32607","description":"Thoracoscopy w/bx infiltrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Renal scope w/tumor resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50562","description":"Renal scope w/tumor resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOD0","description":"ICD-PEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBF0","description":"ICD-EGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKD1","description":"ICD-GFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBE1","description":"ICD-ODBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41114","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDD0","description":"ICD-FBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBA0","description":"ICD-BEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXD0","description":"ICD-JAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc harness_ expand control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2313","description":"Pwc harness_ expand control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intro/sheath_ non-laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1894","description":"Intro/sheath_ non-laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVF1","description":"ICD-GAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOD0","description":"ICD-KEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00802","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","description":"CPT-00802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCD1","description":"ICD-KDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALB1","description":"ICD-CALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQA0","description":"ICD-PDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATD0","description":"ICD-BATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental retainr cast metl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6545","description":"Dental retainr cast metl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDF0","description":"ICD-ECDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYB1","description":"ICD-OAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc osmotic fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85555","description":"Rbc osmotic fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens gas impermeable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2530","description":"Contact lens gas impermeable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWD1","description":"ICD-GCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC224","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISE1","description":"ICD-DISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic sheepskin pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0188","description":"Synthetic sheepskin pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOC0","description":"ICD-GDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Polishing artifical eye","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2624","description":"Polishing artifical eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBD0","description":"ICD-CIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debridement_ bone (includes epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed); first 20 sq cm or less with manual preparation and insertion of drug-d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7561","description":"Debridement_ bone (includes epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed); first 20 sq cm or less with manual preparation and insertion of drug-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB230","description":"Reduced Physical Function _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; subdural taps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0131U","description":"Anesthesia for intracranial procedures; subdural taps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Screening For Tobacco Use (E.G._ Limited Life Expectancy_ Other Medical Reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0028","description":"Documentation Of Medical Reason(S) For Not Screening For Tobacco Use (E.G._ Limited Life Expectancy_ Other Medical Reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETC1","description":"ICD-AETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRC1","description":"ICD-GFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGE1","description":"ICD-OLGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infusion insulin pump needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4231","description":"Infusion insulin pump needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOB0","description":"ICD-OFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis_ cell-free DNA_ initial (baseline) assessment to determine a patient specific panel for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0306U","description":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis_ cell-free DNA_ initial (baseline) assessment to determine a patient specific panel for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1107T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1107T","description":"CPT-1107T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0577","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0577","description":"HCPCS-G0577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQD1","description":"ICD-KGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of heart lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93505","description":"Biopsy of heart lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLF0","description":"ICD-ECLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx atrial fib pulm vein isol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93656","description":"Tx atrial fib pulm vein isol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJF0","description":"ICD-OAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVA0","description":"ICD-BBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFID0","description":"ICD-CFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACF0","description":"ICD-GACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENC0","description":"ICD-OENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQB0","description":"ICD-KHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65270","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rib gusset (elastic) each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1280","description":"Rib gusset (elastic) each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNB1","description":"ICD-NKNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0514U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","description":"CPT-0514U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10 mg and hyaluronidase-fihj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9144","description":"Injection_ daratumumab_ 10 mg and hyaluronidase-fihj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE112","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBD0","description":"ICD-NBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAF1","description":"ICD-NAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICA1","description":"ICD-AICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye muscle evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92265","description":"Eye muscle evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIE0","description":"ICD-MDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDC1","description":"ICD-BDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99378","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHC0","description":"ICD-KGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARB0","description":"ICD-CARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCD0","description":"ICD-BGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIC0","description":"ICD-MGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTB0","description":"ICD-CDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p day <2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90967","description":"Esrd home pt serv p day <2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQD0","description":"ICD-OIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Department of Veterans Affairs Whole Health Partner Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9004","description":"Department of Veterans Affairs Whole Health Partner Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLB0","description":"ICD-NJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anacaulase-bcdb_ 8.8% gel_ 1 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7353","description":"Anacaulase-bcdb_ 8.8% gel_ 1 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB33","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA30","description":"Default_ /30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMF0","description":"ICD-BEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8X","description":"High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24A","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIC0","description":"ICD-MIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","description":"HCPCS-Q4402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAE1","description":"ICD-NLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDE1","description":"ICD-GGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25332","description":"Revise wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthroscopy_ shoulder_ surgical; with implantation of subacromial spacer (e.g._ balloon)_ includes debridement (e.g._ limited or extensive)_ subacromial decompression_ acromio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9781","description":"Arthroscopy_ shoulder_ surgical; with implantation of subacromial spacer (e.g._ balloon)_ includes debridement (e.g._ limited or extensive)_ subacromial decompression_ acromio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCD1","description":"ICD-MGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCC1","description":"ICD-MLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair with detacharm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0165","description":"Commode chair with detacharm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPE0","description":"ICD-NJPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQE0","description":"ICD-PKQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oseltamivir phosp_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9035","description":"Oseltamivir phosp_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQF1","description":"ICD-PBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brst prsths adhsv attchmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4280","description":"Brst prsths adhsv attchmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYA0","description":"ICD-OLYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/90d mrs >2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9648","description":"Pt w/90d mrs >2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMB0","description":"ICD-NIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Warfarin or another FDA-approved oral anticoagulant is prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8967","description":"Warfarin or another FDA-approved oral anticoagulant is prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOC1","description":"ICD-CHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75716","description":"Artery x-rays arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAC0","description":"ICD-GIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVC1","description":"ICD-GHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gi endoscopic ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76975","description":"Gi endoscopic ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8B","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 7 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP07","description":"Auto.test pane pricing code_ 7 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTA0","description":"ICD-NCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ossicular implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8613","description":"Ossicular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit resp therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99503","description":"Home visit resp therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNA0","description":"ICD-KCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/a/gen/trk20.1-30.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12006","description":"Rpr s/n/a/gen/trk20.1-30.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXD0","description":"ICD-ODXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81414","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cabg w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56752","description":"Anesth cabg w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLB1","description":"ICD-ECLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQA1","description":"ICD-PDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGC1","description":"ICD-CFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0590U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","description":"CPT-0590U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTA1","description":"ICD-OJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRA0","description":"ICD-PGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFD1","description":"ICD-NJFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUD0","description":"ICD-CEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLF1","description":"ICD-FGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9875","description":"Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerebrospinal fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78647","description":"Cerebrospinal fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rehab system with interactive interface providing active assistance in rehabilitation therapy_ includes all components and accessories_ motors_ microprocessors_ sensors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0739","description":"Rehab system with interactive interface providing active assistance in rehabilitation therapy_ includes all components and accessories_ motors_ microprocessors_ sensors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assist living waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2031","description":"Assist living waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of lip fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40806","description":"Incision of lip fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glycopyrrolate comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7642","description":"Glycopyrrolate comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHD1","description":"ICD-BAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCD1","description":"ICD-EHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIB0","description":"ICD-NAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52240","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOC1","description":"ICD-OGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12B","description":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGE0","description":"ICD-NBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mh clubhouse svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2031","description":"Mh clubhouse svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEE1","description":"ICD-NIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAE1","description":"ICD-ODAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMB1","description":"ICD-IEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUB1","description":"ICD-GIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWE0","description":"ICD-HHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99404","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYA0","description":"ICD-LDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPA0","description":"ICD-OAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient has documented immunity to hepatitis B and initiating anti-TNF therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8869","description":"Patient has documented immunity to hepatitis B and initiating anti-TNF therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITC1","description":"ICD-GITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11C","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA140","description":"Reduced Physical Function _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEC1","description":"ICD-AIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHE0","description":"ICD-GGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLA1","description":"ICD-ODLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJF1","description":"ICD-BCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1210","description":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADED1","description":"ICD-ADED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic defect closure within the entire gastrointestinal tract_ including upper endoscopy (including diagnostic_ if performed) or colonoscopy (including diagnostic_ if per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9901","description":"Endoscopic defect closure within the entire gastrointestinal tract_ including upper endoscopy (including diagnostic_ if performed) or colonoscopy (including diagnostic_ if per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65275","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mechanical chest wall oscill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94669","description":"Mechanical chest wall oscill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCC0","description":"ICD-MJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWA1","description":"ICD-HHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPA1","description":"ICD-NFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect heart sac lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33050","description":"Resect heart sac lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGB1","description":"ICD-BAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENA1","description":"ICD-KENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPD1","description":"ICD-NLPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNC0","description":"ICD-KGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of anti-infective_ pain management_ chelation_ pulmonary hypertension_ inotropic_ or other intravenous infusion dr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0088","description":"Professional services_ initial visit_ for the administration of anti-infective_ pain management_ chelation_ pulmonary hypertension_ inotropic_ or other intravenous infusion dr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCE0","description":"ICD-NHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0670","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0670","description":"HCPCS-G0670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETE0","description":"ICD-OETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVF0","description":"ICD-JCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOE0","description":"ICD-PGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Init pm e/m new pat infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99381","description":"Init pm e/m new pat infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIE0","description":"ICD-AAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BCR/ABL1 (t(9;22)) (eg_ chronic myelogenous leukemia) translocation analysis_ major breakpoint_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0040U","description":"BCR/ABL1 (t(9;22)) (eg_ chronic myelogenous leukemia) translocation analysis_ major breakpoint_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0221","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQE0","description":"ICD-KIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ foot_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6587","description":"Gradient pressure wrap with adjustable straps_ foot_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKE0","description":"ICD-BCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCC1","description":"ICD-GFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reproductive Medicine (Endometrial Receptivity Analysis)_ Rna Gene Expression Profile_ 238 Genes By Next-Generation Sequencing_ Endometrial Tissue_ Predictive Algorithm Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0253U","description":"Reproductive Medicine (Endometrial Receptivity Analysis)_ Rna Gene Expression Profile_ 238 Genes By Next-Generation Sequencing_ Endometrial Tissue_ Predictive Algorithm Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise submaxillary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42440","description":"Excise submaxillary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1500","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","description":"HCPCS-M1500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQD0","description":"ICD-GBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIA1","description":"ICD-GCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFE1","description":"ICD-FDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMA1","description":"ICD-FGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSA1","description":"ICD-HCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD241","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBME1","description":"ICD-GBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHA1","description":"ICD-FBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33824","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXA1","description":"ICD-CCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKA0","description":"ICD-CFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAD1","description":"ICD-OKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVC0","description":"ICD-CIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUD1","description":"ICD-KBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25907","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSB1","description":"ICD-OKSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCD1","description":"ICD-JBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dissolve clot heart vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92975","description":"Dissolve clot heart vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHB0","description":"ICD-JDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBC0","description":"ICD-OJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Patient Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Patient Declined_ Other Patient Reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2094","description":"Documentation Of Patient Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Patient Declined_ Other Patient Reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTD0","description":"ICD-FFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle-skin graft leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15738","description":"Muscle-skin graft leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBE1","description":"ICD-NKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iv chelationtherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0300","description":"Iv chelationtherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hocm 200-249mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9960","description":"Hocm 200-249mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no ahi or rdi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8843","description":"Doc reas no ahi or rdi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ready gradient glove","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8427","description":"Ready gradient glove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHD0","description":"ICD-MHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44950","description":"Appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g._ inadequate prep_ familial or personal history of colonic polyps_ patient h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9862","description":"Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g._ inadequate prep_ familial or personal history of colonic polyps_ patient h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMC1","description":"ICD-FHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary colon cancer disorders (eg_ Lynch syndrome_ <i>PTEN</i> hamartoma syndrome_ Cowden syndrome_ familial adenomatosis polyposis)_ genomic sequence analysis panel utili","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0101U","description":"Hereditary colon cancer disorders (eg_ Lynch syndrome_ <i>PTEN</i> hamartoma syndrome_ Cowden syndrome_ familial adenomatosis polyposis)_ genomic sequence analysis panel utili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDA0","description":"ICD-IHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHF0","description":"ICD-ACHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair nasal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30540","description":"Repair nasal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSE0","description":"ICD-PJSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; Prolonged Service_ Each Additional 30 Minutes (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80506","description":"Pathology Clinical Consultation; Prolonged Service_ Each Additional 30 Minutes (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC33","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18F","description":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0947T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","description":"CPT-0947T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ballistocardiogram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3902","description":"Ballistocardiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PEANUT ALLG ASMT EPI CLIN RX","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0178U","description":"PEANUT ALLG ASMT EPI CLIN RX","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr s/a/l 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14020","description":"Tis trnfr s/a/l 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC11","description":"ICD-1LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUE1","description":"ICD-NFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGC0","description":"ICD-CDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCB0","description":"ICD-AFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"GYPB GNOTYP NTRNS 1 5 SEUX 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0190U","description":"GYPB GNOTYP NTRNS 1 5 SEUX 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAA1","description":"ICD-FDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNE1","description":"ICD-BGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TB screening not performed or results not interpreted_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1005","description":"TB screening not performed or results not interpreted_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Latex suspension sleeve each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6632","description":"Latex suspension sleeve each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tint photochromatic lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2744","description":"Tint photochromatic lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ delafloxacin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9462","description":"Injection_ delafloxacin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O&p supply/accessory/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L9900","description":"O&p supply/accessory/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLE1","description":"ICD-MGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILA1","description":"ICD-AILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0304","description":"HCPCS-B0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRF1","description":"ICD-PDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFE0","description":"ICD-NCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB251","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration popliteal artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35741","description":"Exploration popliteal artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFED0","description":"ICD-BFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27440","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB30","description":"Medium Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVD1","description":"ICD-GCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPD1","description":"ICD-JGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMD1","description":"ICD-GBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBME0","description":"ICD-BBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBID1","description":"ICD-FBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSB0","description":"ICD-OLSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA21","description":"ICD-3KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLF1","description":"ICD-NKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93227","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPA1","description":"ICD-JAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-49190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","description":"CPT-49190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ meloxicam_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1738","description":"Injection_ meloxicam_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27659","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRF0","description":"ICD-KCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAC0","description":"ICD-NIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUA0","description":"ICD-ABUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMD0","description":"ICD-MGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone imaging limited area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78300","description":"Bone imaging limited area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUE0","description":"ICD-NEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Path consult intraop 1 bloc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88331","description":"Path consult intraop 1 bloc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUD1","description":"ICD-BGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBD0","description":"ICD-MHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC260","description":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMF0","description":"ICD-NFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUA0","description":"ICD-IBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOB0","description":"ICD-LBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18E","description":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue not image intraop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8874","description":"Tissue not image intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26180","description":"Removal of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRB0","description":"ICD-LHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTA0","description":"ICD-IFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLD1","description":"ICD-NFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc no fall in asc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8911","description":"Pt doc no fall in asc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUF1","description":"ICD-GIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Japanese encephalitis virus vaccine_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90735","description":"Japanese encephalitis virus vaccine_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQC0","description":"ICD-CCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient was provided hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9710","description":"Patient was provided hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTA1","description":"ICD-OBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB32","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBA0","description":"ICD-FGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ nonlyophilized_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9318","description":"Injection_ romidepsin_ nonlyophilized_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDE0","description":"ICD-AEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M/phmtrc alysishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88369","description":"M/phmtrc alysishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61315","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Frozen Tissue_ Blood_ Or Bone Marrow_ Comparative Structural Vari","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0299U","description":"Oncology (Pan Tumor)_ Whole Genome Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Frozen Tissue_ Blood_ Or Bone Marrow_ Comparative Structural Vari","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch for bar w lk fl/fltr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4423","description":"Ost pch for bar w lk fl/fltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18H","description":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACD1","description":"ICD-AACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES330","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKED1","description":"ICD-OKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB154","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLD0","description":"ICD-BBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPB0","description":"ICD-GAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17270","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinician Documented That Patient Recevied Vascular Access Other Than Autogenous AV Fistula_ Reason not Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8532","description":"Clinician Documented That Patient Recevied Vascular Access Other Than Autogenous AV Fistula_ Reason not Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair middle ear structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69667","description":"Repair middle ear structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33986","description":"Ecmo/ecls rmvl ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory bp analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93788","description":"Ambulatory bp analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXC0","description":"ICD-CFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neg scrn dep symp by deptool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3351F","description":"Neg scrn dep symp by deptool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRF0","description":"ICD-HBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMB1","description":"ICD-MEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934]_ rs6560711 [WDR37]_ rs3735222 [SCIN/LOC10798676","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0439U","description":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934]_ rs6560711 [WDR37]_ rs3735222 [SCIN/LOC10798676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBID0","description":"ICD-OBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emergency anesthesia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99140","description":"Emergency anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPE0","description":"ICD-KIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72157","description":"MRI chest spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sphyg/bp app w cuff and stet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4660","description":"Sphyg/bp app w cuff and stet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWB1","description":"ICD-CBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv trunk musc 6/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64647","description":"Chemodenerv trunk musc 6/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15A","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATE1","description":"ICD-NATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUA1","description":"ICD-JIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special joystick handle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2323","description":"Special joystick handle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGD0","description":"ICD-ODGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADA0","description":"ICD-OADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye socket wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65290","description":"Repair of eye socket wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQD0","description":"ICD-CHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient not screened for unhealthy alcohol use using a systematic screening method_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2199","description":"Patient not screened for unhealthy alcohol use using a systematic screening method_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromogenic substrate assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85130","description":"Chromogenic substrate assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28150","description":"Removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88027","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB13","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penile contracture device_ manual_ greater than 3 lbs traction force","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4988","description":"Penile contracture device_ manual_ greater than 3 lbs traction force","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJD0","description":"ICD-NCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0204","description":"HCPCS-B0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHC0","description":"ICD-FBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTA1","description":"ICD-MHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTB1","description":"ICD-KGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB03","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal septal prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8047","description":"Nasal septal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOD1","description":"ICD-PKOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMB0","description":"ICD-EAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remv&replc pm gen dual lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33228","description":"Remv&replc pm gen dual lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35276","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDID0","description":"ICD-EDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOC1","description":"ICD-OKOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWF0","description":"ICD-OBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac mgmt pt opt alterna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9059","description":"Onc prac mgmt pt opt alterna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient was referred to another provider or specialist during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9968","description":"Patient was referred to another provider or specialist during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE105","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psytx complex interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90785","description":"Psytx complex interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28C","description":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise vag graft via vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57295","description":"Revise vag graft via vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22325","description":"Treat spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUB0","description":"ICD-KFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTF1","description":"ICD-GBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGF0","description":"ICD-FHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIE1","description":"ICD-OAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANC1","description":"ICD-CANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLA1","description":"ICD-ABLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOD0","description":"ICD-CGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFC0","description":"ICD-OAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJB1","description":"ICD-FEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0260U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVE1","description":"ICD-FBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain outer ear canal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69020","description":"Drain outer ear canal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPA0","description":"ICD-KEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic Examination_ Esophagus_ Including Scout Chest Radiograph(S) And Delayed Image(S)_ When Performed; Double-Contrast (Eg_ High-Density Barium And Effervescent Agent) S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74221","description":"Radiologic Examination_ Esophagus_ Including Scout Chest Radiograph(S) And Delayed Image(S)_ When Performed; Double-Contrast (Eg_ High-Density Barium And Effervescent Agent) S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVD0","description":"ICD-CBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical testimony","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99075","description":"Medical testimony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPF1","description":"ICD-OBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0305","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0305","description":"CDT-D0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMF0","description":"ICD-CEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22845","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ 120 or more drugs and substances_ definitive tandem mass spectrometry with chromatography_ urine_ qualitative report of presence (including quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0006U","description":"Prescription drug monitoring_ 120 or more drugs and substances_ definitive tandem mass spectrometry with chromatography_ urine_ qualitative report of presence (including quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens bifocal seg width over","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2219","description":"Lens bifocal seg width over","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Improve visual funct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0913","description":"Improve visual funct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKE0","description":"ICD-OLKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA30","description":"Low Rehab_ ADL Index 0-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wearable artificial kidney","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1632","description":"Wearable artificial kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPC1","description":"ICD-FEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1015T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","description":"CPT-1015T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUF1","description":"ICD-CEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmi is documented as being outside of normal parameters_ follow-up plan is not completed for documented medical reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1286","description":"Bmi is documented as being outside of normal parameters_ follow-up plan is not completed for documented medical reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSB0","description":"ICD-OGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Position seat spec orth need","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T5001","description":"Position seat spec orth need","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","description":"HCPCS-J7173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78831","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath w/drainage 3-way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4316","description":"Cath w/drainage 3-way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8H","description":"High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ emapalumab-lzsg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9210","description":"Injection_ emapalumab-lzsg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc mel cnr stg 0 - iic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8944","description":"Ajcc mel cnr stg 0 - iic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18H","description":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQB0","description":"ICD-OAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTF0","description":"ICD-ICTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAF1","description":"ICD-AFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Substernal Implantable Defibrillator Pulse Generator Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0580T","description":"Removal Of Substernal Implantable Defibrillator Pulse Generator Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0473U","description":"Oncology (solid tumor)_ next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGB1","description":"ICD-FCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBB0","description":"ICD-IBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGE0","description":"ICD-KIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUD0","description":"ICD-NAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUA0","description":"ICD-KBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation medicine (kidney allograft rejection)_ microarray gene expression profiling of 1494 genes_ utilizing transplant biopsy tissue_ algorithm reported as a probabil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0088U","description":"Transplantation medicine (kidney allograft rejection)_ microarray gene expression profiling of 1494 genes_ utilizing transplant biopsy tissue_ algorithm reported as a probabil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCE0","description":"ICD-NJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYA0","description":"ICD-LCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQC1","description":"ICD-KFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24C","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical place mini implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6013","description":"Surgical place mini implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJE1","description":"ICD-GDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHE0","description":"ICD-EAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHB0","description":"ICD-FBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFME0","description":"ICD-BFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31200","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunosuppressive drug noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7599","description":"Immunosuppressive drug noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKF0","description":"ICD-GEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEB0","description":"ICD-KGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTF1","description":"ICD-KCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQE0","description":"ICD-PHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLD0","description":"ICD-OKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA52","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEE0","description":"ICD-BIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADED0","description":"ICD-ADED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIC1","description":"ICD-OKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAA0","description":"ICD-MEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay glucose blood quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82947","description":"Assay glucose blood quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDA0","description":"ICD-BDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severity angina by actvty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1010F","description":"Severity angina by actvty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBC0","description":"ICD-NHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJB1","description":"ICD-OCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brompheniramine maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0945","description":"Brompheniramine maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fev<60% pred & copd sym","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8924","description":"Fev<60% pred & copd sym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCND0","description":"ICD-GCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor_ including system activation and patient training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0446T","description":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor_ including system activation and patient training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvef < 40% or lvsd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8923","description":"Lvef < 40% or lvsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBA0","description":"ICD-OLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIC1","description":"ICD-JCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4A","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWB1","description":"ICD-CGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIC1","description":"ICD-JFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove drug implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11982","description":"Remove drug implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYD0","description":"ICD-OHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self care current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8987","description":"Self care current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYF1","description":"ICD-CDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDB1","description":"ICD-NJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNB0","description":"ICD-GHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status performed once in the last 12 months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9916","description":"Functional status performed once in the last 12 months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFE1","description":"ICD-FCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISF0","description":"ICD-HISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYE1","description":"ICD-KHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAF0","description":"ICD-JEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary leg bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5112","description":"Urinary leg bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRB1","description":"ICD-PDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral place of fix dev","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7998","description":"Intraoral place of fix dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown-titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2794","description":"Crown-titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIF1","description":"ICD-ICIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOE0","description":"ICD-HBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fld ped wc adjstabl w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1238","description":"Fld ped wc adjstabl w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEE0","description":"ICD-GIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJF1","description":"ICD-CIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1307","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","description":"HCPCS-J1307","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPB0","description":"ICD-FCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWC0","description":"ICD-HEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domicil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0086","description":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domicil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHF1","description":"ICD-BAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPA1","description":"ICD-KGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice in ltch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5007","description":"Hospice in ltch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTB0","description":"ICD-JDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Composite byp grft pros&vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35681","description":"Composite byp grft pros&vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCB0","description":"ICD-MFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEE1","description":"ICD-EDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSD1","description":"ICD-PLSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSF1","description":"ICD-LBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEA1","description":"ICD-EFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plas shoe insert w ank joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2180","description":"Plas shoe insert w ank joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermabrasion other than face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15782","description":"Dermabrasion other than face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indexing for osteotomy using dynamic robotic assisted or dynamic navigation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7939","description":"Indexing for osteotomy using dynamic robotic assisted or dynamic navigation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27517","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLF0","description":"ICD-ADLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBD1","description":"ICD-JBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEC0","description":"ICD-FDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aortobifemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35646","description":"Art byp aortobifemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILA1","description":"ICD-FILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFA0","description":"ICD-CCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap vent/abd hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49652","description":"Lap vent/abd hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIE0","description":"ICD-KCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOD1","description":"ICD-OIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVC0","description":"ICD-NCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQF0","description":"ICD-KFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dna/rna amplified probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87150","description":"Dna/rna amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYC1","description":"ICD-LIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin barrier_ wipe or swab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5120","description":"Skin barrier_ wipe or swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUC1","description":"ICD-NKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30905","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLB0","description":"ICD-CHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHD0","description":"ICD-IGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0615","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","description":"HCPCS-J0615","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUD1","description":"ICD-AGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDE1","description":"ICD-NDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with implantable stimulation lead and external paired stimulation controller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1827","description":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with implantable stimulation lead and external paired stimulation controller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTB0","description":"ICD-OGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull/brain surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61735","description":"Incise skull/brain surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLD1","description":"ICD-CDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cpap full face mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7030","description":"Cpap full face mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation Supply; Sleeve_ Reusable_ Per Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4436","description":"Irrigation Supply; Sleeve_ Reusable_ Per Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort ii anterior intrusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21150","description":"Lefort ii anterior intrusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDC0","description":"ICD-EDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUF1","description":"ICD-FBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBC0","description":"ICD-OCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC35","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALD0","description":"ICD-MALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61321","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXB1","description":"ICD-NHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Casting/strapping procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29799","description":"Casting/strapping procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh_ methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22859","description":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh_ methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 5MCG/0.5ML AS03","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91310","description":"SARSCOV2 VAC 5MCG/0.5ML AS03","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGB0","description":"ICD-CEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of silica","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84285","description":"Assay of silica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNF1","description":"ICD-ODNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0012","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67210","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ inotuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9229","description":"Injection_ inotuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE225","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL11","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHC1","description":"ICD-MHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEE0","description":"ICD-CHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Planar seat for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2292","description":"Planar seat for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18D","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLD0","description":"ICD-JDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74020","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMA0","description":"ICD-NIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIE0","description":"ICD-MLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBB1","description":"ICD-CEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPD0","description":"ICD-JCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJD1","description":"ICD-JGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX07","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temporary replacement eqpmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0462","description":"Temporary replacement eqpmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No follow up pulm nod norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9347","description":"No follow up pulm nod norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ DNA (523 genes) and RNA (55 genes) by next-generation sequencing_ interrogation for sequence variants_ gene cop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0379U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ DNA (523 genes) and RNA (55 genes) by next-generation sequencing_ interrogation for sequence variants_ gene cop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABC0","description":"ICD-AABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Up ext fx orthos humeral nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3980","description":"Up ext fx orthos humeral nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radial keratotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65771","description":"Radial keratotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJB1","description":"ICD-JFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE254","description":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25265","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44363","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA31","description":"ICD-4DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLA1","description":"ICD-AHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemi-wheelchair detachable a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1086","description":"Hemi-wheelchair detachable a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or com","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99218","description":"Initial observation care_ per day_ for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or com","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA56","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILA0","description":"ICD-BILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72158","description":"MRI lumbar spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release muscles of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26593","description":"Release muscles of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx orbit w/o manipulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21400","description":"Closed tx orbit w/o manipulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pure tone audiometry air","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92552","description":"Pure tone audiometry air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDC1","description":"ICD-MIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDA0","description":"ICD-JCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSC1","description":"ICD-CHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place device impacted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7283","description":"Place device impacted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDME0","description":"ICD-EDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE114","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap ins device for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49327","description":"Lap ins device for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25119","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVB0","description":"ICD-JIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0165","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","description":"HCPCS-J0165","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGD0","description":"ICD-JFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKF0","description":"ICD-NHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWD1","description":"ICD-LEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLB1","description":"ICD-JCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional neuromuscularstim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0764","description":"Functional neuromuscularstim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection estrone per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1435","description":"Injection estrone per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPD0","description":"ICD-KAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBC1","description":"ICD-JEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown full high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6790","description":"Crown full high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 0.5cm<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11640","description":"Exc f/e/e/n/l mal+mrg 0.5cm<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00120","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","description":"CPT-00120","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRC0","description":"ICD-OFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Facility-based respite_ 24-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0531","description":"Facility-based respite_ 24-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62140","description":"Repair of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA05","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBC1","description":"ICD-CGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ptnotrcvngsteroid>/=10mg/day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3750F","description":"Ptnotrcvngsteroid>/=10mg/day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA114","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJED1","description":"ICD-MJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penicillin g potassium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2540","description":"Penicillin g potassium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADC0","description":"ICD-KADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diast bp 80-89 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3079F","description":"Diast bp 80-89 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18I","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscop stent placement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43212","description":"Esophagoscop stent placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYF1","description":"ICD-DAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5212","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKD0","description":"ICD-OKKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins device for rt guide open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49412","description":"Ins device for rt guide open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIED1","description":"ICD-NIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ low density channel foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6603","description":"Gradient compression bandaging supply_ low density channel foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFC0","description":"ICD-OJFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLE0","description":"ICD-IFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDF0","description":"ICD-JHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilated Retinal Eye Exam With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2102","description":"Dilated Retinal Eye Exam With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILC0","description":"ICD-OILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; supply and technical support_ per 30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0733T","description":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; supply and technical support_ per 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth biopsy of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32251","description":"Anesth biopsy of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKC1","description":"ICD-GEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22630","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHE1","description":"ICD-IBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGA0","description":"ICD-FIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGB1","description":"ICD-BEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIC0","description":"ICD-BGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lang comp d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9161","description":"Lang comp d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot inhibit prot s free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85306","description":"Clot inhibit prot s free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDF0","description":"ICD-MLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQB0","description":"ICD-DAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8F","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable corrugated tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7010","description":"Disposable corrugated tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobramycin non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7682","description":"Tobramycin non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITE0","description":"ICD-JITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGD0","description":"ICD-NCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove colloid cyst w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62162","description":"Remove colloid cyst w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFD1","description":"ICD-CHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscope w/vc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31570","description":"Laryngoscope w/vc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety)_ genomic analysis panel_ including variant analysis of 26 genes_ buccal swab_ report including metabolizer status and risk of drug toxicit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0423U","description":"Psychiatry (eg_ depression_ anxiety)_ genomic analysis panel_ including variant analysis of 26 genes_ buccal swab_ report including metabolizer status and risk of drug toxicit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCE0","description":"ICD-NBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEB1","description":"ICD-JDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYF0","description":"ICD-LHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHC0","description":"ICD-CGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXA1","description":"ICD-KFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJD1","description":"ICD-OCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFF0","description":"ICD-OHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90966","description":"Esrd home pt serv p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYE1","description":"ICD-GDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1pc ost pch drain hgh output","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4435","description":"1pc ost pch drain hgh output","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meningococcal recombinant lipoprotein vaccine_ serogroup B (MenB-FHbp)_ 2 or 3 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90621","description":"Meningococcal recombinant lipoprotein vaccine_ serogroup B (MenB-FHbp)_ 2 or 3 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD220","description":"Reduced Physical Function _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61692","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44125","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0925T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","description":"CPT-0925T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELC1","description":"ICD-GELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA54","description":"High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ank-foot sys dors-plant flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5973","description":"Ank-foot sys dors-plant flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder harness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5699","description":"Shoulder harness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33737","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDC0","description":"ICD-OBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHE0","description":"ICD-IIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21B","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETF0","description":"ICD-NETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBE1","description":"ICD-OCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB205","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA31","description":"ICD-1DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWC1","description":"ICD-HEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis_ male_ including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52284","description":"Cystourethroscopy_ with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis_ male_ including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38720","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visit to determ ldct elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0296","description":"Visit to determ ldct elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA13","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen quantalcohols","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80320","description":"Drug screen quantalcohols","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHB0","description":"ICD-MEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00832","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","description":"CPT-00832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAME0","description":"ICD-GAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNF1","description":"ICD-FBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLE1","description":"ICD-MJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96573","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJE0","description":"ICD-CEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQA1","description":"ICD-DCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBB1","description":"ICD-CBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1130","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEF0","description":"ICD-GFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00810","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00810","description":"CPT-00810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hcg free betachain test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84704","description":"Hcg free betachain test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCB1","description":"ICD-ECCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ genital region_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6571","description":"Gradient compression garment_ genital region_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPB0","description":"ICD-ODPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69300","description":"Revise external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot/toes surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28899","description":"Foot/toes surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urea-n clearance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84545","description":"Urea-n clearance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYB0","description":"ICD-HBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00580","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","description":"CPT-00580","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4342","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","description":"HCPCS-Q4342","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft head/neck </4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64885","description":"Nerve graft head/neck </4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEA0","description":"ICD-NJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acupunct w/stimul addl 15m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97814","description":"Acupunct w/stimul addl 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGB1","description":"ICD-JAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1438","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","description":"HCPCS-M1438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of shoulder cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29058","description":"Application of shoulder cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDD1","description":"ICD-AFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSD0","description":"ICD-GDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALD0","description":"ICD-EALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Semen anal strict criteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89322","description":"Semen anal strict criteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIA0","description":"ICD-JCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUD1","description":"ICD-GIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNA1","description":"ICD-FDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEA1","description":"ICD-AAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNE1","description":"ICD-GCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOA1","description":"ICD-OCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9310","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9310","description":"HCPCS-C9310","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unspecified periodontal proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4999","description":"Unspecified periodontal proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy or excision of lymph node(s); open_ inguinofemoral node(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38531","description":"Biopsy or excision of lymph node(s); open_ inguinofemoral node(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDC0","description":"ICD-OJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBA1","description":"ICD-AIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGB0","description":"ICD-NFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHE1","description":"ICD-KFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWF0","description":"ICD-KAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJC1","description":"ICD-KBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61559","description":"Excision of skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec knee-shin swing/stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5856","description":"Elec knee-shin swing/stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct colonography dx w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74262","description":"Ct colonography dx w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYA1","description":"ICD-OIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKB0","description":"ICD-FEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRB0","description":"ICD-KCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Restorigin_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4192","description":"Restorigin_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen dua rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8687","description":"Implt nrostm pls gen dua rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including An Implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0674T","description":"Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including An Implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1241","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absolute Quantitation Of Myocardial Blood Flow (Aqmbf)_ Positron Emission Tomography (Pet)_ Rest And Pharmacologic Stress (List Separately In Addition To Code For Primary Proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78434","description":"Absolute Quantitation Of Myocardial Blood Flow (Aqmbf)_ Positron Emission Tomography (Pet)_ Rest And Pharmacologic Stress (List Separately In Addition To Code For Primary Proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHA1","description":"ICD-AAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCB0","description":"ICD-IGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVF1","description":"ICD-KEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATB0","description":"ICD-IATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILD0","description":"ICD-IILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICF0","description":"ICD-KICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKB1","description":"ICD-CIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Structured Day Habilitation Group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0104","description":"Structured Day Habilitation Group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise lumbar artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22862","description":"Revise lumbar artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPD1","description":"ICD-GHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of arm artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35045","description":"Repair defect of arm artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRC1","description":"ICD-LGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGA1","description":"ICD-FHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVF0","description":"ICD-OAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBA1","description":"ICD-CBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJA1","description":"ICD-BEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQA1","description":"ICD-LBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDB0","description":"ICD-MJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEE0","description":"ICD-EHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt notrcvng1st antitnf txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6150F","description":"Pt notrcvng1st antitnf txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXE1","description":"ICD-GFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYB1","description":"ICD-LDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHF1","description":"ICD-NKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXA0","description":"ICD-NGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0577U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","description":"CPT-0577U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOF1","description":"ICD-HIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHD1","description":"ICD-ADHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEF1","description":"ICD-NAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUA1","description":"ICD-ACUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSD1","description":"ICD-PBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70150","description":"X-ray exam of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cine/vid x-ray throat/esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74230","description":"Cine/vid x-ray throat/esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gauze >16<=48 no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6223","description":"Gauze >16<=48 no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asp presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9435","description":"Asp presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCD1","description":"ICD-OGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWE0","description":"ICD-HBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home phototherapy visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9098","description":"Home phototherapy visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brst cncr stage > t1n0m0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8881","description":"Brst cncr stage > t1n0m0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMF0","description":"ICD-NLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96165","description":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant auditory brain imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2235","description":"Implant auditory brain imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1)_ serum_ reported as positive or negative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0059U","description":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1)_ serum_ reported as positive or negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3d predictive model generation for pre-planning of a cardiac procedure_ using data from cardiac computed tomographic angiography with report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9793","description":"3d predictive model generation for pre-planning of a cardiac procedure_ using data from cardiac computed tomographic angiography with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFB0","description":"ICD-GBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWE1","description":"ICD-OJWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQE1","description":"ICD-KHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endometr ablate thermal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58353","description":"Endometr ablate thermal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYD0","description":"ICD-CAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelet deplete of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38213","description":"Platelet deplete of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUD0","description":"ICD-KHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOB1","description":"ICD-GFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIE0","description":"ICD-IDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUE0","description":"ICD-MGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVB0","description":"ICD-JDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart vessel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33501","description":"Repair heart vessel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Legionella micdadei ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87277","description":"Legionella micdadei ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Promethazine hcl 12.5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0169","description":"Promethazine hcl 12.5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECB0","description":"ICD-MECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSE0","description":"ICD-CCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0799T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDC0","description":"ICD-EHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRB0","description":"ICD-DIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37287","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","description":"CPT-37287","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEED0","description":"ICD-BEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHC1","description":"ICD-AEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cat scan follow-up study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76380","description":"Cat scan follow-up study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1132","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEA0","description":"ICD-AGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUA0","description":"ICD-EAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intrvasc us noncoronary 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37252","description":"Intrvasc us noncoronary 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSF1","description":"ICD-DHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBA0","description":"ICD-AFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic Ultrafiltration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0692T","description":"Therapeutic Ultrafiltration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; each separate/additional lesion (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11101","description":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; each separate/additional lesion (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAD1","description":"ICD-AFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-1 piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21145","description":"Lefort i-1 piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGD1","description":"ICD-NAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARC1","description":"ICD-PARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPC1","description":"ICD-NAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIF1","description":"ICD-CGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPE0","description":"ICD-KHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNB1","description":"ICD-GHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place cecostomy tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49442","description":"Place cecostomy tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso flex no ri stays pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0628","description":"Lso flex no ri stays pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBD1","description":"ICD-FCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVE1","description":"ICD-KBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAB0","description":"ICD-BEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDC1","description":"ICD-IEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15934","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQF1","description":"ICD-OCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUC0","description":"ICD-NLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27146","description":"Incision of hip bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99192","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVC0","description":"ICD-NGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scrn hcv infec not recd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9386","description":"Scrn hcv infec not recd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28B","description":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCD1","description":"ICD-JCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22D","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65420","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision Or Replacement (Including Removal Of Existing Device)_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69719","description":"Revision Or Replacement (Including Removal Of Existing Device)_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place cath intracranial art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36228","description":"Place cath intracranial art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1079","description":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJA1","description":"ICD-FDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imm admin by intramusc inj of (SARS-CoV-2) (coronavirus disease [COVID-19]) vacc_ mRNA-LNP_ spike protein_ preserv free_ 30mcg/0.3 mL dose_ tris-sucrose formula_ booster dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054A","description":"Imm admin by intramusc inj of (SARS-CoV-2) (coronavirus disease [COVID-19]) vacc_ mRNA-LNP_ spike protein_ preserv free_ 30mcg/0.3 mL dose_ tris-sucrose formula_ booster dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9891","description":"MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clozapine_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0136","description":"Clozapine_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECE1","description":"ICD-BECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70300","description":"X-ray exam of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASA0","description":"ICD-CASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50010","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDB1","description":"ICD-EIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCE1","description":"ICD-ICCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGC0","description":"ICD-NBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); single analyte not elsewhere specified_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82491","description":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); single analyte not elsewhere specified_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPA0","description":"ICD-NKPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj biperiden lactate/5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0190","description":"Inj biperiden lactate/5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically node negative (T1N0N0 or T2N0N0) invasive breast cancer before or after neoadjuvant systemic therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9911","description":"Clinically node negative (T1N0N0 or T2N0N0) invasive breast cancer before or after neoadjuvant systemic therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo sing bar clasp attach sh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1910","description":"Afo sing bar clasp attach sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVA0","description":"ICD-NCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed total elect w/o mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0297","description":"Hosp bed total elect w/o mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67218","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull/brain surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61720","description":"Incise skull/brain surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJA0","description":"ICD-KCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMD1","description":"ICD-JAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITB0","description":"ICD-KITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of arm artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34111","description":"Removal of arm artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPF1","description":"ICD-JDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGD0","description":"ICD-NKGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27279","description":"Arthrodesis sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPF1","description":"ICD-BGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYA1","description":"ICD-GIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB45","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8I","description":"High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ elranatamab-bcmm_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9165","description":"Injection_ elranatamab-bcmm_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTE1","description":"ICD-FDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUF1","description":"ICD-IFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; download review_ interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0536T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; download review_ interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80438","description":"Trh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of feces porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84126","description":"Assay of feces porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8013","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8013","description":"HCPCS-C8013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fee covid-19 vac 3 booster","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0023A","description":"Fee covid-19 vac 3 booster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42842","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSE0","description":"ICD-OKSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35103","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Darbepoetin alfa_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0881","description":"Darbepoetin alfa_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEE0","description":"ICD-KIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCA0","description":"ICD-MLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEE0","description":"ICD-AGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWA0","description":"ICD-PKWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNE1","description":"ICD-JBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPA1","description":"ICD-CHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTB1","description":"ICD-FGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKC1","description":"ICD-CGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAD0","description":"ICD-EEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20A","description":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTD0","description":"ICD-IGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEB1","description":"ICD-NLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBE1","description":"ICD-GCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0678","description":"Non-pneumatic sequential compression garment_ full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNA1","description":"ICD-BBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Olanzapine long-acting inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2358","description":"Olanzapine long-acting inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL06","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNB1","description":"ICD-NLNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Covers for upright each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1120","description":"Covers for upright each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELB0","description":"ICD-IELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"L hrt artery/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93458","description":"L hrt artery/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post vert arthrplst 1 lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0202T","description":"Post vert arthrplst 1 lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla typing a b or c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86812","description":"Hla typing a b or c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEF0","description":"ICD-IDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22867","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75805","description":"Lymph vessel x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc antibody elution","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86860","description":"Rbc antibody elution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJC1","description":"ICD-OGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEC0","description":"ICD-GHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1003","description":"HCPCS-A1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg >4.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11406","description":"Exc tr-ext b9+marg >4.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRE1","description":"ICD-KBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQF1","description":"ICD-HIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJA0","description":"ICD-CIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78607","description":"Brain imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEA0","description":"ICD-KIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIC0","description":"ICD-FCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXA0","description":"ICD-KFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIME0","description":"ICD-JIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPF0","description":"ICD-FCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOB0","description":"ICD-GIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test socket above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5624","description":"Test socket above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap jejunostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44186","description":"Lap jejunostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insitu hybridization auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88367","description":"Insitu hybridization auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (coronary artery disease [CAD])_ analysis of 3 proteins (high sensitivity [hs] troponin_ adiponectin_ and kidney injury molecule-1 [KIM-1])_ plasma_ algorithm repor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0308U","description":"Cardiology (coronary artery disease [CAD])_ analysis of 3 proteins (high sensitivity [hs] troponin_ adiponectin_ and kidney injury molecule-1 [KIM-1])_ plasma_ algorithm repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc hep gene risk classifier","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0006M","description":"Onc hep gene risk classifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mycobacteria dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87551","description":"Mycobacteria dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUE0","description":"ICD-NAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1701","description":"HCPCS-B1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHF1","description":"ICD-IBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analys placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88267","description":"Chromosome analys placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXF1","description":"ICD-GAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSB1","description":"ICD-DDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAA1","description":"ICD-KAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27680","description":"Release of lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVB1","description":"ICD-OGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUA1","description":"ICD-OGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cold agglutinin screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86156","description":"Cold agglutinin screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTF1","description":"ICD-IGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB114","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFF0","description":"ICD-JCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen meniscus implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0428","description":"Collagen meniscus implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSA1","description":"ICD-LFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"West nile virus ab igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86788","description":"West nile virus ab igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1433","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","description":"HCPCS-M1433","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx cml dx status unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9139","description":"Onc dx cml dx status unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device_ percutaneous approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0545T","description":"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device_ percutaneous approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC220","description":"Special Care Low _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGF0","description":"ICD-JGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnioamp-mp_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4250","description":"Amnioamp-mp_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33853","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Romidepsin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9315","description":"Romidepsin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAF1","description":"ICD-GFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBND1","description":"ICD-JBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fast/dir ldl = 190 mg/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9663","description":"Fast/dir ldl = 190 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHD1","description":"ICD-OFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCA1","description":"ICD-ACCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Haberman feeder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8265","description":"Haberman feeder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLA0","description":"ICD-GBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLD0","description":"ICD-BCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exome re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81417","description":"Exome re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of body section","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76100","description":"X-ray exam of body section","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRE1","description":"ICD-PCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCD1","description":"ICD-NDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICA0","description":"ICD-CICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKME1","description":"ICD-NKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTF1","description":"ICD-NCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJC1","description":"ICD-KIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAB1","description":"ICD-CCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Performance Met: Multimodal Pain Management Was Used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2148","description":"Performance Met: Multimodal Pain Management Was Used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Docetaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9171","description":"Docetaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carry current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8984","description":"Carry current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIF1","description":"ICD-GDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBC0","description":"ICD-BIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCE0","description":"ICD-AFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25D","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NEURO ALZHEIMER QUAN IMAGING","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0207U","description":"NEURO ALZHEIMER QUAN IMAGING","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNB1","description":"ICD-FFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ patisiran_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9036","description":"Injection_ patisiran_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hocm <=149 mg/ml iodine_ 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9958","description":"Hocm <=149 mg/ml iodine_ 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dstrj neurofibromata xtnsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0420T","description":"Dstrj neurofibromata xtnsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC56","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETA1","description":"ICD-AETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral_ with volume adjustment of intragastric bariatric balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0813T","description":"Esophagogastroduodenoscopy_ flexible_ transoral_ with volume adjustment of intragastric bariatric balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28A","description":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNA1","description":"ICD-CCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20D","description":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28E","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise external hemorrhoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46083","description":"Incise external hemorrhoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMD1","description":"ICD-OEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVB1","description":"ICD-KCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES112","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTB0","description":"ICD-IDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Per pm reeval est pat infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99391","description":"Per pm reeval est pat infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Graft hand or finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26416","description":"Graft hand or finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYF0","description":"ICD-CHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01840","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","description":"CPT-01840","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXB0","description":"ICD-CCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61541","description":"Incision of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUF1","description":"ICD-MJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOC0","description":"ICD-KAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQC0","description":"ICD-GCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon t1-4 no dx prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9086","description":"Onc dx colon t1-4 no dx prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCF0","description":"ICD-FHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray eye for foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70030","description":"X-ray eye for foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAC1","description":"ICD-GDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair safety vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0980","description":"Wheelchair safety vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDA1","description":"ICD-OLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28070","description":"Removal of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD105","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22634","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLA0","description":"ICD-OHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc drug-el cor stent bran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9601","description":"Perc drug-el cor stent bran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECD0","description":"ICD-FECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOD0","description":"ICD-GEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX11","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5A","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC240","description":"Clinically Complex _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28225","description":"Release of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Facial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5919","description":"Facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval amniotic fluid protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84112","description":"Eval amniotic fluid protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUC0","description":"ICD-KEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCD0","description":"ICD-GFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBF1","description":"ICD-NJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable Collection And Storage Bag For Breast Milk_ Any Size_ Any Type_ Each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1005","description":"Disposable Collection And Storage Bag For Breast Milk_ Any Size_ Any Type_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBD0","description":"ICD-BCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMB1","description":"ICD-GBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FUT1 GNOTYP FUT1 EXON 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0185U","description":"FUT1 GNOTYP FUT1 EXON 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXF1","description":"ICD-FCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDF0","description":"ICD-BIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA06","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELE0","description":"ICD-FELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMF1","description":"ICD-BHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10A","description":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQC1","description":"ICD-HCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whfo_ rigid w/o joints","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3808","description":"Whfo_ rigid w/o joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC245","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6611","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","description":"HCPCS-A6611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEE0","description":"ICD-NCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using pretransplant peripheral blood_ algorithm reported as a risk score for early acute reje","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0319U","description":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using pretransplant peripheral blood_ algorithm reported as a risk score for early acute reje","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXD1","description":"ICD-FDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEE1","description":"ICD-JDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQF0","description":"ICD-DDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tremelimumab-actl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9347","description":"Injection_ tremelimumab-actl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ whole blood or buccal_ DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0460U","description":"Oncology_ whole blood or buccal_ DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPA0","description":"ICD-OFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOB1","description":"ICD-KEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVE0","description":"ICD-JDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISB0","description":"ICD-GISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ortho shoe add full sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3540","description":"Ortho shoe add full sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4378","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","description":"HCPCS-Q4378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cebpa gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81218","description":"Cebpa gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARB1","description":"ICD-HARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALB0","description":"ICD-BALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res W/Chf Billd Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9680","description":"Onsite Ac C Tx Nsg Fac Res W/Chf Billd Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDA1","description":"ICD-JHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1452","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","description":"HCPCS-M1452","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscpy inj agent for incont","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0377T","description":"Anoscpy inj agent for incont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBD0","description":"ICD-FHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBA1","description":"ICD-JHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXD0","description":"ICD-NAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A5102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","description":"HCPCS-A5102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHE1","description":"ICD-MIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBF1","description":"ICD-JBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24C","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26352","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFID1","description":"ICD-MFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBF0","description":"ICD-EHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert non-tunnel cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36555","description":"Insert non-tunnel cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDF0","description":"ICD-GHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supplies and accessories (e.g._ transducer) for low frequency ultrasonic diathermy treatment device_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1036","description":"Supplies and accessories (e.g._ transducer) for low frequency ultrasonic diathermy treatment device_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAC1","description":"ICD-NEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRB0","description":"ICD-GIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOF1","description":"ICD-LEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28D","description":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISE0","description":"ICD-PISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level II_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0751T","description":"Digitization of glass microscope slides for level II_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of orbit (transcranial approach); with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61332","description":"Exploration of orbit (transcranial approach); with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAC1","description":"ICD-AGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLE0","description":"ICD-NKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBME1","description":"ICD-FBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASA0","description":"ICD-OASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBED1","description":"ICD-IBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBC1","description":"ICD-NJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUA0","description":"ICD-IEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBE1","description":"ICD-OFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTA0","description":"ICD-ECTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cervix/repair vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57555","description":"Remove cervix/repair vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dark field examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87166","description":"Dark field examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHC0","description":"ICD-OEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0203","description":"HCPCS-B0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHF1","description":"ICD-OEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYD0","description":"ICD-DDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis_ review_ and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0529T","description":"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis_ review_ and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2106","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement impl pump cathet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0785","description":"Replacement impl pump cathet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEC0","description":"ICD-MLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoskel knee-shin mnl lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5810","description":"Endoskel knee-shin mnl lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQF1","description":"ICD-OFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11770","description":"Remove pilonidal cyst simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHE1","description":"ICD-CAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforced solid stirrup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2260","description":"Reinforced solid stirrup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYA0","description":"ICD-HAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Storage/year oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89346","description":"Storage/year oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine flow measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51736","description":"Urine flow measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELD1","description":"ICD-AELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFE1","description":"ICD-KIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove exostosis mandible","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21031","description":"Remove exostosis mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj occipital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64405","description":"N block inj occipital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37247","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25274","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWD0","description":"ICD-HBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECF0","description":"ICD-JECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFD1","description":"ICD-OBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQD0","description":"ICD-HBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPF1","description":"ICD-KGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronch w/balloon occlusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31634","description":"Bronch w/balloon occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB31","description":"ICD-4GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSD1","description":"ICD-DBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61521","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESB0","description":"ICD-OESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA45","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTD0","description":"ICD-BFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D6280","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6280","description":"CDT-D6280","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEB0","description":"ICD-NEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWD1","description":"ICD-LGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIE0","description":"ICD-EBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBB0","description":"ICD-KHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVF1","description":"ICD-JAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXB1","description":"ICD-OKXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXB0","description":"ICD-FEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHB0","description":"ICD-OIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBC0","description":"ICD-CEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEB1","description":"ICD-MCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor xiii recomb a-subunit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7181","description":"Factor xiii recomb a-subunit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26545","description":"Reconstruct finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCC1","description":"ICD-EBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWB1","description":"ICD-PIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBC0","description":"ICD-BCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFB0","description":"ICD-BIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ahi or rdi initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8842","description":"Ahi or rdi initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28126","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWB0","description":"ICD-OFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWD1","description":"ICD-CAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKE0","description":"ICD-BBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFB0","description":"ICD-FCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Audit/dast over 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99409","description":"Audit/dast over 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43631","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOA0","description":"ICD-OJOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRC1","description":"ICD-LIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCB1","description":"ICD-EGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOD1","description":"ICD-HDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL42","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYE0","description":"ICD-CEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDB0","description":"ICD-EGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHA0","description":"ICD-KBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0600U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","description":"CPT-0600U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise thigh tendon & fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27305","description":"Incise thigh tendon & fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Paraffin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4265","description":"Paraffin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADD0","description":"ICD-IADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIB0","description":"ICD-MHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of metanephrines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83835","description":"Assay of metanephrines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4415","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","description":"HCPCS-Q4415","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; complete system (electrode and implantable monitor)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0530T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; complete system (electrode and implantable monitor)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lightweight wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0003","description":"Lightweight wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQC0","description":"ICD-KEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMD0","description":"ICD-GEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove rectal obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45915","description":"Remove rectal obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOA1","description":"ICD-OBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEB1","description":"ICD-AEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ant fusion 8/> vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22812","description":"Ant fusion 8/> vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPC1","description":"ICD-BBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQD1","description":"ICD-HBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQC0","description":"ICD-GFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient immunocompromised","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1062","description":"Patient immunocompromised","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFB0","description":"ICD-OLFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens pmma bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2502","description":"Contact lens pmma bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOF1","description":"ICD-DDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD201","description":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGA0","description":"ICD-NHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0575U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","description":"CPT-0575U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCC0","description":"ICD-GBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1019","description":"Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUB1","description":"ICD-FBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA117","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAC0","description":"ICD-KDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAID1","description":"ICD-KAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFME1","description":"ICD-AFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETD1","description":"ICD-OETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/o implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21406","description":"Opn tx orbit fx w/o implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEB1","description":"ICD-GBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Card MRI w/stress img & dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75563","description":"Card MRI w/stress img & dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBF0","description":"ICD-KBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; each additional 15 minutes (List separately in addition to code fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92623","description":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; each additional 15 minutes (List separately in addition to code fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX12","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46615","description":"Anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lang express current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9162","description":"Lang express current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTA0","description":"ICD-NBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRA1","description":"ICD-GFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Duplicate/copy patient_s records","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9961","description":"Duplicate/copy patient_s records","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0504T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB226","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enterectomy cong add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44128","description":"Enterectomy cong add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE240","description":"Clinically Complex _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frnt cstr cmpl sem-pneum tir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0072","description":"Frnt cstr cmpl sem-pneum tir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFC1","description":"ICD-CFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTD0","description":"ICD-OBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99241","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen amphetamines 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80324","description":"Drug screen amphetamines 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFC0","description":"ICD-OLFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBB0","description":"ICD-FEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fqhc visit_ mh estab pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0470","description":"Fqhc visit_ mh estab pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCD1","description":"ICD-OLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCE0","description":"ICD-FBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNE1","description":"ICD-FDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISC0","description":"ICD-OISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caster wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2395","description":"Caster wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55200","description":"Incision of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAC1","description":"ICD-OAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9994","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBE1","description":"ICD-BDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKA0","description":"ICD-NJKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82626","description":"Dehydroepiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMB0","description":"ICD-NBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise palsy hand tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25315","description":"Revise palsy hand tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHD0","description":"ICD-MAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYC0","description":"ICD-CEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPE0","description":"ICD-NHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNA1","description":"ICD-CFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUE0","description":"ICD-KGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPD0","description":"ICD-JBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTE0","description":"ICD-AFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cam relese assem ftrst/lgrst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0051","description":"Cam relese assem ftrst/lgrst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlamydia igm antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86632","description":"Chlamydia igm antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTF0","description":"ICD-KHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast diep or siea flap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2068","description":"Breast diep or siea flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRE1","description":"ICD-PHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVD0","description":"ICD-KDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGC0","description":"ICD-OBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMF1","description":"ICD-EFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFB0","description":"ICD-FAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33958","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ (aristada initio)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1943","description":"Injection_ aripiprazole lauroxil_ (aristada initio)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHC0","description":"ICD-JCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2D","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEC1","description":"ICD-AFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSF0","description":"ICD-PJSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13151","description":"Cmplx rpr e/n/e/l 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ONC SLD TUM ALYS BRCA1 BRCA2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172U","description":"ONC SLD TUM ALYS BRCA1 BRCA2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFA1","description":"ICD-FGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXD0","description":"ICD-BGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trans shoe solid stirrup exi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3620","description":"Trans shoe solid stirrup exi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQF0","description":"ICD-PLQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conductive gel or paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4558","description":"Conductive gel or paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBB0","description":"ICD-FIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/2.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2308","description":"Lens sphc trifocal 4.25-7/2.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDD0","description":"ICD-FEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGA0","description":"ICD-FEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFF0","description":"ICD-GIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4206","description":"1 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01202","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","description":"CPT-01202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46750","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sebelipase alfa_ 1mg (Kanuma)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9478","description":"Injection_ sebelipase alfa_ 1mg (Kanuma)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB244","description":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enclosed ped crib hosp grade","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0300","description":"Enclosed ped crib hosp grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXA0","description":"ICD-GBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthesis_ penile_ non-inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2622","description":"Prosthesis_ penile_ non-inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9224","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9224","description":"CDT-D9224","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGE1","description":"ICD-CFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient died at any time during the 24-month measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9751","description":"Patient died at any time during the 24-month measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2029","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","description":"HCPCS-A2029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ thrombectomy/embolect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1757","description":"Cath_ thrombectomy/embolect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracostomy w/rib resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32035","description":"Thoracostomy w/rib resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65760","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic exenteration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45126","description":"Pelvic exenteration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQC1","description":"ICD-PIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1401","description":"HCPCS-B1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release palm & finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26442","description":"Release palm & finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAA1","description":"ICD-CIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sotalol hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9482","description":"Injection_ sotalol hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Addition to lower extremity prosthesis_ endoskeletal_ kneedisarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1022","description":"Addition to lower extremity prosthesis_ endoskeletal_ kneedisarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDD1","description":"ICD-IHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHB0","description":"ICD-CCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBF0","description":"ICD-CGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8002","description":"HCPCS-C8002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEA0","description":"ICD-MLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWD0","description":"ICD-GEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDE1","description":"ICD-EDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe lifts tapered to one-ha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3332","description":"Shoe lifts tapered to one-ha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGB1","description":"ICD-BFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fee covid-19 vac 2 res","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014A","description":"Fee covid-19 vac 2 res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9958","description":"Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCB0","description":"ICD-NKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE114","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow disart myoelectronic c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6945","description":"Elbow disart myoelectronic c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0499U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","description":"CPT-0499U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEB1","description":"ICD-NHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA44","description":"Low Rehab_ ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61535","description":"Remove brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surg proc w/in 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8627","description":"Surg proc w/in 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFF1","description":"ICD-GBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVE0","description":"ICD-NEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE105","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc rsn do qual life assm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9635","description":"No doc rsn do qual life assm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of progesterone 20-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83499","description":"Assay of progesterone 20-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMA0","description":"ICD-NJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIA0","description":"ICD-MEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB21","description":"ICD-4BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBB1","description":"ICD-BGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43886","description":"Revise gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITC0","description":"ICD-KITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine vma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84585","description":"Assay of urine vma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"64 lead ecg w/i&r only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0180T","description":"64 lead ecg w/i&r only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNE0","description":"ICD-OJNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of a peritoneal ascites pump system_ including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0874T","description":"Removal of a peritoneal ascites pump system_ including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flu imm no admin doc rea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8483","description":"Flu imm no admin doc rea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJB1","description":"ICD-BHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYB0","description":"ICD-PFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYC1","description":"ICD-CFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENA1","description":"ICD-NENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSD0","description":"ICD-ODSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1437","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","description":"HCPCS-M1437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJE0","description":"ICD-BBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABA1","description":"ICD-IABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADE1","description":"ICD-KADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLB1","description":"ICD-EBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAF0","description":"ICD-JDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAD1","description":"ICD-MFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inc thyr node <1.0 in rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9552","description":"Inc thyr node <1.0 in rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEF1","description":"ICD-ACEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHB0","description":"ICD-MDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJA0","description":"ICD-CBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIA0","description":"ICD-CFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35236","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGC0","description":"ICD-KEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGB0","description":"ICD-GAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYA1","description":"ICD-PJYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJF1","description":"ICD-CCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunofluor antb 1st stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88346","description":"Immunofluor antb 1st stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavior management","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9920","description":"Behavior management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC16","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAB0","description":"ICD-CBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 12.6-20 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12055","description":"Intmd rpr face/mm 12.6-20 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEE0","description":"ICD-OBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1056T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1056T","description":"CPT-1056T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEA0","description":"ICD-KAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFD0","description":"ICD-OBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20A","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interferon alfa-n3 inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9215","description":"Interferon alfa-n3 inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent treatment day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0891T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent treatment day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagus endoscopy/ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43205","description":"Esophagus endoscopy/ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of scrotum abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55100","description":"Drainage of scrotum abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/cont_ f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8922","description":"Tte w or w/o fol w/cont_ f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPB1","description":"ICD-FHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automated platelet count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85049","description":"Automated platelet count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUD0","description":"ICD-OFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYA0","description":"ICD-PLYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant cochlear device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69930","description":"Implant cochlear device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq card revasc mi 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92941","description":"Prq card revasc mi 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Azithromycin dihydrate_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0144","description":"Azithromycin dihydrate_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Keroxx (2.5 g/cc)_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4202","description":"Keroxx (2.5 g/cc)_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA24","description":"Low Rehab_ ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTE0","description":"ICD-BGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tongue and mouth surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41599","description":"Tongue and mouth surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLD0","description":"ICD-EGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPB0","description":"ICD-BGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q24h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9500","description":"Hit antibiotic q24h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOD0","description":"ICD-HDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bilobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32482","description":"Bilobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBD0","description":"ICD-CEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJD1","description":"ICD-KGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENE1","description":"ICD-BENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0677T","description":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCE1","description":"ICD-IBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJD1","description":"ICD-CIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerv col supp adj bar & thor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0200","description":"Cerv col supp adj bar & thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYB1","description":"ICD-CIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBD0","description":"ICD-OIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin rapid 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5550","description":"Insulin rapid 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHD1","description":"ICD-NGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Symptom mgmnt plan care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0555F","description":"Symptom mgmnt plan care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUB0","description":"ICD-KIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoskeletal axial rotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5984","description":"Endoskeletal axial rotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58400","description":"Suspension of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVD0","description":"ICD-OGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0664U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0664U","description":"CPT-0664U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJF0","description":"ICD-GAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Most Recent Hemoglobin A1C (Hba1C) Level 7.0 To 9.0%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2089","description":"Most Recent Hemoglobin A1C (Hba1C) Level 7.0 To 9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak pelvic control belt light","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5692","description":"Ak pelvic control belt light","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental sealant per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1351","description":"Dental sealant per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft finger lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26215","description":"Remove/graft finger lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHD1","description":"ICD-AFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc arm/elbow les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24071","description":"Exc arm/elbow les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dimethyl sulfoxide 50% 50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1212","description":"Dimethyl sulfoxide 50% 50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vacsular emobolization or occlusion procedure with use of pressure-generation catheter (e.g._ one-way_ intermittentrly occluding)_ inclusive of all radiological supervision an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9797","description":"Vacsular emobolization or occlusion procedure with use of pressure-generation catheter (e.g._ one-way_ intermittentrly occluding)_ inclusive of all radiological supervision an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHD1","description":"ICD-EEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Fixed Unilateral Space Maintainer - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1556","description":"Removal Of Fixed Unilateral Space Maintainer - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain lower leg bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27604","description":"Drain lower leg bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Safety frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0516","description":"Safety frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","description":"CPT-01638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAE0","description":"ICD-BDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACD1","description":"ICD-KACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; With Continuous Oximetry Monitoring (Per Session)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94626","description":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; With Continuous Oximetry Monitoring (Per Session)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1933","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","description":"HCPCS-L1933","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cochlear device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8614","description":"Cochlear device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYE1","description":"ICD-DGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCB1","description":"ICD-NHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0976T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","description":"CPT-0976T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVC1","description":"ICD-CCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing loss sequence analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81430","description":"Hearing loss sequence analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCD0","description":"ICD-GHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth upper gi visualize","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74051","description":"Anesth upper gi visualize","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25442","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0834T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair iris & ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66682","description":"Repair iris & ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAE0","description":"ICD-BIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ human papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0500T","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ human papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDB1","description":"ICD-JHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care prof when the vaccine(s) is not admin on the same date of service for ages under 21_ 16-30 min Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0313","description":"Imm counseling by a physician or other qualified health care prof when the vaccine(s) is not admin on the same date of service for ages under 21_ 16-30 min Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15B","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOF0","description":"ICD-KAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSE1","description":"ICD-DFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLB1","description":"ICD-NKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tocilizumab-bavi (tofidence)_ biosimilar_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5133","description":"Injection_ tocilizumab-bavi (tofidence)_ biosimilar_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSE0","description":"ICD-CDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWF1","description":"ICD-ODWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95709","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAF1","description":"ICD-IGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDD1","description":"ICD-KIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excursion amplifier pulley t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6641","description":"Excursion amplifier pulley t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDC1","description":"ICD-NCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEA0","description":"ICD-EDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1205","description":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIF0","description":"ICD-NEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIC0","description":"ICD-JIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWA1","description":"ICD-LBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCA1","description":"ICD-ECCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAF0","description":"ICD-EGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0504","description":"HCPCS-B0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza imm status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1030F","description":"Influenza imm status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFC0","description":"ICD-JDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXB1","description":"ICD-GAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA01","description":"High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE231","description":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIB0","description":"ICD-NKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rectal sensation test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91120","description":"Rectal sensation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWF1","description":"ICD-CBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_onabotulinumtoxina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0585","description":"Injection_onabotulinumtoxina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMB1","description":"ICD-ABMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBD0","description":"ICD-OLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt post facet implt thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0220T","description":"Plmt post facet implt thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of tear duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70170","description":"X-ray exam of tear duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLF0","description":"ICD-ABLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supportive care for neurodegenerative conditions mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0004","description":"Supportive care for neurodegenerative conditions mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD130","description":"Special Care Low _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC201","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGD0","description":"ICD-JBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1259","description":"Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDE1","description":"ICD-JDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54050","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTD0","description":"ICD-JHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA21","description":"ICD-4CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sp bone agrft struct add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20938","description":"Sp bone agrft struct add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray/ct/ultrsnd et al ord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3319F","description":"X-ray/ct/ultrsnd et al ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLB0","description":"ICD-KBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES114","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Path rpt malig cancer docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3317F","description":"Path rpt malig cancer docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ infliximab-dyyb_ biosimilar_ (Inflectra)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5103","description":"Injection_ infliximab-dyyb_ biosimilar_ (Inflectra)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXA0","description":"ICD-NJXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap enterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44202","description":"Lap enterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSA1","description":"ICD-CHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVF0","description":"ICD-FDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand restoration replacmnt g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6915","description":"Hand restoration replacmnt g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo ablate renal mass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50542","description":"Laparo ablate renal mass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUF0","description":"ICD-CDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc death in hosp aaa repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9262","description":"Doc death in hosp aaa repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of lymph channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38308","description":"Incision of lymph channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEID0","description":"ICD-OEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPC0","description":"ICD-BFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic submucosal dissection (ESD)_ including endoscopyor colonoscopy_ mucosal closure_ when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9779","description":"Endoscopic submucosal dissection (ESD)_ including endoscopyor colonoscopy_ mucosal closure_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUD1","description":"ICD-FIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCID0","description":"ICD-JCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52332","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18I","description":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ micafungin sodium (par pharm) not thereapeutically equivalent to j2248_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2247","description":"Injection_ micafungin sodium (par pharm) not thereapeutically equivalent to j2248_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPC1","description":"ICD-KAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise thumb tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26490","description":"Revise thumb tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABA1","description":"ICD-BABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ sacral_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0787T","description":"Revision or removal of neurostimulator electrode array_ sacral_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no scrn hcv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9452","description":"Doc med reas no scrn hcv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96935","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMB1","description":"ICD-FAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXD0","description":"ICD-GCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8H","description":"Medium Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECC0","description":"ICD-CECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOD1","description":"ICD-PHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGF0","description":"ICD-JAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUA0","description":"ICD-BIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABE1","description":"ICD-GABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADD1","description":"ICD-JADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIA1","description":"ICD-OHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVC1","description":"ICD-CFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC151","description":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCE1","description":"ICD-BFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9859","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA235","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYF1","description":"ICD-LDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYD1","description":"ICD-CEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lamellas xt_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4291","description":"Lamellas xt_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allergen specific IgE; quantitative or semiquantitative_ crude allergen extract_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86003","description":"Allergen specific IgE; quantitative or semiquantitative_ crude allergen extract_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1709","description":"Pfizer-BioNTech Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0904","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0904","description":"CDT-D0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1151","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occlusal guard - hard appliance_ partial arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9946","description":"Occlusal guard - hard appliance_ partial arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAC1","description":"ICD-CBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening mammography_ bilateral (2-view study of each breast)_ including computer-aided detection (CAD) when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77067","description":"Screening mammography_ bilateral (2-view study of each breast)_ including computer-aided detection (CAD) when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHF1","description":"ICD-IDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Candida antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86628","description":"Candida antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVA1","description":"ICD-GHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); modulating antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86043","description":"Acetylcholine receptor (AChR); modulating antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18F","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit prenatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99500","description":"Home visit prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKD0","description":"ICD-GCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prost cncr rsk not lw/md/hgh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3274F","description":"Prost cncr rsk not lw/md/hgh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAF1","description":"ICD-NFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8C","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSA1","description":"ICD-LHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC01","description":"Medium Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFF0","description":"ICD-GDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBB1","description":"ICD-ICBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imp/abut fixed dent part max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6116","description":"Imp/abut fixed dent part max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUA0","description":"ICD-NLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDB1","description":"ICD-ECDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNF1","description":"ICD-GGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99211","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHE1","description":"ICD-GEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFF1","description":"ICD-KEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0894T","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Renal abscess open drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50020","description":"Renal abscess open drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5C","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYF0","description":"ICD-DIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDB1","description":"ICD-GDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC21","description":"ICD-3EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETC0","description":"ICD-KETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogen test marrow b/4 tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3155F","description":"Cytogen test marrow b/4 tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko double upright pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0902","description":"Ko double upright pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGD1","description":"ICD-KCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36903","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOE1","description":"ICD-DFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIC1","description":"ICD-NCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBA0","description":"ICD-NCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQC0","description":"ICD-OCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAE0","description":"ICD-NEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAD0","description":"ICD-EHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJF1","description":"ICD-KGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWC0","description":"ICD-OLWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJB1","description":"ICD-JBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt alkaline 1.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0603","description":"Repl batt alkaline 1.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unclassified biologics","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3590","description":"Unclassified biologics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEA1","description":"ICD-FGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVB0","description":"ICD-CAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6014","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ing hern premie blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49492","description":"Rpr ing hern premie blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATD1","description":"ICD-MATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJF1","description":"ICD-JDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQB0","description":"ICD-HBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKC0","description":"ICD-KHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPF0","description":"ICD-NJPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUD0","description":"ICD-CIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVB1","description":"ICD-NCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUC1","description":"ICD-MBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA101","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHC1","description":"ICD-KGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIA0","description":"ICD-OCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEB1","description":"ICD-MAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58150","description":"Total hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUA1","description":"ICD-MIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTE0","description":"ICD-IGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited dental tx adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8040","description":"Limited dental tx adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25A","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAF0","description":"ICD-OJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer administration set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7003","description":"Nebulizer administration set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst base mtl >=3 surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6613","description":"Onlay cst base mtl >=3 surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23D","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDE0","description":"ICD-CGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ovine_ 1000 usp units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3472","description":"Ovine_ 1000 usp units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Position wc cush wdth>=22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2606","description":"Position wc cush wdth>=22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18E","description":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mass spectrometry and tandem mass spectrometry (ms_ ms/ms)_ analyte notelsewhere specified; qualitative_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83788","description":"Mass spectrometry and tandem mass spectrometry (ms_ ms/ms)_ analyte notelsewhere specified; qualitative_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXE0","description":"ICD-FHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAA0","description":"ICD-KEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQA0","description":"ICD-OLQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collect sweat for test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89230","description":"Collect sweat for test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBB1","description":"ICD-KBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEF0","description":"ICD-EIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28H","description":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEE0","description":"ICD-MKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD160","description":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLF0","description":"ICD-ACLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYC1","description":"ICD-HAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test urine for lactose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83633","description":"Test urine for lactose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXE1","description":"ICD-OCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic myomectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58545","description":"Laparoscopic myomectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFED1","description":"ICD-IFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWC1","description":"ICD-PBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace non-molded calf lace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4055","description":"Replace non-molded calf lace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5B","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No urtr inj at surg/1ms post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9633","description":"No urtr inj at surg/1ms post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PAS (Consumer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1792","description":"PAS (Consumer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contraceptive pills for bc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4993","description":"Contraceptive pills for bc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18H","description":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVE0","description":"ICD-NGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oasis tri-layer wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4124","description":"Oasis tri-layer wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYF0","description":"ICD-LIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gum tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41830","description":"Removal of gum tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2003","description":"HCPCS-A2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscp guide wire dilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43196","description":"Esophagoscp guide wire dilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBB1","description":"ICD-EDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13C","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93284","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penicillin g procaine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2510","description":"Penicillin g procaine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20D","description":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray assay calculus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82370","description":"X-ray assay calculus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Finger tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26497","description":"Finger tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In hospice or using hospice services during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1167","description":"In hospice or using hospice services during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADD1","description":"ICD-KADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBF0","description":"ICD-KEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALC0","description":"ICD-BALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electric current therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97033","description":"Electric current therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTA0","description":"ICD-JGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTC0","description":"ICD-IFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBB0","description":"ICD-MLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial amputation of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28825","description":"Partial amputation of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental bitewings two films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0272","description":"Dental bitewings two films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone mineral dual photon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78351","description":"Bone mineral dual photon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWF1","description":"ICD-GCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALA0","description":"ICD-KALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDA1","description":"ICD-EIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDE0","description":"ICD-NDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel thomas extend to b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3470","description":"Shoe heel thomas extend to b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26412","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFB0","description":"ICD-KGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endosteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6012","description":"Endosteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITC1","description":"ICD-KITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAC1","description":"ICD-EFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mopath procedure level 9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81408","description":"Mopath procedure level 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHA0","description":"ICD-ECHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXE1","description":"ICD-OJXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX14","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulance 02 life sustaining","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0422","description":"Ambulance 02 life sustaining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replantation hand complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20808","description":"Replantation hand complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNC1","description":"ICD-NGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc rect tum transanal part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45171","description":"Exc rect tum transanal part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8H","description":"Low Rehab_ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryoprecipitate each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9012","description":"Cryoprecipitate each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJA0","description":"ICD-JAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGB1","description":"ICD-NIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFD1","description":"ICD-KGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Semen analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0027","description":"Semen analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE205","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIF1","description":"ICD-AHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUD1","description":"ICD-IFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHED1","description":"ICD-CHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAF0","description":"ICD-GCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHC0","description":"ICD-MEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24600","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIC1","description":"ICD-MBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antistreptolysin o titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86060","description":"Antistreptolysin o titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24365","description":"Reconstruct head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2101","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWB0","description":"ICD-PFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEA0","description":"ICD-BCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXB1","description":"ICD-CBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHE1","description":"ICD-FEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rx cntact lens aphakia 2 eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92316","description":"Rx cntact lens aphakia 2 eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIA0","description":"ICD-OKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xyntha inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7185","description":"Xyntha inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIE0","description":"ICD-ODIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFE1","description":"ICD-CDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIC1","description":"ICD-GHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMD1","description":"ICD-MHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSC1","description":"ICD-DGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQF1","description":"ICD-DDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8C","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUB0","description":"ICD-CBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUE1","description":"ICD-OLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXD0","description":"ICD-OEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJA0","description":"ICD-JBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Affinity1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4159","description":"Affinity1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQE1","description":"ICD-GIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCA1","description":"ICD-CBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intermittent asthma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1039F","description":"Intermittent asthma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coordinated specialty care_ team-based_ for first episode psychosis_ per encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2041","description":"Coordinated specialty care_ team-based_ for first episode psychosis_ per encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVF0","description":"ICD-BCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99283","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0103","description":"HCPCS-B0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGC0","description":"ICD-NJGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx planar_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2645","description":"Brachytx planar_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54865","description":"Explore epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thorabd diaphr hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43336","description":"Thorabd diaphr hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC31","description":"ICD-4DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg cast chg shlder/t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6384","description":"Postop dsg cast chg shlder/t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5C","description":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBE1","description":"ICD-IHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93979","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27333","description":"Removal of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compression stocking bk18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6530","description":"Compression stocking bk18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB56","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of pregnanetriol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84138","description":"Assay of pregnanetriol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFED1","description":"ICD-EFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATD0","description":"ICD-EATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDF0","description":"ICD-OCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJD1","description":"ICD-JHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGA0","description":"ICD-BGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEE0","description":"ICD-EBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93799","description":"Cardiovascular procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99411","description":"Preventive counseling group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain arm/elbow bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23935","description":"Drain arm/elbow bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo frict swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5712","description":"Knee-shin exo frict swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adenoma detected screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3775F","description":"Adenoma detected screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMD0","description":"ICD-KDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFC0","description":"ICD-CCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol > 100gm prote","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4199","description":"Parenteral sol > 100gm prote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOF0","description":"ICD-PBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADC0","description":"ICD-NADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Community/work reintegration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97537","description":"Community/work reintegration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTD1","description":"ICD-MJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWA1","description":"ICD-CAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVC0","description":"ICD-BFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29879","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pvb thoracic 2nd+ inj site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64462","description":"Pvb thoracic 2nd+ inj site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAC0","description":"ICD-NJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFD0","description":"ICD-NGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABF0","description":"ICD-CABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRC0","description":"ICD-DIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRC0","description":"ICD-LIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYC1","description":"ICD-PFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUB0","description":"ICD-KCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPA1","description":"ICD-JFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69706","description":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36560","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrode stim brain add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95962","description":"Electrode stim brain add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHF0","description":"ICD-MAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQA1","description":"ICD-LHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6525","description":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVC0","description":"ICD-JHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95726","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPB0","description":"ICD-KHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aortic anrysm5.5-5.9cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9003F","description":"Aortic anrysm5.5-5.9cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14B","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam si joints 3/> vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72202","description":"X-ray exam si joints 3/> vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE216","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20690","description":"Apply bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHB1","description":"ICD-ODHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9975","description":"Documentation of medical reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCA1","description":"ICD-GBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vascular flow imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78445","description":"Vascular flow imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct both jaws","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0383","description":"Cone beam ct both jaws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peanut allergen specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA)_ blood_ individual epitope results and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0165U","description":"Peanut allergen specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA)_ blood_ individual epitope results and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEA0","description":"ICD-JEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ translumin angio laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1885","description":"Cath_ translumin angio laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Npm1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81310","description":"Npm1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOA0","description":"ICD-LAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGC0","description":"ICD-CBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27441","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ naxitamab-gqgk_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9348","description":"Injection_ naxitamab-gqgk_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove nail bed/tip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11752","description":"Remove nail bed/tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDA0","description":"ICD-KCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCB1","description":"ICD-IBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQC0","description":"ICD-HAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including ultrasound guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10005","description":"Fine needle aspiration biopsy_ including ultrasound guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - bitewing radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0388","description":"intraoral tomosynthesis - bitewing radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHD0","description":"ICD-MBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fabrication and delivery of oral appliance therapy (OAT) morning repositioning device","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9954","description":"Fabrication and delivery of oral appliance therapy (OAT) morning repositioning device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKE1","description":"ICD-JIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKB1","description":"ICD-FHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPA1","description":"ICD-CEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg arterial four or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33536","description":"Cabg arterial four or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENE0","description":"ICD-KENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIC1","description":"ICD-EHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13B","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8E","description":"Very High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures immediat mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5140","description":"Dentures immediat mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGF1","description":"ICD-FBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXD1","description":"ICD-FAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWB1","description":"ICD-GFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLA1","description":"ICD-OCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthroscopy of joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29999","description":"Arthroscopy of joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWC1","description":"ICD-DEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denileukin diftitox inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9160","description":"Denileukin diftitox inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDA1","description":"ICD-IDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0963T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","description":"CPT-0963T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure for pyelography (as nephrostogram_ pyelostogram_ antegrade pyeloureterograms) through nephrostomy or pyelostomy tube_ or indwelling ureteral c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50394","description":"Injection procedure for pyelography (as nephrostogram_ pyelostogram_ antegrade pyeloureterograms) through nephrostomy or pyelostomy tube_ or indwelling ureteral c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21267","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAC0","description":"ICD-OFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEB0","description":"ICD-EHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABF0","description":"ICD-NABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVB0","description":"ICD-GEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIF1","description":"ICD-CCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35081","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Polysom any age 1-3> param","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95808","description":"Polysom any age 1-3> param","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHD0","description":"ICD-EHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCC0","description":"ICD-FGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBE1","description":"ICD-JCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB246","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCA0","description":"ICD-FCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYA0","description":"ICD-PJYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99439","description":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTF1","description":"ICD-IHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98981","description":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHE1","description":"ICD-MLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTC1","description":"ICD-JFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fos c chld non-ther per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0041","description":"Fos c chld non-ther per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCD1","description":"ICD-IDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18H","description":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICE0","description":"ICD-GICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWC0","description":"ICD-PDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMC1","description":"ICD-CGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genetic test spec analysis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0423","description":"Genetic test spec analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Second stage implant surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6011","description":"Second stage implant surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMC0","description":"ICD-OCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 3 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91318","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 3 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Composite skin graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15760","description":"Composite skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDE0","description":"ICD-ACDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHF1","description":"ICD-NCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXC0","description":"ICD-GEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDA0","description":"ICD-AIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTD1","description":"ICD-JCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18F","description":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ including placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])_ without place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27278","description":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ including placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])_ without place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41100","description":"Biopsy of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Fetal Monitoring Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0621","description":"Hospital Special Treatment Room Support Component (Hstrsc) Fetal Monitoring Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGB1","description":"ICD-FAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection of contrast for knee arthrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27370","description":"Injection of contrast for knee arthrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVE1","description":"ICD-NIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIME1","description":"ICD-JIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correct rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45541","description":"Correct rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcyte_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4182","description":"Transcyte_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIA1","description":"ICD-OJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUF1","description":"ICD-BAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJB1","description":"ICD-CFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWE0","description":"ICD-DDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMA0","description":"ICD-NKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGB1","description":"ICD-NLGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ann breast exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0613","description":"Ann breast exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kerecis Omega3_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4158","description":"Kerecis Omega3_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Routine ophthalmological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0620","description":"Routine ophthalmological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMF0","description":"ICD-JHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTF1","description":"ICD-GDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of hemosiderin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83070","description":"Assay of hemosiderin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAE0","description":"ICD-IBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXA1","description":"ICD-OHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOE1","description":"ICD-PJOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMF1","description":"ICD-EBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHA1","description":"ICD-EFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9734","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20D","description":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA251","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIF1","description":"ICD-OBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAF1","description":"ICD-NGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUC1","description":"ICD-OEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQA0","description":"ICD-HDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice evaluation preelecti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0337","description":"Hospice evaluation preelecti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTB0","description":"ICD-EFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMF0","description":"ICD-OFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj testostero enanthate 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3121","description":"Inj testostero enanthate 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14D","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQF1","description":"ICD-PGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair dura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61618","description":"Repair dura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore limb vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35860","description":"Explore limb vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAF1","description":"ICD-MFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of haptoglobins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83012","description":"Assay of haptoglobins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIA1","description":"ICD-NFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ DNA_ PIK3CA (phosphatidylinositol-4_5-bisphosphate 3-kinase_ catalytic subunit alpha) (eg_ breast cancer) gene analysis (ie_ p.C420R_ p.E542K_ p.E545","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0155U","description":"Oncology (breast cancer)_ DNA_ PIK3CA (phosphatidylinositol-4_5-bisphosphate 3-kinase_ catalytic subunit alpha) (eg_ breast cancer) gene analysis (ie_ p.C420R_ p.E542K_ p.E545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMF1","description":"ICD-FFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney & ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50236","description":"Removal of kidney & ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOE1","description":"ICD-LIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo <2yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90963","description":"Esrd home pt serv p mo <2yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no 7d f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9406","description":"Doc reas no 7d f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVD1","description":"ICD-FCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLID0","description":"ICD-NLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18A","description":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12C","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputate metacarpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26910","description":"Amputate metacarpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKF0","description":"ICD-BHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low density lipoprotein(ldl)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2120","description":"Low density lipoprotein(ldl)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEC1","description":"ICD-BDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wash harvest stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38209","description":"Wash harvest stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0568","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","description":"HCPCS-G0568","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGA1","description":"ICD-NKGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation_ including imaging guidance (eg_ ultrasound and/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7549","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation_ including imaging guidance (eg_ ultrasound and/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABD1","description":"ICD-FABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJF0","description":"ICD-NFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast percut w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19100","description":"Bx breast percut w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRC1","description":"ICD-ODRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANB0","description":"ICD-JANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99213","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ full leg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6586","description":"Gradient pressure wrap with adjustable straps_ full leg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phlebotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99195","description":"Phlebotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRB1","description":"ICD-CHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFE1","description":"ICD-NBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAB1","description":"ICD-GGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYE0","description":"ICD-DCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0575","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0575","description":"HCPCS-G0575","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRE0","description":"ICD-DDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITB0","description":"ICD-EITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opto-acoustic imaging_ breast (including axilla when performed)_ unilateral_ with image documentation_ analysis and report_obtained with ultrasound examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9788","description":"Opto-acoustic imaging_ breast (including axilla when performed)_ unilateral_ with image documentation_ analysis and report_obtained with ultrasound examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACD0","description":"ICD-BACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESB0","description":"ICD-GESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDF0","description":"ICD-EBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAE0","description":"ICD-CBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADB0","description":"ICD-BADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of larynx & pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31390","description":"Removal of larynx & pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chloroprocaine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2400","description":"Chloroprocaine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJE0","description":"ICD-KAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQB0","description":"ICD-KCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inversion/eversion correction device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9285","description":"Inversion/eversion correction device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/rmv pn/gastr stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64595","description":"Revise/rmv pn/gastr stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22513","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Misc integral lens serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0590","description":"Misc integral lens serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGC1","description":"ICD-JDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYB0","description":"ICD-DAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Th/wght bear quad-lat brim m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2510","description":"Th/wght bear quad-lat brim m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ casimersen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9075","description":"Injection_ casimersen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Strain Imaging Using Speckle Tracking-Derived Assessment Of Myocardial Mechanics (List Separately In Addition To Codes For Echocardiography Imaging)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93356","description":"Myocardial Strain Imaging Using Speckle Tracking-Derived Assessment Of Myocardial Mechanics (List Separately In Addition To Codes For Echocardiography Imaging)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB11","description":"ICD-2GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art trnsposj subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35693","description":"Art trnsposj subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMA0","description":"ICD-MIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMA0","description":"ICD-GEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVA0","description":"ICD-BFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt post facet implt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0222T","description":"Plmt post facet implt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIF0","description":"ICD-JEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFB0","description":"ICD-FDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ phylogenetic-based report of strain relatedness_ per submitted isolate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0010U","description":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ phylogenetic-based report of strain relatedness_ per submitted isolate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIF0","description":"ICD-NCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKE0","description":"ICD-OAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytomeg dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87496","description":"Cytomeg dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVD1","description":"ICD-NIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYF0","description":"ICD-PHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAE1","description":"ICD-IEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc brst cncr stage 1 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3374F","description":"Ajcc brst cncr stage 1 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXD0","description":"ICD-OKXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55812","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUB1","description":"ICD-BBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35331","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70328","description":"X-ray exam of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr umbil hern block > 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49587","description":"Rpr umbil hern block > 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLD1","description":"ICD-OCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2956","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2956","description":"CDT-D2956","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTD0","description":"ICD-JDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSD1","description":"ICD-PCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance_ unilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0718T","description":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance_ unilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sho lift taper to metatarsal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3300","description":"Sho lift taper to metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYC0","description":"ICD-OHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDA0","description":"ICD-GFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraop cyst eval not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9608","description":"Intraop cyst eval not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Air elevator for heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0370","description":"Air elevator for heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below knee surgical stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4500","description":"Below knee surgical stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWB1","description":"ICD-CHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74283","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXC0","description":"ICD-GGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIA0","description":"ICD-BIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post-coital mucous exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0115","description":"Post-coital mucous exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA236","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUE1","description":"ICD-NBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHB0","description":"ICD-BAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visc & infraren abd 1 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34845","description":"Visc & infraren abd 1 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAB0","description":"ICD-GBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECF0","description":"ICD-AECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt infosys alarm 4 nxt mammo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7025F","description":"Pt infosys alarm 4 nxt mammo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient lift electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0635","description":"Patient lift electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFB1","description":"ICD-CEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADE1","description":"ICD-BADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCB1","description":"ICD-MFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture interm part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5821","description":"Denture interm part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEC0","description":"ICD-NGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNF1","description":"ICD-JCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Air fluidized bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0194","description":"Air fluidized bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSD1","description":"ICD-PJSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATC1","description":"ICD-JATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14A","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYF1","description":"ICD-KEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair throat esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42953","description":"Repair throat esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amiodarone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80151","description":"Amiodarone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xray endovasc thor ao repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75957","description":"Xray endovasc thor ao repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKC0","description":"ICD-JDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAB1","description":"ICD-CAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Splint - extra-coronal; natural teeth or prosthetic crowns","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4323","description":"Splint - extra-coronal; natural teeth or prosthetic crowns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","description":"HCPCS-Q4391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth major vein ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88251","description":"Anesth major vein ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Theragenesis_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2008","description":"Theragenesis_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVD0","description":"ICD-GBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit declotting kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5517","description":"Hit declotting kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPF0","description":"ICD-JGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBC0","description":"ICD-OBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ac5 advanced wound system (ac5)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2020","description":"Ac5 advanced wound system (ac5)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKA1","description":"ICD-CHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cgh test developmental delay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3870","description":"Cgh test developmental delay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYC0","description":"ICD-KIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJC0","description":"ICD-OEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coombs test direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86880","description":"Coombs test direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOA0","description":"ICD-PAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Als esophageal intub suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0396","description":"Als esophageal intub suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEF0","description":"ICD-NFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUA1","description":"ICD-OBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEB0","description":"ICD-IDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glycosylated hb home device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83037","description":"Glycosylated hb home device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIB0","description":"ICD-MGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Totazoline hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2670","description":"Totazoline hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99238","description":"Hospital discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPF0","description":"ICD-JFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB241","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cortisol free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82530","description":"Cortisol free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEC1","description":"ICD-CFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUA1","description":"ICD-AHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECB0","description":"ICD-GECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision/fixation of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27165","description":"Incision/fixation of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBB0","description":"ICD-GCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29035","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absolute quantitation of myocardial blood flow_ positron emission tomography (PET)_ rest and stress (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0482T","description":"Absolute quantitation of myocardial blood flow_ positron emission tomography (PET)_ rest and stress (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9701","description":"Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPE1","description":"ICD-FFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOD0","description":"ICD-KHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBF1","description":"ICD-FEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSE1","description":"ICD-DBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCED1","description":"ICD-FCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETB1","description":"ICD-EETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC40","description":"Medium Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICC0","description":"ICD-JICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1A","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMB0","description":"ICD-OJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB110","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYC0","description":"ICD-LCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOF1","description":"ICD-HDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCE1","description":"ICD-OHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVB0","description":"ICD-GHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj multihance multipack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9578","description":"Inj multihance multipack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; initial single probe stain procedure (List separately in addition to code for prima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0848T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; initial single probe stain procedure (List separately in addition to code for prima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCE0","description":"ICD-CDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXF0","description":"ICD-NJXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVE0","description":"ICD-GDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMA1","description":"ICD-KGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMF1","description":"ICD-NEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKA0","description":"ICD-NEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pcp prophylaxis rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4279F","description":"Pcp prophylaxis rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOE0","description":"ICD-PAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFC1","description":"ICD-GIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLF1","description":"ICD-EHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vis field assmnt tech suppt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0379T","description":"Vis field assmnt tech suppt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHF0","description":"ICD-GFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1224","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Per pm reeval est pat 65+ yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99397","description":"Per pm reeval est pat 65+ yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSA0","description":"ICD-OFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBD1","description":"ICD-NEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Promoting wellness mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0005","description":"Promoting wellness mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECB1","description":"ICD-GECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert xdrl body crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63300","description":"Remove vert xdrl body crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMF1","description":"ICD-NBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBA0","description":"ICD-OFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVF1","description":"ICD-CDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25151","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0688U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688U","description":"CPT-0688U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHF1","description":"ICD-AGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB40","description":"Very High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood mucoprotein","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2038","description":"Blood mucoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-70472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","description":"CPT-70472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relieve bladder contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52640","description":"Relieve bladder contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_maintenance rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9002","description":"Mccd_maintenance rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients using hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9688","description":"Patients using hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQE1","description":"ICD-OKQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEF1","description":"ICD-MFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reas no adhere pos air pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8854","description":"Reas no adhere pos air pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISE0","description":"ICD-CISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18B","description":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0535","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","description":"HCPCS-G0535","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand/chin ctrl spec joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2373","description":"Hand/chin ctrl spec joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Cardiac Catheterization Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0622","description":"Hospital Special Treatment Room Support Component (Hstrsc) Cardiac Catheterization Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27848","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9121","description":"Injection_ argatroban","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBE0","description":"ICD-MDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDE1","description":"ICD-KHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB15","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Devise bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44316","description":"Devise bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0498U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","description":"CPT-0498U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISD0","description":"ICD-PISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls daily mgmt artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33949","description":"Ecmo/ecls daily mgmt artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6750","description":"Crown porcelain high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pedicle e/n/e/l/ntroral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15576","description":"Pedicle e/n/e/l/ntroral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat sesamoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28531","description":"Treat sesamoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMD1","description":"ICD-NJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELB0","description":"ICD-AELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYC0","description":"ICD-OFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDC0","description":"ICD-FCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRA0","description":"ICD-ODRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOF0","description":"ICD-GAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2384","description":"Pneumatic caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auditory osseointegrated device_ external sound processor_ excludes transducer/actuator_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8691","description":"Auditory osseointegrated device_ external sound processor_ excludes transducer/actuator_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00754","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","description":"CPT-00754","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18E","description":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35002","description":"Repair artery rupture neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYA0","description":"ICD-CAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKD0","description":"ICD-OIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 resin-based compos","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2712","description":"Crown 3/4 resin-based compos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQB1","description":"ICD-DAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITE1","description":"ICD-CITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLF0","description":"ICD-CFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hdr elctrnc skn surf brchytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0394T","description":"Hdr elctrnc skn surf brchytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEC0","description":"ICD-CAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMC1","description":"ICD-NEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Butorphanol tartrate_ nasal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0012","description":"Butorphanol tartrate_ nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lowr extremity prosthes nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5999","description":"Lowr extremity prosthes nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJB0","description":"ICD-OAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Germline disorders_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood_ report of specific gene rearrangement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012U","description":"Germline disorders_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood_ report of specific gene rearrangement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGE1","description":"ICD-CCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot insert silicone gel eac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3003","description":"Foot insert silicone gel eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIB1","description":"ICD-IHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGE1","description":"ICD-BGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJE1","description":"ICD-OGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPA1","description":"ICD-GFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCE1","description":"ICD-EGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin pro flex/ext cont","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5859","description":"Knee-shin pro flex/ext cont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDA1","description":"ICD-NHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA11","description":"ICD-2IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wet-dry dressings rx recmd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4265F","description":"Wet-dry dressings rx recmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBF1","description":"ICD-OHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47120","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj unspecified therapy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7899","description":"Tmj unspecified therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIE0","description":"ICD-NIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHA0","description":"ICD-NFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLB0","description":"ICD-NFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMC0","description":"ICD-CHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVB1","description":"ICD-BDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26075","description":"Explore/treat finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIF1","description":"ICD-MCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBA0","description":"ICD-EHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC113","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALF1","description":"ICD-FALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIB1","description":"ICD-MBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagus motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91010","description":"Esophagus motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17263","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair gum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41872","description":"Repair gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWD0","description":"ICD-OEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22A","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAF1","description":"ICD-MJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLE1","description":"ICD-IHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVB0","description":"ICD-NGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBD0","description":"ICD-NLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icut allergy test drug/bug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95024","description":"Icut allergy test drug/bug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCA1","description":"ICD-NHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAC0","description":"ICD-MBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant eye drug system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67027","description":"Implant eye drug system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJA0","description":"ICD-BIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMC0","description":"ICD-AAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB34","description":"Very High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Integra meshed bil wound mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9363","description":"Integra meshed bil wound mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Battery charger_ dual mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2367","description":"Battery charger_ dual mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99600","description":"Home visit nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Construct bowel bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50825","description":"Construct bowel bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wnd prep f/n/hf/g addl cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15005","description":"Wnd prep f/n/hf/g addl cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSE1","description":"ICD-PJSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYE1","description":"ICD-GAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEB0","description":"ICD-NAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDF0","description":"ICD-GBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIB1","description":"ICD-JBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6600","description":"Gradient compression bandaging supply_ high density foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAA1","description":"ICD-MBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth amputation of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93251","description":"Anesth amputation of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Term dev precision pinch dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6810","description":"Term dev precision pinch dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJB1","description":"ICD-OKJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98010","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","description":"CPT-98010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65286","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"R&l hrt cath w/ventriclgrphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93453","description":"R&l hrt cath w/ventriclgrphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMC1","description":"ICD-JAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBB0","description":"ICD-OIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVD0","description":"ICD-CCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDA1","description":"ICD-ECDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Av fusion direct any site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36821","description":"Av fusion direct any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLF1","description":"ICD-MFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBD1","description":"ICD-EEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tigecycline (accord) not therapeutically equivalent to j3243_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3244","description":"Injection_ tigecycline (accord) not therapeutically equivalent to j3243_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWD1","description":"ICD-PLWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 125","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86304","description":"Immunoassay tumor ca 125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYD1","description":"ICD-DCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINB1","description":"ICD-FINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAF0","description":"ICD-IHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOC0","description":"ICD-PHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEE0","description":"ICD-IDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluphenazine decanoate 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2680","description":"Fluphenazine decanoate 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBF0","description":"ICD-CIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSF1","description":"ICD-PHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup gauntlet ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4015","description":"Cast sup gauntlet ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXB1","description":"ICD-CEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post and core cast + crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2952","description":"Post and core cast + crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOF1","description":"ICD-PCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOD0","description":"ICD-PAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat larynx fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31584","description":"Treat larynx fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAME0","description":"ICD-OAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKE0","description":"ICD-NBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRF1","description":"ICD-GFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit periorbtl implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21390","description":"Opn tx orbit periorbtl implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70250","description":"X-ray exam of skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73501","description":"X-ray exam hip uni 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAA1","description":"ICD-BFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colostomy with biopsies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44322","description":"Colostomy with biopsies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove kidney open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50220","description":"Remove kidney open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1806","description":"HCPCS-B1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUF0","description":"ICD-IAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound prep trk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15002","description":"Wound prep trk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Note hring tst w/in 6 mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3230F","description":"Note hring tst w/in 6 mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQE1","description":"ICD-LGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18F","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1066T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1066T","description":"CPT-1066T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ peramivir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2547","description":"Injection_ peramivir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24C","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26561","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supported employ_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2024","description":"Supported employ_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental gold foil three surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2430","description":"Dental gold foil three surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOF1","description":"ICD-PAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIE1","description":"ICD-NJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmic mitomycin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7315","description":"Ophthalmic mitomycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGC1","description":"ICD-OEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33978","description":"Remove ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEE0","description":"ICD-ODEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEC1","description":"ICD-MAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0077","description":"Injection_ clindamycin phosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behav hlth day treat_ per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2012","description":"Behav hlth day treat_ per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1125","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBE1","description":"ICD-GEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAF1","description":"ICD-FIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPA0","description":"ICD-OHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKD0","description":"ICD-OHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dispensing fee_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5241","description":"Dispensing fee_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBB1","description":"ICD-FCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQB1","description":"ICD-CBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rebase hybrid prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5725","description":"Rebase hybrid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sirolimus_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7520","description":"Sirolimus_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct chest spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72130","description":"Ct chest spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9258","description":"Injection_ paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB134","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg >16<=48 w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6235","description":"Hydrocolld drg >16<=48 w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATA0","description":"ICD-MATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","description":"HCPCS-J7601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXD1","description":"ICD-GBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBE1","description":"ICD-MLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spacer without mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8100","description":"Spacer without mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCE1","description":"ICD-IHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Precision attachment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5862","description":"Precision attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8F","description":"Medium Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0202","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0202","description":"CDT-D0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathologist(s)/dermatopathologist(s) is the same clinician who performed the biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9939","description":"Pathologist(s)/dermatopathologist(s) is the same clinician who performed the biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Csit lowrisk surg pts preop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8961","description":"Csit lowrisk surg pts preop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJA1","description":"ICD-FEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDA1","description":"ICD-OHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mh partial hosp tx under 24h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0035","description":"Mh partial hosp tx under 24h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBB0","description":"ICD-MEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMC1","description":"ICD-NHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQD0","description":"ICD-LEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJF1","description":"ICD-NLJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome study additional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88289","description":"Chromosome study additional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIF1","description":"ICD-KAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVC1","description":"ICD-CHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28E","description":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRA0","description":"ICD-PIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHB0","description":"ICD-CBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEB0","description":"ICD-GAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ chloroprocaine hydrochloride_  per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2401","description":"Injection_ chloroprocaine hydrochloride_  per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aicd_ other than sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1882","description":"Aicd_ other than sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTD1","description":"ICD-ECTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXA0","description":"ICD-OKXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ bandage liner_ upper extremity_ any size or length_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6595","description":"Gradient compression bandaging supply_ bandage liner_ upper extremity_ any size or length_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA31","description":"ICD-3EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0218T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (acute myelogenous leukemia)_ DNA_ whole genome next-generation sequencing to detect gene rearrangement(s)_ blood or bone marrow_ report of specific gene rearrangem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0056U","description":"Hematology (acute myelogenous leukemia)_ DNA_ whole genome next-generation sequencing to detect gene rearrangement(s)_ blood or bone marrow_ report of specific gene rearrangem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1111T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1111T","description":"CPT-1111T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25905","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise spine eltrd perq aray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63663","description":"Revise spine eltrd perq aray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTB0","description":"ICD-GCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0458","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","description":"HCPCS-J0458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Diffuse Large B-Cell Lymphoma [Dlbcl])_ Mrna_ Gene Expression Profiling By Fluorescent Probe Hybridization Of 20 Genes_ Formalin-Fixed Paraffin-Embedded Tissue_ Algo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0017M","description":"Oncology (Diffuse Large B-Cell Lymphoma [Dlbcl])_ Mrna_ Gene Expression Profiling By Fluorescent Probe Hybridization Of 20 Genes_ Formalin-Fixed Paraffin-Embedded Tissue_ Algo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair hand deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26580","description":"Repair hand deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRC0","description":"ICD-OCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEA1","description":"ICD-CCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEC0","description":"ICD-FEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQB0","description":"ICD-HCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWD1","description":"ICD-DHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNA1","description":"ICD-NCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUE1","description":"ICD-NEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIC1","description":"ICD-NKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemi-facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8044","description":"Hemi-facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXA0","description":"ICD-KGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTA0","description":"ICD-CBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAA1","description":"ICD-NIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup hip spica ped plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4027","description":"Cast sup hip spica ped plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHB1","description":"ICD-NKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELD1","description":"ICD-NELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDB0","description":"ICD-NJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRD1","description":"ICD-OJRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB21","description":"ICD-2BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJE1","description":"ICD-BAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDD0","description":"ICD-FDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES306","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI abdomen w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74181","description":"MRI abdomen w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEB0","description":"ICD-EIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0679","description":"Non-pneumatic sequential compression garment_ half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18F","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m maa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9540","description":"Tc99m maa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEID0","description":"ICD-KEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lockingelbow forearm cntrbal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6693","description":"Lockingelbow forearm cntrbal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTB1","description":"ICD-BCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3B","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE225","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRB1","description":"ICD-LHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKD0","description":"ICD-CGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo ablate renal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50541","description":"Laparo ablate renal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67413","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maintenance 5% WL from baseline weight in months 7-12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9888","description":"Maintenance 5% WL from baseline weight in months 7-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTB0","description":"ICD-NJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQB0","description":"ICD-DIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ interphalangeal joints_ with or without internal fixation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7506","description":"Arthrodesis_ interphalangeal joints_ with or without internal fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHB0","description":"ICD-MLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUC0","description":"ICD-JEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXD0","description":"ICD-OFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWB0","description":"ICD-OJWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9813","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9813","description":"HCPCS-C9813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERB1","description":"ICD-CERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQE0","description":"ICD-DGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 5MCG/.5ML AS03B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0104A","description":"ADM SARSCOV2 5MCG/.5ML AS03B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNB0","description":"ICD-BFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29820","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18A","description":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Atten goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9166","description":"Atten goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITA0","description":"ICD-EITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHF0","description":"ICD-OCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemostats for dialysis_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1637","description":"Hemostats for dialysis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQD0","description":"ICD-HDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise inferior turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30130","description":"Excise inferior turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Split blood or products","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86985","description":"Split blood or products","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of inner eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66770","description":"Removal of inner eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADD0","description":"ICD-FADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00530","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","description":"CPT-00530","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sent lymph node biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8878","description":"Sent lymph node biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES235","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLB1","description":"ICD-ABLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44150","description":"Removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diskectomy_ anterior_ with d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2351","description":"Diskectomy_ anterior_ with d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJD0","description":"ICD-BCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PermeaDer B_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2016","description":"PermeaDer B_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOC1","description":"ICD-CGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFB1","description":"ICD-FGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHE0","description":"ICD-KFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Locm 300-399mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9967","description":"Locm 300-399mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDF0","description":"ICD-CIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC24","description":"Medium Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBD0","description":"ICD-MLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWD1","description":"ICD-CCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFA0","description":"ICD-KIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJB0","description":"ICD-JFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCE1","description":"ICD-OCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJF1","description":"ICD-GEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21B","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNB0","description":"ICD-OBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0613U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","description":"CPT-0613U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23C","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOA1","description":"ICD-LBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64893","description":"Nerve graft arm/leg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28675","description":"Repair of toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEE1","description":"ICD-KGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIA1","description":"ICD-OKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRC0","description":"ICD-KIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOE1","description":"ICD-LGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chikungunya virus vaccine_ live attenuated_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90589","description":"Chikungunya virus vaccine_ live attenuated_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSA0","description":"ICD-PGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43216","description":"Esophagoscopy lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48102","description":"Needle biopsy pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDC1","description":"ICD-FEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKC0","description":"ICD-KEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cane adjust/fixed with tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0100","description":"Cane adjust/fixed with tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81538","description":"Oncology lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQE0","description":"ICD-LIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC11","description":"ICD-4GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQB1","description":"ICD-DGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEME1","description":"ICD-OEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50630","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNF1","description":"ICD-JFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMF0","description":"ICD-CGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ftl cgen abnor two proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81508","description":"Ftl cgen abnor two proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of spleen total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38100","description":"Removal of spleen total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXA0","description":"ICD-CIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99348","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCA0","description":"ICD-KCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWB0","description":"ICD-LDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYD1","description":"ICD-GAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93241","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of corticosteroids 17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83491","description":"Assay of corticosteroids 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCC0","description":"ICD-EHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOC0","description":"ICD-HAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye Imaging Validated To Match Diagnosis From Seven Standard Field Stereoscopic Photos Results Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2104","description":"Eye Imaging Validated To Match Diagnosis From Seven Standard Field Stereoscopic Photos Results Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57500","description":"Biopsy of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj beta interferon im 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3027","description":"Inj beta interferon im 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWA1","description":"ICD-LDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTE1","description":"ICD-MCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGD1","description":"ICD-NHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12002","description":"Rpr s/n/ax/gen/trnk2.6-7.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAA1","description":"ICD-ODAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUC1","description":"ICD-BDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUE1","description":"ICD-OAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add metal substructure to acrylic full denture (per arch)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5876","description":"Add metal substructure to acrylic full denture (per arch)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIB0","description":"ICD-ADIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJF0","description":"ICD-FBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDB0","description":"ICD-GHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Device evaluation_ interrogation_ and initial programming of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ with iterative adjustment of the implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0472T","description":"Device evaluation_ interrogation_ and initial programming of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ with iterative adjustment of the implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQB0","description":"ICD-LAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1033","description":"Nonpneumatic sequential compression garment_ half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYC1","description":"ICD-PAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neonate crit care initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99468","description":"Neonate crit care initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28H","description":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ meloxicam_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9059","description":"Injection_ meloxicam_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAF0","description":"ICD-GDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUB1","description":"ICD-EAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid exam one ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92590","description":"Hearing aid exam one ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL46","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18B","description":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75880","description":"Vein x-ray eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1233","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNA0","description":"ICD-CCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28665","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vestronidase alfa-vjbk_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3397","description":"Injection_ vestronidase alfa-vjbk_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28D","description":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj aspiration joint fluid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7870","description":"Tmj aspiration joint fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDF1","description":"ICD-NGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13D","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEND1","description":"ICD-NEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBE0","description":"ICD-BBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28G","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23B","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmv antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86645","description":"Cmv antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHD0","description":"ICD-MDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDC1","description":"ICD-BEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43865","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ off-the-shelf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3761","description":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ off-the-shelf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYC0","description":"ICD-PCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVD1","description":"ICD-NKVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYC0","description":"ICD-CDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extrnl beam other than prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4201F","description":"Extrnl beam other than prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/stent plcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44402","description":"Colonoscopy w/stent plcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJD0","description":"ICD-FCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart-vein defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33732","description":"Repair heart-vein defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00770","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","description":"CPT-00770","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAC0","description":"ICD-CIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHED0","description":"ICD-OHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB141","description":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd demo bundle level i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9013","description":"Esrd demo bundle level i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel-bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44661","description":"Repair bowel-bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLB0","description":"ICD-FGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFF1","description":"ICD-FCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl car modulj tranvns elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0413T","description":"Rmvl car modulj tranvns elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLD0","description":"ICD-JBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6780","description":"Crown 3/4 high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFD0","description":"ICD-CBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1103","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1103","description":"CDT-D1103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB254","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64469","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","description":"CPT-64469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC151","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDD1","description":"ICD-IBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSD0","description":"ICD-DDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXB1","description":"ICD-BCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspirate pleura w/ imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32555","description":"Aspirate pleura w/ imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42950","description":"Reconstruction of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOB1","description":"ICD-HIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHC1","description":"ICD-EDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kne sing axis fric shin sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5200","description":"Kne sing axis fric shin sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEE1","description":"ICD-GHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKF0","description":"ICD-FGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ allopurinol sodium_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0206","description":"Injection_ allopurinol sodium_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHA0","description":"ICD-FEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADB1","description":"ICD-OADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18X","description":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB216","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYA0","description":"ICD-PKYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYD1","description":"ICD-DBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21C","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWA1","description":"ICD-GFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allergy/immunology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0060","description":"Allergy/immunology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJB1","description":"ICD-KFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl devital tis addl 20cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97598","description":"Rmvl devital tis addl 20cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse liver ducts & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47765","description":"Fuse liver ducts & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Truskin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4167","description":"Truskin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIE1","description":"ICD-FFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRF0","description":"ICD-OHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull for biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61140","description":"Pierce skull for biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIE0","description":"ICD-JHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDF1","description":"ICD-NHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMC0","description":"ICD-GAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNB0","description":"ICD-JDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETD1","description":"ICD-KETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTE0","description":"ICD-NLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1401","description":"HCPCS-A1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHF0","description":"ICD-KHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAE0","description":"ICD-EAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical nutrition indiv in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97802","description":"Medical nutrition indiv in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla class i&ii antibody qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86828","description":"Hla class i&ii antibody qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJA0","description":"ICD-NGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Halo repl liner/interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0861","description":"Halo repl liner/interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vasectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92151","description":"Anesth vasectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRF1","description":"ICD-PKRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXE0","description":"ICD-NDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFF1","description":"ICD-NBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport case worker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0160","description":"Noner transport case worker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med list docd in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1159F","description":"Med list docd in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOC0","description":"ICD-HGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBB1","description":"ICD-NCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOE1","description":"ICD-HEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1185","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKF0","description":"ICD-OBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scaling in the presence of generalized moderate or severe gingival inflammation--full mouth_ after oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4346","description":"Scaling in the presence of generalized moderate or severe gingival inflammation--full mouth_ after oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound(s) care non-selective","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97602","description":"Wound(s) care non-selective","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVF1","description":"ICD-BFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVB0","description":"ICD-FHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Signs of melanoma absent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8749","description":"Signs of melanoma absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Construct vagina with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57292","description":"Construct vagina with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunohistochemical stains","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0478","description":"Immunohistochemical stains","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD217","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMB0","description":"ICD-JFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQA1","description":"ICD-KEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise bladder/drain ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51045","description":"Incise bladder/drain ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood split unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9011","description":"Blood split unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBB1","description":"ICD-IIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18G","description":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLA1","description":"ICD-ADLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete ivf nos case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4015","description":"Complete ivf nos case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALA0","description":"ICD-EALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIA1","description":"ICD-NAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIB0","description":"ICD-GAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood fungus culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87103","description":"Blood fungus culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ infliximab-axxq_ biosimilar_ (AVSOLA)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5121","description":"Injection_ infliximab-axxq_ biosimilar_ (AVSOLA)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25C","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSD1","description":"ICD-HFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1006","description":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18B","description":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2D","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg3b-4 metasta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9066","description":"Onc dx nsclc stg3b-4 metasta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1089","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQD0","description":"ICD-CIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHE1","description":"ICD-IIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18X","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Memory current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9168","description":"Memory current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53235","description":"Removal of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSF0","description":"ICD-OBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOF0","description":"ICD-DBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSC0","description":"ICD-PCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWF0","description":"ICD-OKWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10B","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLB0","description":"ICD-AHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXF1","description":"ICD-FDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEF0","description":"ICD-JEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRF0","description":"ICD-OFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apomorphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0364","description":"Apomorphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLC0","description":"ICD-OLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt tx sys bio med psori 6mth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9652","description":"Pt tx sys bio med psori 6mth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla typing dr/dq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86817","description":"Hla typing dr/dq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGF0","description":"ICD-CIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDB1","description":"ICD-NEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26205","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPE0","description":"ICD-JBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vitrectomy_ mechanical_ pars plana approach_ with subretinal injection of pharmacologic/biologic agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9770","description":"Vitrectomy_ mechanical_ pars plana approach_ with subretinal injection of pharmacologic/biologic agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flu immunize order/admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8482","description":"Flu immunize order/admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUE0","description":"ICD-MEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fragmenting of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50590","description":"Fragmenting of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth amniocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84251","description":"Anesth amniocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEF1","description":"ICD-NGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracostomy w/flap drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32036","description":"Thoracostomy w/flap drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNE1","description":"ICD-NFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg artery-vein single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33517","description":"Cabg artery-vein single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLA1","description":"ICD-OHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plan care lipid control docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0556F","description":"Plan care lipid control docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group behave couns 2-10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0473","description":"Group behave couns 2-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFF1","description":"ICD-KAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gasket or seal_ for use with prosthetic socket insert_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7700","description":"Gasket or seal_ for use with prosthetic socket insert_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Volun service at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9476","description":"Volun service at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOD1","description":"ICD-LDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC213","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSE0","description":"ICD-HGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA112","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWB0","description":"ICD-LEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENB1","description":"ICD-GENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGA0","description":"ICD-KEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10B","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIC0","description":"ICD-OCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX60","description":"High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68130","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pouch drain high output","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4412","description":"Ost pouch drain high output","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDD1","description":"ICD-JGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Flow Cytometry (Ie_ Fluorescence-Activated Cell Sorting [Facs])_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86363","description":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Flow Cytometry (Ie_ Fluorescence-Activated Cell Sorting [Facs])_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMD1","description":"ICD-GIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTD0","description":"ICD-FCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCF0","description":"ICD-ODCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33860","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYB1","description":"ICD-PCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBA0","description":"ICD-MLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2203","description":"Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOA1","description":"ICD-GCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYE0","description":"ICD-LFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99281","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLF1","description":"ICD-JCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit int pain per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9327","description":"Hit int pain per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMD1","description":"ICD-NBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung transplant with bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32852","description":"Lung transplant with bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD151","description":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDE1","description":"ICD-AEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNA0","description":"ICD-OJNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCED1","description":"ICD-OCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 cast base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2781","description":"Crown 3/4 cast base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAF0","description":"ICD-OIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00102","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","description":"CPT-00102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso r post pnl sj-t9 pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0630","description":"Lso r post pnl sj-t9 pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLA1","description":"ICD-KDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDA0","description":"ICD-GEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis repeated eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90947","description":"Dialysis repeated eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABE0","description":"ICD-GABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADD0","description":"ICD-OADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGA1","description":"ICD-GIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15C","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53410","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mattress innerspring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0271","description":"Mattress innerspring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWE0","description":"ICD-PJWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX56","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy dilate w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31631","description":"Bronchoscopy dilate w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay c-d transfer measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82373","description":"Assay c-d transfer measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWC0","description":"ICD-CGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNB1","description":"ICD-JCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption studies combined_ with and without intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78272","description":"Vitamin B-12 absorption studies combined_ with and without intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC256","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMD0","description":"ICD-OGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19366","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abdomen surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22999","description":"Abdomen surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLD1","description":"ICD-BHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1011T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","description":"CPT-1011T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medrsn >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9353","description":"Medrsn >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy balloon <30mm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43220","description":"Esophagoscopy balloon <30mm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC150","description":"Special Care Low _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDF1","description":"ICD-NIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKA1","description":"ICD-FHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDID1","description":"ICD-FDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCB1","description":"ICD-JCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ multiple analytes_ quantitative_ single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82544","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ multiple analytes_ quantitative_ single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTC0","description":"ICD-CGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Long qt synd gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81280","description":"Long qt synd gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0336U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25670","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14A","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUA0","description":"ICD-EEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEF0","description":"ICD-KEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43123","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tick-borne encephalitis virus vaccine_ inactivated; 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90627","description":"Tick-borne encephalitis virus vaccine_ inactivated; 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert idrl body thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63305","description":"Remove vert idrl body thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58563","description":"Hysteroscopy ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETD0","description":"ICD-GETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUD0","description":"ICD-CDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVE1","description":"ICD-FAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Battery charger_ single mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2366","description":"Battery charger_ single mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exchange nephrostomy cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50435","description":"Exchange nephrostomy cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMD1","description":"ICD-GDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEB1","description":"ICD-CFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPA0","description":"ICD-CEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coronary artery angio s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93454","description":"Coronary artery angio s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHF0","description":"ICD-IAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX12","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVA0","description":"ICD-NHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amniotic fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82143","description":"Amniotic fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA30","description":"Ultra High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0B","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3C","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral infus pump statio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9006","description":"Parenteral infus pump statio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ag detection polyval if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87300","description":"Ag detection polyval if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTA0","description":"ICD-AHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAME1","description":"ICD-GAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICF0","description":"ICD-BICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1022","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXC0","description":"ICD-NCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penis plastic surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54360","description":"Penis plastic surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEE0","description":"ICD-ACEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEME0","description":"ICD-GEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMC1","description":"ICD-GGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEME0","description":"ICD-CEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69806","description":"Explore inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPF0","description":"ICD-OKPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12A","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61536","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJD0","description":"ICD-KDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNF1","description":"ICD-JDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rigid wheeled walker adj/fix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0141","description":"Rigid wheeled walker adj/fix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKE1","description":"ICD-NJKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy dilate/fx repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31630","description":"Bronchoscopy dilate/fx repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQB0","description":"ICD-LEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0502","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0502","description":"CDT-D0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy surg colpopexy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57425","description":"Laparoscopy surg colpopexy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual standing system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2230","description":"Manual standing system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDD1","description":"ICD-MEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAID0","description":"ICD-AAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXE0","description":"ICD-FGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFC1","description":"ICD-FDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVD1","description":"ICD-CEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEB1","description":"ICD-MKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSD0","description":"ICD-GHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26357","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABB1","description":"ICD-JABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADB1","description":"ICD-NADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKA1","description":"ICD-FDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9289","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","description":"HCPCS-J9289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLF1","description":"ICD-NGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLF0","description":"ICD-NJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDC0","description":"ICD-AHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr wc dr wh motor/gear comb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2370","description":"Pwr wc dr wh motor/gear comb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with strain im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9762","description":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with strain im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00846","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","description":"CPT-00846","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIC0","description":"ICD-EEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALA1","description":"ICD-IALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMA0","description":"ICD-CAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUC1","description":"ICD-NBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Circum 28 days or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54161","description":"Circum 28 days or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRB0","description":"ICD-DCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBA1","description":"ICD-ACBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBE0","description":"ICD-ABBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKA0","description":"ICD-JAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUC1","description":"ICD-ICUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIB0","description":"ICD-KBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for spleen x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38200","description":"Injection for spleen x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB21","description":"ICD-3IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB105","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair tcat mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33418","description":"Repair tcat mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDF1","description":"ICD-KFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer for use w/ regulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0580","description":"Nebulizer for use w/ regulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWB1","description":"ICD-LAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 7.6-12.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12015","description":"Rpr f/e/e/n/l/m 7.6-12.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6538","description":"Gc stocking full lngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACE0","description":"ICD-BACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETF0","description":"ICD-JETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0764T","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj magnesium sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3475","description":"Inj magnesium sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures maxill part resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5211","description":"Dentures maxill part resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATB0","description":"ICD-GATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJE1","description":"ICD-OIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracranial uni/ltd study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93882","description":"Extracranial uni/ltd study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFD0","description":"ICD-NEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJB0","description":"ICD-FEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ortho sidebar disconnect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2768","description":"Ortho sidebar disconnect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYD0","description":"ICD-LGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJF0","description":"ICD-FGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODID1","description":"ICD-ODID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0102U","description":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKC1","description":"ICD-OIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise lesion skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61616","description":"Resect/excise lesion skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEE1","description":"ICD-MLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMB0","description":"ICD-FFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for shoulder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23350","description":"Injection for shoulder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ gadopiclenol_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9573","description":"Injection_ gadopiclenol_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNA0","description":"ICD-GGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCE1","description":"ICD-ECCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11102","description":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt lft inpt fac w/in 60 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1110F","description":"Pt lft inpt fac w/in 60 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIA1","description":"ICD-NJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tildrakizumab_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3245","description":"Injection_ tildrakizumab_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTB1","description":"ICD-MFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0462","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","description":"HCPCS-J0462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGB0","description":"ICD-OKGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iop down <15% of pre-svc lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3285F","description":"Iop down <15% of pre-svc lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dna/rna sequencing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87153","description":"Dna/rna sequencing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Novachor_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4194","description":"Novachor_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDB1","description":"ICD-MLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECA1","description":"ICD-EECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open tx iliac spine uni/bil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0412","description":"Open tx iliac spine uni/bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relieve cranial pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61345","description":"Relieve cranial pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDC0","description":"ICD-MLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFB0","description":"ICD-NLFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLC0","description":"ICD-OCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYA1","description":"ICD-DDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEED1","description":"ICD-CEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Battery charger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4613","description":"Battery charger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRF0","description":"ICD-DFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1596","description":"Injection_ glycopyrrolate_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJF1","description":"ICD-JEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHF1","description":"ICD-BHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo anti-neopl sq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96401","description":"Chemo anti-neopl sq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHF0","description":"ICD-GIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27176","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJE0","description":"ICD-GDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE204","description":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAA1","description":"ICD-AIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shoulder cast plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4003","description":"Cast sup shoulder cast plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXD0","description":"ICD-OJXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92517","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAA0","description":"ICD-CIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIA1","description":"ICD-MGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWF0","description":"ICD-GIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA33","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12B","description":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYB0","description":"ICD-LHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKF1","description":"ICD-NKKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQE0","description":"ICD-PIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMF1","description":"ICD-KHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABD0","description":"ICD-KABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCE1","description":"ICD-OKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVC1","description":"ICD-BFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHID0","description":"ICD-OHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB55","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01250","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","description":"CPT-01250","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPB1","description":"ICD-OAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx head/neck ext unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9112","description":"Onc dx head/neck ext unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp multidisipln evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2000","description":"Comp multidisipln evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove muti-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54406","description":"Remove muti-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWB0","description":"ICD-KCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWA1","description":"ICD-HDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIF0","description":"ICD-GIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NuDYN DL or NuDYN DL MESH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4285","description":"NuDYN DL or NuDYN DL MESH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWC0","description":"ICD-KHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left ventricular pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0518T","description":"Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left ventricular pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPA1","description":"ICD-CBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXA1","description":"ICD-KHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14D","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary stress testing (eg_ 6-minute walk test)_ including measurement of heart rate_ oximetry_ and oxygen titration_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94618","description":"Pulmonary stress testing (eg_ 6-minute walk test)_ including measurement of heart rate_ oximetry_ and oxygen titration_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTD1","description":"ICD-MCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEB1","description":"ICD-EDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITE0","description":"ICD-IITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61608","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous injection of calcium-based biodegradable osteoconductive material_ proximal femur_ including imaging guidance_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0814T","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material_ proximal femur_ including imaging guidance_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDA1","description":"ICD-GDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0582U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","description":"CPT-0582U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1104T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1104T","description":"CPT-1104T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUD0","description":"ICD-ABUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33413","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8F","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair windpipe opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31613","description":"Repair windpipe opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFF0","description":"ICD-FEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUD1","description":"ICD-EHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUA1","description":"ICD-NBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOD0","description":"ICD-OHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNA0","description":"ICD-NGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWA0","description":"ICD-KFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28F","description":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC34","description":"High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection Sulfur Hexafouride Lipid Microsphere Per Ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9457","description":"Injection Sulfur Hexafouride Lipid Microsphere Per Ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITA0","description":"ICD-OITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB135","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEB1","description":"ICD-KBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43850","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31030","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Modify speech aid prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5960","description":"Modify speech aid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC51","description":"High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAE0","description":"ICD-JIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCME1","description":"ICD-JCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAC0","description":"ICD-KEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIA1","description":"ICD-JCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYB1","description":"ICD-HCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis one evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90945","description":"Dialysis one evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repr per/vag pouch sngl proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46710","description":"Repr per/vag pouch sngl proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8E","description":"Medium Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physical medicine procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97799","description":"Physical medicine procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB21","description":"ICD-4LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Var vaccine live subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90716","description":"Var vaccine live subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20704","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2291","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","description":"HCPCS-J2291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKC1","description":"ICD-GAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56740","description":"Remove vagina gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVD1","description":"ICD-OJVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIF0","description":"ICD-MIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHB1","description":"ICD-AHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCB0","description":"ICD-ECCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acq_ interpretation_ and report; each additional lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0471T","description":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acq_ interpretation_ and report; each additional lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCF1","description":"ICD-GDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVB1","description":"ICD-NKVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMA1","description":"ICD-MJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit postnatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99501","description":"Home visit postnatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYE1","description":"ICD-HEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurectomy foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28055","description":"Neurectomy foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prednisone_ oral_ per 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7506","description":"Prednisone_ oral_ per 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIME0","description":"ICD-FIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVD1","description":"ICD-OAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gs mg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9235","description":"Gs mg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPD1","description":"ICD-JCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTA0","description":"ICD-BFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAE0","description":"ICD-EBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20D","description":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACD0","description":"ICD-MACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5909","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5909","description":"CDT-D5909","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep c scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3514F","description":"Hep c scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Major Abdominal Blood Vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77059","description":"Major Abdominal Blood Vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12B","description":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIB0","description":"ICD-EHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMC0","description":"ICD-FFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adenovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86603","description":"Adenovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA12","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair Of Fixed Retainer_ Includes Reattachment - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8701","description":"Repair Of Fixed Retainer_ Includes Reattachment - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLID0","description":"ICD-OLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTC0","description":"ICD-OBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC105","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCD0","description":"ICD-MJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAA0","description":"ICD-BHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy resect bullae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32655","description":"Thoracoscopy resect bullae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88150","description":"Cytopath c/v manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC230","description":"Reduced Physical Function _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0233","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","description":"HCPCS-M0233","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endodontic procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3999","description":"Endodontic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIED1","description":"ICD-BIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine & cord cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63194","description":"Incise spine & cord cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe lifts elevation heel /i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3334","description":"Shoe lifts elevation heel /i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERC0","description":"ICD-OERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRE1","description":"ICD-HFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pectin based ostomy paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4406","description":"Pectin based ostomy paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22548","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq device breast 1st imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19281","description":"Perq device breast 1st imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medication admin visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1502","description":"Medication admin visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYC0","description":"ICD-CGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC16","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle_ myocutaneous_ or fasciocutaneous flap; head and neck with named vascular pedicle (ie_ buccinators_ genioglossus_ temporalis_ masseter_ sternocleidomastoid_ levator sca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15733","description":"Muscle_ myocutaneous_ or fasciocutaneous flap; head and neck with named vascular pedicle (ie_ buccinators_ genioglossus_ temporalis_ masseter_ sternocleidomastoid_ levator sca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUE1","description":"ICD-NGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos pain assess no f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8509","description":"Pos pain assess no f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLA1","description":"ICD-MJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0702","description":"HCPCS-A0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDD1","description":"ICD-CFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAC0","description":"ICD-AEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEF1","description":"ICD-JCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Principal illness navigation services_ additional 30 minutes per calendar month (list separately in addition to g0023)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0024","description":"Principal illness navigation services_ additional 30 minutes per calendar month (list separately in addition to g0023)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteochondral knee autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27416","description":"Osteochondral knee autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWF1","description":"ICD-PJWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial_ fungal_ or viral infection)_ semiquantitative biomechanical assessment (via deformability cytometry)_ whole blood_ with algorithmic analysis and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0441U","description":"Infectious disease (bacterial_ fungal_ or viral infection)_ semiquantitative biomechanical assessment (via deformability cytometry)_ whole blood_ with algorithmic analysis and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic type socket molde","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2350","description":"Prosthetic type socket molde","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSE0","description":"ICD-GFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1026","description":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21082","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debride infected skin add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11001","description":"Debride infected skin add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCE0","description":"ICD-MHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin fluid swg/sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5828","description":"Endo knee-shin fluid swg/sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA21","description":"ICD-3JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dihydrotestosterone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6047","description":"Dihydrotestosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICE0","description":"ICD-JICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHD1","description":"ICD-AHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95974","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVE0","description":"ICD-BEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLA0","description":"ICD-BHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE231","description":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKA0","description":"ICD-GBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75736","description":"Artery x-rays pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1393","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","description":"HCPCS-M1393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHC0","description":"ICD-ACHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA34","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJF0","description":"ICD-JCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC11","description":"ICD-3JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hdr elctr ntrst/ntrcv brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0395T","description":"Hdr elctr ntrst/ntrcv brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eptifibatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1327","description":"Eptifibatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replantation foot complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20838","description":"Replantation foot complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQD0","description":"ICD-PIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC204","description":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3B","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJC1","description":"ICD-BCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dispos cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0500","description":"Dispos cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ usin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0116U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ usin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt asked re sleep disturb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4328F","description":"Pt asked re sleep disturb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00702","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","description":"CPT-00702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQC1","description":"ICD-LFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of thiocyanate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84430","description":"Assay of thiocyanate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADD0","description":"ICD-CADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reusable oral thermometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4931","description":"Reusable oral thermometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating The Patient Has Received Or Is Currently Receiving Palliative Or Hospice Care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9996","description":"Documentation Stating The Patient Has Received Or Is Currently Receiving Palliative Or Hospice Care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal and reinsertion of sinus tarsi implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0511T","description":"Removal and reinsertion of sinus tarsi implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drive wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2394","description":"Drive wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIE0","description":"ICD-CIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXE0","description":"ICD-GIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRA0","description":"ICD-HCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRF0","description":"ICD-GFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Staggered spondaic word test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92572","description":"Staggered spondaic word test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Financial Management Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7341","description":"Financial Management Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0091A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMC0","description":"ICD-BFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy cerv/thor facet jnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64633","description":"Destroy cerv/thor facet jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIF1","description":"ICD-GCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00406","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","description":"CPT-00406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLD0","description":"ICD-GHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contour seat for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2294","description":"Contour seat for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC11","description":"ICD-4HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAB0","description":"ICD-KAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILE0","description":"ICD-IILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8X","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBD1","description":"ICD-NIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKD0","description":"ICD-BEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg artery-vein two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33518","description":"Cabg artery-vein two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQC1","description":"ICD-LHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUD0","description":"ICD-JFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMF1","description":"ICD-JBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc w/tla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37228","description":"Tib/per revasc w/tla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPE0","description":"ICD-CDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of arm & girdle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23900","description":"Amputation of arm & girdle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental unspec restorative pr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2999","description":"Dental unspec restorative pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBE1","description":"ICD-IGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychi sympt 1+present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1182F","description":"Neuropsychi sympt 1+present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fqhc visit_ ippe or awv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0468","description":"Fqhc visit_ ippe or awv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHC0","description":"ICD-GBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICE1","description":"ICD-KICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelet survival kinetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78190","description":"Platelet survival kinetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3A","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBF0","description":"ICD-OIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUD1","description":"ICD-KCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replc vagus nerve pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0316T","description":"Replc vagus nerve pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA11","description":"ICD-2BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX36","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHA0","description":"ICD-BFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cord blood-derived stem-cell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2142","description":"Cord blood-derived stem-cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Head surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21499","description":"Head surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33254","description":"Ablate atria lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVA0","description":"ICD-JGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOA0","description":"ICD-CEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABF1","description":"ICD-NABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 3 MCG TRS-SUCR","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91308","description":"SARSCOV2 VAC 3 MCG TRS-SUCR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary compliance study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94750","description":"Pulmonary compliance study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLF0","description":"ICD-MDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2207","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXA0","description":"ICD-GGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9769","description":"Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hib prp-t vaccine 4 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90648","description":"Hib prp-t vaccine 4 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNB1","description":"ICD-JHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUB1","description":"ICD-IAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKC1","description":"ICD-GHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQE1","description":"ICD-HGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITB1","description":"ICD-JITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHB0","description":"ICD-MAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gene test alpha-thalassemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3845","description":"Gene test alpha-thalassemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37292","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","description":"CPT-37292","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVA1","description":"ICD-NJVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61151","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye surgery follow-up add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67331","description":"Eye surgery follow-up add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHF0","description":"ICD-NHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-3/> piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21147","description":"Lefort i-3/> piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ avalglucosidase alfa-ngpt_ 4 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0219","description":"Injection_ avalglucosidase alfa-ngpt_ 4 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8B","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28062","description":"Removal of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWD1","description":"ICD-OIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza dna amp prob 1+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87501","description":"Influenza dna amp prob 1+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDE0","description":"ICD-JFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ven thrombosis images bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78458","description":"Ven thrombosis images bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft kneecap tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27381","description":"Repair/graft kneecap tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68330","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATA1","description":"ICD-EATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDB0","description":"ICD-MLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEB0","description":"ICD-ODEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNF1","description":"ICD-NCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAA0","description":"ICD-NKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAC0","description":"ICD-OKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVE1","description":"ICD-CFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUF1","description":"ICD-JEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepc measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8545","description":"Hepc measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFD1","description":"ICD-JIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spinal fluid tap diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62270","description":"Spinal fluid tap diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient not screened for tobacco use_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9905","description":"Patient not screened for tobacco use_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMB1","description":"ICD-FEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGND0","description":"ICD-GGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33962","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGB1","description":"ICD-JIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCB1","description":"ICD-GFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A7021","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","description":"HCPCS-A7021","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL25","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJE1","description":"ICD-CAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reimplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50380","description":"Reimplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD145","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01230","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","description":"CPT-01230","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk knee joints polycentric p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5677","description":"Bk knee joints polycentric p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC116","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEE1","description":"ICD-MEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23B","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAD1","description":"ICD-BHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTA1","description":"ICD-MDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPD0","description":"ICD-NIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQE1","description":"ICD-HCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEA0","description":"ICD-JCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attendant control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2331","description":"Attendant control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9063","description":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMC1","description":"ICD-IAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYB1","description":"ICD-LCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagectomy_ distal two-thirds_ with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43287","description":"Esophagectomy_ distal two-thirds_ with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0662","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","description":"HCPCS-G0662","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGE0","description":"ICD-BDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMB1","description":"ICD-NBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPC0","description":"ICD-CBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1010","description":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA11","description":"ICD-2GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBA1","description":"ICD-IGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLC0","description":"ICD-BGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy remove lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46610","description":"Anoscopy remove lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXC0","description":"ICD-OGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein byp grft fem-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35583","description":"Vein byp grft fem-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove impacted ear wax uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69210","description":"Remove impacted ear wax uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/4.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2209","description":"Lens sphcy bifocal 4.25-7/4.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTA0","description":"ICD-MKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMD1","description":"ICD-OCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal foreign body mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40805","description":"Removal foreign body mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXC0","description":"ICD-NEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ca screen;pelvic/breast exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0101","description":"Ca screen;pelvic/breast exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93015","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEE0","description":"ICD-MCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25355","description":"Revision of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPE0","description":"ICD-FAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHD1","description":"ICD-IIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNB0","description":"ICD-CHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD226","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prostate laser enucleation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52649","description":"Prostate laser enucleation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILF1","description":"ICD-GILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26445","description":"Release hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virus inoculate eggs/animal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87250","description":"Virus inoculate eggs/animal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25D","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 4/5vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72050","description":"X-ray exam neck spine 4/5vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22D","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imatinib 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0088","description":"Imatinib 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ring flange plastic/leather","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1100","description":"Ring flange plastic/leather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPE0","description":"ICD-FEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exoskeletal axial rotation u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5982","description":"Exoskeletal axial rotation u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplt autol hct/donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38241","description":"Transplt autol hct/donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Polysom 6/>yrs cpap 4/> parm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95811","description":"Polysom 6/>yrs cpap 4/> parm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of adrenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86651","description":"Anesth removal of adrenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTD0","description":"ICD-KCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDD1","description":"ICD-BBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMD0","description":"ICD-BAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXC1","description":"ICD-KCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGC0","description":"ICD-CCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNF1","description":"ICD-KCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHE1","description":"ICD-KBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGA1","description":"ICD-NFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism curbside clinical augmented workflow_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1020","description":"Clinical decision support mechanism curbside clinical augmented workflow_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSA1","description":"ICD-DFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99492","description":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOD1","description":"ICD-OEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA34","description":"Medium Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; initial 4 hours of monitoring time_ including hourly physiological and laboratory a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0895T","description":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; initial 4 hours of monitoring time_ including hourly physiological and laboratory a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJD0","description":"ICD-FIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVD0","description":"ICD-NHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEF0","description":"ICD-IHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHA0","description":"ICD-ACHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIC0","description":"ICD-ADIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALD0","description":"ICD-CALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34401","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMA0","description":"ICD-IAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMA1","description":"ICD-GGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cesarean delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59514","description":"Cesarean delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50280","description":"Removal of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYC1","description":"ICD-PBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11626","description":"Exc s/n/h/f/g mal+mrg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay resin 2 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2662","description":"Dental onlay resin 2 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLD1","description":"ICD-FFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1358","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEC1","description":"ICD-CAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11B","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOC0","description":"ICD-DAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJND0","description":"ICD-NJND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQC1","description":"ICD-OFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFD0","description":"ICD-BEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEF1","description":"ICD-ICEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYF1","description":"ICD-PBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRA1","description":"ICD-GIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPF0","description":"ICD-CHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMD0","description":"ICD-NHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test for urine cystines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82615","description":"Test for urine cystines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gemtuzumab ozogamicin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9300","description":"Gemtuzumab ozogamicin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc deglycerolized","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9039","description":"Rbc deglycerolized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMD1","description":"ICD-OLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emr pwr cbl elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0492","description":"Emr pwr cbl elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUA0","description":"ICD-GEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISF0","description":"ICD-LISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Axillary crutch extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0978","description":"Axillary crutch extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd trach dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87491","description":"Chylmd trach dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCF1","description":"ICD-BDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vim_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4251","description":"Vim_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGF1","description":"ICD-KHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic control hip heavy dut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2620","description":"Pelvic control hip heavy dut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 81 Years And Older With A Diagnosis Of Frailty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2131","description":"Patients 81 Years And Older With A Diagnosis Of Frailty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTC1","description":"ICD-KBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNC1","description":"ICD-OHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cultr oocyte/embryo <4 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89250","description":"Cultr oocyte/embryo <4 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTA0","description":"ICD-IGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVB1","description":"ICD-KAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUD1","description":"ICD-AEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHC1","description":"ICD-IIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB224","description":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4A","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin sys stance flexion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5845","description":"Knee-shin sys stance flexion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36660","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPC1","description":"ICD-OCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJB0","description":"ICD-NEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX24","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHF0","description":"ICD-FBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGE0","description":"ICD-OEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYC1","description":"ICD-KFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCF1","description":"ICD-FBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVA1","description":"ICD-GEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHC1","description":"ICD-ACHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow aspiration for bone grafting_ spine surgery only_ through separate skin or fascial incision (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20939","description":"Bone marrow aspiration for bone grafting_ spine surgery only_ through separate skin or fascial incision (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMA1","description":"ICD-FEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOF1","description":"ICD-HCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso trnk sj-t9 pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0454","description":"Tlso trnk sj-t9 pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning_ utilizing first morni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0228U","description":"Oncology (prostate)_ multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning_ utilizing first morni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBB0","description":"ICD-KFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWD1","description":"ICD-GEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC125","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCB1","description":"ICD-NLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQD1","description":"ICD-CAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0950T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","description":"CPT-0950T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gel cap for trach voice pros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8512","description":"Gel cap for trach voice pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRE1","description":"ICD-KFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap ileo/jejuno-stomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44187","description":"Lap ileo/jejuno-stomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients receiving high doses of immunosuppressive therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1063","description":"Patients receiving high doses of immunosuppressive therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ramucirumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9308","description":"Injection_ ramucirumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIC0","description":"ICD-IAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACB1","description":"ICD-JACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDA1","description":"ICD-MEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEE1","description":"ICD-ECEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0616","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","description":"HCPCS-J0616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations_ based on selected intervals of interest from 12-lead elect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0897T","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations_ based on selected intervals of interest from 12-lead elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGD0","description":"ICD-KEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plating chrome/nickel pr bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2750","description":"Plating chrome/nickel pr bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDC1","description":"ICD-FBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDF1","description":"ICD-IBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ diffuse large B-cell lymphoma) gene analysis_ common variant(s) (eg_ codon 646)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81237","description":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ diffuse large B-cell lymphoma) gene analysis_ common variant(s) (eg_ codon 646)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUA0","description":"ICD-GGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor IX (antihemophilic factor_ recombinant)_ glycopegylated_ Rebinyn_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9468","description":"Injection_ Factor IX (antihemophilic factor_ recombinant)_ glycopegylated_ Rebinyn_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGE1","description":"ICD-JDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRD1","description":"ICD-DCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIC1","description":"ICD-MEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWA1","description":"ICD-KFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alveoplasty w/ extraction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7310","description":"Alveoplasty w/ extraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDC0","description":"ICD-KGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNF0","description":"ICD-NLNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace prox & dist upright","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4070","description":"Replace prox & dist upright","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51585","description":"Removal of bladder & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stat lab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3600","description":"Stat lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30200","description":"Injection treatment of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAF1","description":"ICD-KEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUD1","description":"ICD-CDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUA1","description":"ICD-ICUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20C","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64467","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","description":"CPT-64467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lat thor/lumb addl seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22534","description":"Lat thor/lumb addl seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWB0","description":"ICD-PAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99342","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWA0","description":"ICD-CAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGND1","description":"ICD-NGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAD1","description":"ICD-EAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQA1","description":"ICD-PHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMB0","description":"ICD-FAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18X","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Buprenorphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0592","description":"Buprenorphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous electrical nerve field stimulation_ cranial nerves_ without implantation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0720T","description":"Percutaneous electrical nerve field stimulation_ cranial nerves_ without implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKA1","description":"ICD-KGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42340","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic propulsion tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2211","description":"Pneumatic propulsion tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise/repair mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40812","description":"Excise/repair mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPC1","description":"ICD-NFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMC1","description":"ICD-AEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sterile water/saline_ 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4216","description":"Sterile water/saline_ 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9076","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","description":"HCPCS-J9076","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFB0","description":"ICD-JBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIB0","description":"ICD-JDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGB0","description":"ICD-BFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doppler color flow add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93325","description":"Doppler color flow add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDE0","description":"ICD-KCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB10","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJA0","description":"ICD-NAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELC1","description":"ICD-JELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDA0","description":"ICD-JGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC131","description":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITB1","description":"ICD-OITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lube sterile packet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4332","description":"Lube sterile packet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluconazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1450","description":"Fluconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETA1","description":"ICD-NETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9857","description":"Patient admitted to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNC0","description":"ICD-FHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCB0","description":"ICD-OHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDED0","description":"ICD-CDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDA0","description":"ICD-FDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDE1","description":"ICD-IEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epsd bk pain for >12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1137F","description":"Epsd bk pain for >12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6061","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRD0","description":"ICD-LIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco-use counsel>10min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0437","description":"Tobacco-use counsel>10min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj lumbar plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64449","description":"N block inj lumbar plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA40","description":"Medium Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMC1","description":"ICD-KHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients age 75 or older on their initiation of dialysis date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1264","description":"Patients age 75 or older on their initiation of dialysis date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of lingual tonsil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42870","description":"Excision of lingual tonsil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFB0","description":"ICD-GHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPC0","description":"ICD-CIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8F","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJD1","description":"ICD-KAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary prostate cancer-related disorders_ genomic sequence analysis panel using next-generation sequencing (NGS)_ Sanger sequencing_ multiplex ligation-dependent probe amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0475U","description":"Hereditary prostate cancer-related disorders_ genomic sequence analysis panel using next-generation sequencing (NGS)_ Sanger sequencing_ multiplex ligation-dependent probe amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17107","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB52","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Central dexa results docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3095F","description":"Central dexa results docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLA0","description":"ICD-EBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDA0","description":"ICD-EFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES126","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEB1","description":"ICD-GIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automated reticulocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85045","description":"Automated reticulocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Term dev modifier wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6805","description":"Term dev modifier wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg >16<=48 w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6238","description":"Hydrocolld drg >16<=48 w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vestibuloplasty ridge extens","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7340","description":"Vestibuloplasty ridge extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQB1","description":"ICD-DCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ with blue-violet filter_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2526","description":"Contact lens_ hydrophilic_ with blue-violet filter_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMF1","description":"ICD-OBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMB0","description":"ICD-MEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin b-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84425","description":"Assay of vitamin b-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove external ear partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69110","description":"Remove external ear partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEME0","description":"ICD-KEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUF1","description":"ICD-CCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28576","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUA0","description":"ICD-CCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hib prp-omp vacc 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90647","description":"Hib prp-omp vacc 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTF0","description":"ICD-FHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of spinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63173","description":"Drainage of spinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGC1","description":"ICD-KEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNB0","description":"ICD-OHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLA0","description":"ICD-CCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECD1","description":"ICD-MECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC11","description":"ICD-3DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEB1","description":"ICD-CAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removable Unilateral Partial Denture - One Piece Resin - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5286","description":"Removable Unilateral Partial Denture - One Piece Resin - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0991T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","description":"CPT-0991T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Freeing of bowel adhesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44005","description":"Freeing of bowel adhesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFE1","description":"ICD-OBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSD1","description":"ICD-ODSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharm rx agent noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9699","description":"Radiopharm rx agent noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMD0","description":"ICD-BFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36573","description":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMF0","description":"ICD-NHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRF1","description":"ICD-OBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWB0","description":"ICD-KDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFA1","description":"ICD-CBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFC0","description":"ICD-FFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE136","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27822","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSF0","description":"ICD-LBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 50 MCG/0.5 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91313","description":"SARSCOV2 VACCINE BIVALENT 50 MCG/0.5 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYB0","description":"ICD-CIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQF0","description":"ICD-KBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray upper gi delay w/o kub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74240","description":"X-ray upper gi delay w/o kub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sterile gauze <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6402","description":"Sterile gauze <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJE1","description":"ICD-JCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat kneecap fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27524","description":"Treat kneecap fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2013","description":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYE1","description":"ICD-CBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ oliceridine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9101","description":"Injection_ oliceridine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVD0","description":"ICD-BGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC126","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCA0","description":"ICD-NLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo ia infusion up to 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96422","description":"Chemo ia infusion up to 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMB0","description":"ICD-IIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRC0","description":"ICD-LFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69740","description":"Repair facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDME0","description":"ICD-MDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPA0","description":"ICD-NEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHF1","description":"ICD-CBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCA0","description":"ICD-OFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSC0","description":"ICD-CDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg cylinder fb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4034","description":"Cast sup lng leg cylinder fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","description":"HCPCS-M1373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDC0","description":"ICD-JDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28465","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped compr care pkg_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1025","description":"Ped compr care pkg_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYF1","description":"ICD-PIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22D","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDF1","description":"ICD-OBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUB0","description":"ICD-OBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMD0","description":"ICD-MAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reass appr remo filt 3ms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9542","description":"Doc reass appr remo filt 3ms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22B","description":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOB1","description":"ICD-GAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0084","description":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHE0","description":"ICD-MCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject spine w/cath crv/thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62318","description":"Inject spine w/cath crv/thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABD0","description":"ICD-FABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of percutaneous transhepatic stent for internal and external biliary drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47511","description":"Introduction of percutaneous transhepatic stent for internal and external biliary drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITA0","description":"ICD-CITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gr24 nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2362","description":"Gr24 nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Division of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58605","description":"Division of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCE1","description":"ICD-GCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVB1","description":"ICD-BEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWB0","description":"ICD-LFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red cell survival study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78130","description":"Red cell survival study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADD0","description":"ICD-GADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain hand tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26020","description":"Drain hand tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transferase (ast) (sgot)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84450","description":"Transferase (ast) (sgot)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA214","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJE0","description":"ICD-BHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTB1","description":"ICD-ACTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEA1","description":"ICD-FCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXE1","description":"ICD-GIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5514","description":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAF0","description":"ICD-GAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOB0","description":"ICD-GBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Node neg inv brst cncr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8879","description":"Node neg inv brst cncr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9877","description":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma scrn hgh risk direc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0117","description":"Glaucoma scrn hgh risk direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx gastr intub w/asp spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43754","description":"Dx gastr intub w/asp spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUE0","description":"ICD-FCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAME1","description":"ICD-NAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0676U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676U","description":"CPT-0676U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXE0","description":"ICD-CHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upright gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8001","description":"Upright gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMF1","description":"ICD-KCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","description":"HCPCS-M1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00908","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","description":"CPT-00908","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11C","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABE1","description":"ICD-KABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2252","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","description":"HCPCS-J2252","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVA0","description":"ICD-NGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Long qt synd known fam var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81281","description":"Long qt synd known fam var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEF1","description":"ICD-KBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCE1","description":"ICD-FBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXE0","description":"ICD-NFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJA1","description":"ICD-GGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITC0","description":"ICD-JITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNE0","description":"ICD-KGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGA1","description":"ICD-OBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGD1","description":"ICD-OGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4421","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","description":"HCPCS-Q4421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEF1","description":"ICD-CBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYD1","description":"ICD-PIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNA1","description":"ICD-NGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAD0","description":"ICD-FCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1C","description":"Default_ /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEB1","description":"ICD-MLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQD1","description":"ICD-KFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21C","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tibper revasc w/ather add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37233","description":"Tibper revasc w/ather add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRD0","description":"ICD-OHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1001","description":"Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA06","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Appl multlay comprs arm/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29584","description":"Appl multlay comprs arm/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Milwaukee type superstructur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1230","description":"Milwaukee type superstructur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinogen test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85370","description":"Fibrinogen test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPB1","description":"ICD-ODPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQB0","description":"ICD-DHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAD1","description":"ICD-GIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUA0","description":"ICD-OFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHF1","description":"ICD-ICHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILB1","description":"ICD-JILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA21","description":"ICD-1IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHE1","description":"ICD-CFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection_ and post administration monitoring in the home or residence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0241","description":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection_ and post administration monitoring in the home or residence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX44","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mnt subs tx for change dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0270","description":"Mnt subs tx for change dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJA1","description":"ICD-FHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNC0","description":"ICD-JGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNE0","description":"ICD-NLNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Misc sup/acc ext vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0507","description":"Misc sup/acc ext vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATA1","description":"ICD-OATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML16","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYB1","description":"ICD-LIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE144","description":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24B","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYD0","description":"ICD-PFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMF1","description":"ICD-AIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMD1","description":"ICD-BAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMC1","description":"ICD-GBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transab esoph hiat hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43333","description":"Transab esoph hiat hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUC1","description":"ICD-NJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOD1","description":"ICD-PBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUC0","description":"ICD-AHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87428","description":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEC1","description":"ICD-IIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37280","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","description":"CPT-37280","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWF1","description":"ICD-GEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLC0","description":"ICD-IDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCF0","description":"ICD-JDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9708","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD221","description":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUE1","description":"ICD-OCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Othe therapist at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9478","description":"Othe therapist at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9743","description":"Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Splint elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8452","description":"Splint elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHF1","description":"ICD-KHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFD0","description":"ICD-GEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHE1","description":"ICD-KIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAA0","description":"ICD-NJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVE0","description":"ICD-NHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo plastic molded w/ankle j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1970","description":"Afo plastic molded w/ankle j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Robotic surgical system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2900","description":"Robotic surgical system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28A","description":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph imped funct test > 1hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91038","description":"Esoph imped funct test > 1hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETC0","description":"ICD-EETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYE0","description":"ICD-OFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart pacing mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93631","description":"Heart pacing mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise excessive skin buttck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15835","description":"Excise excessive skin buttck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom fab w/c back cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2617","description":"Custom fab w/c back cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of ankle and/or ft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29540","description":"Strapping of ankle and/or ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWA0","description":"ICD-DBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg cast chg elb dis/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6382","description":"Postop dsg cast chg elb dis/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTD1","description":"ICD-BFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigidlined cust fab two","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0486","description":"Tlso rigidlined cust fab two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rehab thxpy options w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4400F","description":"Rehab thxpy options w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit new age 18-39","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99385","description":"Prev visit new age 18-39","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSF1","description":"ICD-DGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFB0","description":"ICD-NJFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interv hlth/behav fam no pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96155","description":"Interv hlth/behav fam no pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGD0","description":"ICD-BDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSD1","description":"ICD-KHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter therapy_ infusion other than for thrombolysis_ any type (eg_ spasmolytic_ vasoconstrictive)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37202","description":"Transcatheter therapy_ infusion other than for thrombolysis_ any type (eg_ spasmolytic_ vasoconstrictive)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUA0","description":"ICD-EFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPD1","description":"ICD-GDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB201","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syringe w/wo needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4657","description":"Syringe w/wo needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Camp overnite waiver/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2036","description":"Camp overnite waiver/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUF0","description":"ICD-GAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36010","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHA1","description":"ICD-NGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATC0","description":"ICD-EATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD206","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plate pheres leukoredu irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9037","description":"Plate pheres leukoredu irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8I","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit tpn 1 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9365","description":"Hit tpn 1 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFE1","description":"ICD-OJFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Beta-blocker therapy rxd/tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4008F","description":"Beta-blocker therapy rxd/tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBD1","description":"ICD-CBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inlay titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6624","description":"Inlay titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44010","description":"Incision of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nicotine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6055","description":"Nicotine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29889","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22B","description":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9816","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9816","description":"HCPCS-C9816","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58558","description":"Hysteroscopy biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMA0","description":"ICD-BAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDE1","description":"ICD-AHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUA0","description":"ICD-KCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGC1","description":"ICD-CHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0515T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shorten/lengthen thighs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27468","description":"Shorten/lengthen thighs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRA0","description":"ICD-PKRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIF1","description":"ICD-BGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAF0","description":"ICD-IBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Paclitaxel protein bound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9264","description":"Paclitaxel protein bound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDC1","description":"ICD-IGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML54","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJE0","description":"ICD-OCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam for fungi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87220","description":"Tissue exam for fungi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATE1","description":"ICD-CATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAF1","description":"ICD-BBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXD1","description":"ICD-BIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSD1","description":"ICD-OJSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht inj anticoag diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9372","description":"Ht inj anticoag diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOD0","description":"ICD-DFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recement space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1550","description":"Recement space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peripheral nerve block (PNB)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9770","description":"Peripheral nerve block (PNB)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (Mood Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 144 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0291U","description":"Psychiatry (Mood Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 144 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYC1","description":"ICD-GAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA236","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPE0","description":"ICD-FDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autologous blood op salvage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86891","description":"Autologous blood op salvage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVB1","description":"ICD-NFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documented medical reasons for not performing intraoperative cystoscopy (e.g._ urethral pathology precluding cystoscopy_ any patient who has a congenital or acquired absence o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9607","description":"Documented medical reasons for not performing intraoperative cystoscopy (e.g._ urethral pathology precluding cystoscopy_ any patient who has a congenital or acquired absence o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreserve stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38207","description":"Cryopreserve stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYB1","description":"ICD-OEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVC0","description":"ICD-OLVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Miscellaneous external component_ supply or accessory for use with the Argus II Retinal Prosthesis System","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8608","description":"Miscellaneous external component_ supply or accessory for use with the Argus II Retinal Prosthesis System","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBF0","description":"ICD-BIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Services outside us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9989","description":"Services outside us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Talymed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4127","description":"Talymed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj foramen epidural add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64484","description":"Inj foramen epidural add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove intestinal allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44137","description":"Remove intestinal allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMA0","description":"ICD-BCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWC1","description":"ICD-KFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal septal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5922","description":"Nasal septal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDID1","description":"ICD-CDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair arm rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0994","description":"Wheelchair arm rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBB1","description":"ICD-BHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIC1","description":"ICD-KBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRD1","description":"ICD-KFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKA0","description":"ICD-FHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOC0","description":"ICD-DEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95722","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAD1","description":"ICD-OFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00926","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","description":"CPT-00926","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardioassist external","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92971","description":"Cardioassist external","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJD1","description":"ICD-BHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31255","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29435","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bundle of his recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93600","description":"Bundle of his recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Separate Self-Measurements Of Two Readings One Minute Apart_ Twice Daily Over A 30-Day Period (Min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99474","description":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Separate Self-Measurements Of Two Readings One Minute Apart_ Twice Daily Over A 30-Day Period (Min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE251","description":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mitochondrial Antibody (Eg_ M2)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86381","description":"Mitochondrial Antibody (Eg_ M2)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Isoetharine comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7647","description":"Isoetharine comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAC0","description":"ICD-IIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVD1","description":"ICD-GIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3B","description":"Default_ /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOF0","description":"ICD-CIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXD0","description":"ICD-KEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSD1","description":"ICD-DCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8I","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDC0","description":"ICD-GBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sleep apnea assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8839","description":"Sleep apnea assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Semen analysis w/huhner","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89300","description":"Semen analysis w/huhner","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Weight mgmt class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9449","description":"Weight mgmt class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBF0","description":"ICD-KIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5256","description":"Hearing aid_ digit_ mon_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Certified translation or sign-language services per visit.","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9990","description":"Certified translation or sign-language services per visit.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmprs burngarment foot-knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6507","description":"Cmprs burngarment foot-knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPC0","description":"ICD-NJPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC31","description":"ICD-2EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Dissection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33858","description":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Dissection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo cholecystectomy/explr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47564","description":"Laparo cholecystectomy/explr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTC0","description":"ICD-CCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAB0","description":"ICD-MFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26426","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC226","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGB0","description":"ICD-JBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled nitric oxide meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95012","description":"Exhaled nitric oxide meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC11","description":"ICD-4DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unspec maxillofacial prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8048","description":"Unspec maxillofacial prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1011","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transect pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33922","description":"Transect pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDD0","description":"ICD-AEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKF1","description":"ICD-NGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYC1","description":"ICD-OKYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUE1","description":"ICD-NJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2C","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3A","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUF1","description":"ICD-MBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49611","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJE1","description":"ICD-NEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAD0","description":"ICD-KIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4047","description":"Cast sup sht leg splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVF0","description":"ICD-GDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAC0","description":"ICD-FGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABD0","description":"ICD-OABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUD1","description":"ICD-GDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD240","description":"Special Care Low _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVB0","description":"ICD-CHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLA0","description":"ICD-KBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26373","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVC0","description":"ICD-NDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJC1","description":"ICD-GDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFE0","description":"ICD-GGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"JAK2 (Janus kinase 2) (eg_ myeloproliferative disorder) gene analysis_ targeted sequence analysis exons 12-15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0027U","description":"JAK2 (Janus kinase 2) (eg_ myeloproliferative disorder) gene analysis_ targeted sequence analysis exons 12-15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQB0","description":"ICD-ODQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of custom sleep apnea appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9949","description":"Repair of custom sleep apnea appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHD1","description":"ICD-MHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services for patient provided any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1067","description":"Hospice services for patient provided any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHA1","description":"ICD-EIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo tib fx cast molded to pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2108","description":"Afo tib fx cast molded to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTB0","description":"ICD-ICTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal foreign body gum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41805","description":"Removal foreign body gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit tpn 3 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9367","description":"Hit tpn 3 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81190","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJF0","description":"ICD-OBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"F18 fdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9552","description":"F18 fdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIC1","description":"ICD-EAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPB0","description":"ICD-FAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYB0","description":"ICD-CCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9748","description":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PelloGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4320","description":"PelloGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPF1","description":"ICD-GDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDD0","description":"ICD-FIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCA0","description":"ICD-NGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTC1","description":"ICD-EDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOD0","description":"ICD-PIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDD1","description":"ICD-OFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABC1","description":"ICD-FABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47605","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology breast mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81519","description":"Oncology breast mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1B","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSD0","description":"ICD-OBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKC1","description":"ICD-NFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ammonia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82140","description":"Assay of ammonia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGED1","description":"ICD-BGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQF0","description":"ICD-CDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELF1","description":"ICD-MELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36581","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVB0","description":"ICD-FIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIC0","description":"ICD-MBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRC1","description":"ICD-HBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular imp_ aqueous drain de","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1783","description":"Ocular imp_ aqueous drain de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Md document visit by npp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0454","description":"Md document visit by npp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-66683","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","description":"CPT-66683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFC0","description":"ICD-NKFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXC0","description":"ICD-KEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69636","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWC0","description":"ICD-CBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKD0","description":"ICD-GIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29046","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repos nstim apnea stimj ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0432T","description":"Repos nstim apnea stimj ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ meropenem (WG Critical Care)_ not therapeutically equivalent to J2185_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2183","description":"Injection_ meropenem (WG Critical Care)_ not therapeutically equivalent to J2185_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27884","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA11","description":"ICD-2DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJD1","description":"ICD-JCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWD0","description":"ICD-HGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUB1","description":"ICD-FFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWA0","description":"ICD-PBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILA0","description":"ICD-IILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneum compres w/cal pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0652","description":"Pneum compres w/cal pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDC0","description":"ICD-EIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aortic hemiarch graft including isolation and control of the arch vessels_ beveled open distal aortic anastomosis extending under one or more of the arch vessels_ and total ci","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33866","description":"Aortic hemiarch graft including isolation and control of the arch vessels_ beveled open distal aortic anastomosis extending under one or more of the arch vessels_ and total ci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor_ including s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0309","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor_ including s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWB0","description":"ICD-OAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAF0","description":"ICD-KDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECID1","description":"ICD-ECID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25B","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYB1","description":"ICD-PAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB221","description":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osa mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8759","description":"Osa mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18E","description":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rxt breast appl place/remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9726","description":"Rxt breast appl place/remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrogastrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91132","description":"Electrogastrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Portable gaseous 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0431","description":"Portable gaseous 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1474","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","description":"HCPCS-M1474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAF0","description":"ICD-FFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGID0","description":"ICD-BGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXB0","description":"ICD-GAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1046T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1046T","description":"CPT-1046T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWE0","description":"ICD-LEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor xi pta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85270","description":"Clot factor xi pta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cult skin grft f/n/hfg add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15156","description":"Cult skin grft f/n/hfg add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRE1","description":"ICD-KHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQE1","description":"ICD-CGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDA0","description":"ICD-GDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban_ 1 mg (for non-ESRD use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0883","description":"Injection_ argatroban_ 1 mg (for non-ESRD use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYA1","description":"ICD-CCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16370","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16370","description":"CPT-16370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90639","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90639","description":"CPT-90639","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genotype dna/rna hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87902","description":"Genotype dna/rna hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMC0","description":"ICD-BHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sgd spelling phys contact","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2508","description":"Sgd spelling phys contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCC1","description":"ICD-IGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGD1","description":"ICD-BAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37286","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","description":"CPT-37286","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKD0","description":"ICD-OJKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1171","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJC0","description":"ICD-NKJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNF0","description":"ICD-JFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37278","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","description":"CPT-37278","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHB0","description":"ICD-JAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKF0","description":"ICD-BIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRB1","description":"ICD-PLRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMA0","description":"ICD-IIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental gold foil two surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2420","description":"Dental gold foil two surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB146","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sympt sten-tia/strk<120days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9006F","description":"Sympt sten-tia/strk<120days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of complications","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9930","description":"Treatment of complications","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt screened for depression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1220F","description":"Pt screened for depression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUE1","description":"ICD-MCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVB0","description":"ICD-CDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0108U","description":"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESC0","description":"ICD-CESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFB1","description":"ICD-BEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAF0","description":"ICD-EIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ margetuximab-cmkb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9353","description":"Injection_ margetuximab-cmkb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had only urgent care visits during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1054","description":"Patient had only urgent care visits during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXA0","description":"ICD-BAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tte f-up or lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93308","description":"Tte f-up or lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4543","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","description":"HCPCS-A4543","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med reminder serv per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5185","description":"Med reminder serv per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC11","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6097","description":"Abutment Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytp urine 3-5 probes cmptr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88121","description":"Cytp urine 3-5 probes cmptr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHC1","description":"ICD-FDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKB1","description":"ICD-OBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNA0","description":"ICD-NLNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No implantable/insertable device used with device-intensive procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1890","description":"No implantable/insertable device used with device-intensive procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTA1","description":"ICD-OHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB121","description":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYE0","description":"ICD-LEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLA1","description":"ICD-OJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMF1","description":"ICD-OLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frame typ sock above elb/dis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6688","description":"Frame typ sock above elb/dis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPA1","description":"ICD-NCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRA1","description":"ICD-DGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPB0","description":"ICD-CEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADB0","description":"ICD-KADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEF0","description":"ICD-GIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEF0","description":"ICD-EBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tofersen_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1304","description":"Injection_ tofersen_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid >","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4178","description":"Parenteral sol amino acid >","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYF0","description":"ICD-OCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 600 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0240","description":"Injection_ casirivimab and imdevimab_ 600 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69602","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDF1","description":"ICD-NJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB60","description":"Medium Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVB0","description":"ICD-OBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor xiii fibrin scrn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85291","description":"Clot factor xiii fibrin scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23462","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0560","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","description":"HCPCS-G0560","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8043","description":"Upper facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPA1","description":"ICD-KHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXA1","description":"ICD-KDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Battery chrgr six volt otto","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7362","description":"Battery chrgr six volt otto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFD0","description":"ICD-GAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYD0","description":"ICD-OJYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coombs test indirect titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86886","description":"Coombs test indirect titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCB0","description":"ICD-IHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTB0","description":"ICD-OFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9172","description":"HCPCS-C9172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transport portable ekg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0076","description":"Transport portable ekg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glasses bicros hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5230","description":"Glasses bicros hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDA1","description":"ICD-BBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0485U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","description":"CPT-0485U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKF0","description":"ICD-JDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQD1","description":"ICD-OCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUF1","description":"ICD-NJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carbidopa levodopa enteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7340","description":"Carbidopa levodopa enteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal_ Osseointegrated Implant_ Skull; With Percutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69726","description":"Removal_ Osseointegrated Implant_ Skull; With Percutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA13","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEC1","description":"ICD-ACEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHF1","description":"ICD-JEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUE0","description":"ICD-IFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHE1","description":"ICD-KEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunodiffusion nes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86329","description":"Immunodiffusion nes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55720","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCB0","description":"ICD-ODCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQA1","description":"ICD-CGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJC0","description":"ICD-OKJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXE0","description":"ICD-KIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPE0","description":"ICD-CFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWC0","description":"ICD-CHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBC1","description":"ICD-BBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEF0","description":"ICD-ECEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0695U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695U","description":"CPT-0695U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDA1","description":"ICD-BGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thiethylperazine maleate10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0174","description":"Thiethylperazine maleate10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fxnl status assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1170F","description":"Fxnl status assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDB0","description":"ICD-CBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVD0","description":"ICD-FGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDD0","description":"ICD-JGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No record of HBV results documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9915","description":"No record of HBV results documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATB1","description":"ICD-IATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilated fundus eval done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2020F","description":"Dilated fundus eval done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"R hrt coronary artery angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93456","description":"R hrt coronary artery angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap sleeve gastrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43775","description":"Lap sleeve gastrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9232","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9232","description":"HCPCS-J9232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Odontics eposteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6040","description":"Odontics eposteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of mastoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70120","description":"X-ray exam of mastoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Cell-Based Immunofluorescence Assay (Cba)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86362","description":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Cell-Based Immunofluorescence Assay (Cba)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28I","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQF1","description":"ICD-DIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant; with biopsy_ polypectomy or debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0407T","description":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant; with biopsy_ polypectomy or debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA256","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHID1","description":"ICD-JHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services used by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9709","description":"Hospice services used by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUE0","description":"ICD-FHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDED1","description":"ICD-EDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYB1","description":"ICD-GGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stimulation pacing heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93623","description":"Stimulation pacing heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALE0","description":"ICD-JALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4334","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","description":"HCPCS-Q4334","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQF1","description":"ICD-HDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comm psy sup tx pgm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0037","description":"Comm psy sup tx pgm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEB1","description":"ICD-GAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other drugs/medicaments","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9630","description":"Other drugs/medicaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRB1","description":"ICD-PFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC60","description":"Ultra High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYE0","description":"ICD-LAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23472","description":"Reconstruct shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic cholecystectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47562","description":"Laparoscopic cholecystectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIC1","description":"ICD-BHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWD0","description":"ICD-GIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVF0","description":"ICD-JHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYC0","description":"ICD-DEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC11","description":"ICD-4FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29806","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68100","description":"Biopsy of eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMF0","description":"ICD-EDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGC0","description":"ICD-KAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0904","description":"HCPCS-B0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDF0","description":"ICD-OEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision/drain abscess intra","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7511","description":"Incision/drain abscess intra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLB1","description":"ICD-NGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01953","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","description":"CPT-01953","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUA0","description":"ICD-KAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEID0","description":"ICD-CEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28C","description":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOA0","description":"ICD-PBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNA0","description":"ICD-NHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAF0","description":"ICD-JFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonic lavage_ 35 or more liters of water_ gravity-fed_ with induced defecation_ including insertion of rectal catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0736T","description":"Colonic lavage_ 35 or more liters of water_ gravity-fed_ with induced defecation_ including insertion of rectal catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35211","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of nickel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83885","description":"Assay of nickel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ctlso a-p-l control molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0700","description":"Ctlso a-p-l control molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27006","description":"Incision of hip tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ustekinumab_ for intravenous injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3358","description":"Ustekinumab_ for intravenous injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ has hcv treatment initiated within 3 months of the reactive hcv an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1228","description":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ has hcv treatment initiated within 3 months of the reactive hcv an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXA1","description":"ICD-GGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSD1","description":"ICD-GHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Slp stdy unattended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95800","description":"Slp stdy unattended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE215","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide for biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76942","description":"Echo guide for biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYB1","description":"ICD-DEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKB0","description":"ICD-JHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX50","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove forearm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25248","description":"Remove forearm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (fresenius kabi)_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0612","description":"Injection_ calcium gluconate (fresenius kabi)_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYB0","description":"ICD-DIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPC1","description":"ICD-BIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNC0","description":"ICD-ODNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSC0","description":"ICD-LHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGD0","description":"ICD-FGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18C","description":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit chelation diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9355","description":"Hit chelation diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEA0","description":"ICD-KHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace duod/jej tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49451","description":"Replace duod/jej tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligate/strip long leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37722","description":"Ligate/strip long leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVE0","description":"ICD-FFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anterior thoracic derotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1260","description":"Anterior thoracic derotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTC0","description":"ICD-NGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41015","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMF1","description":"ICD-ODMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAME0","description":"ICD-AAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) W","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2141","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla class i/ii antibody qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86829","description":"Hla class i/ii antibody qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12B","description":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Device handling phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99002","description":"Device handling phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCB0","description":"ICD-FDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIB0","description":"ICD-CDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOE0","description":"ICD-PJOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Centrifuge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1500","description":"Centrifuge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46045","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastroenterology_ malabsorption evaluation of alpha-1-antitrypsin_ calprotectin_ pancreatic elastase and reducing substances_ feces_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0430U","description":"Gastroenterology_ malabsorption evaluation of alpha-1-antitrypsin_ calprotectin_ pancreatic elastase and reducing substances_ feces_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNA0","description":"ICD-CGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDB0","description":"ICD-ACDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXA1","description":"ICD-JBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open ablate liver tumor cryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47381","description":"Open ablate liver tumor cryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate (Xatmep)_ oral_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8612","description":"Methotrexate (Xatmep)_ oral_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAA0","description":"ICD-IBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUF0","description":"ICD-MHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWA1","description":"ICD-KIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEC1","description":"ICD-IDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28250","description":"Revision of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTA0","description":"ICD-FHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB104","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor_ including system ac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0448T","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor_ including system ac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTE1","description":"ICD-BHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEB0","description":"ICD-CDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METD1","description":"ICD-METD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLB1","description":"ICD-OKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYB1","description":"ICD-GCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUF0","description":"ICD-ADUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDD0","description":"ICD-CGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVC1","description":"ICD-KIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTA1","description":"ICD-GHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removable Unilateral Partial Denture - One Piece Flexible Base - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5284","description":"Removable Unilateral Partial Denture - One Piece Flexible Base - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLD0","description":"ICD-IDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic source imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8035","description":"Magnetic source imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68810","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDD0","description":"ICD-KHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bethanechol chloride inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0520","description":"Bethanechol chloride inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAB1","description":"ICD-AAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peritoneal lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49084","description":"Peritoneal lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDE0","description":"ICD-CHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAID1","description":"ICD-GAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVA1","description":"ICD-JGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOD1","description":"ICD-OGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75840","description":"Vein x-ray adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUA0","description":"ICD-OAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLA0","description":"ICD-JGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth head vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21651","description":"Anesth head vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUA0","description":"ICD-OCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIB0","description":"ICD-IHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove abdomen lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38780","description":"Remove abdomen lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGC0","description":"ICD-FHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma plan of care documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1223","description":"Glaucoma plan of care documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum_ low energy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0864T","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum_ low energy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pituitary evaluation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80418","description":"Pituitary evaluation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMB0","description":"ICD-IFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSC1","description":"ICD-OGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9309","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9309","description":"HCPCS-C9309","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIC1","description":"ICD-NGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJF1","description":"ICD-NBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0503","description":"HCPCS-B0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES201","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLC1","description":"ICD-JFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHB1","description":"ICD-OLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBA1","description":"ICD-CGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALD0","description":"ICD-JALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBME1","description":"ICD-BBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who screened positive for at least 1 of the 5 hrsns","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1320","description":"Patients who screened positive for at least 1 of the 5 hrsns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCE0","description":"ICD-CHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantable pump replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0786","description":"Implantable pump replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Herpes simplex type 2 test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86696","description":"Herpes simplex type 2 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUA0","description":"ICD-FDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive Full Body Computer-Based Markerless 3D Kinematic And Kinetic Motion Analysis And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0693T","description":"Comprehensive Full Body Computer-Based Markerless 3D Kinematic And Kinetic Motion Analysis And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGA1","description":"ICD-NJGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYA1","description":"ICD-PKYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kelch-like protein 11 (KLHL11) antibody_ serum or cerebrospinal fluid (CSF)_ cell-binding assay_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0432U","description":"Kelch-like protein 11 (KLHL11) antibody_ serum or cerebrospinal fluid (CSF)_ cell-binding assay_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVE1","description":"ICD-GAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMA1","description":"ICD-NBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSB1","description":"ICD-HBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRF0","description":"ICD-PKRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bupren/nal up to 3mg bupreno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0572","description":"Bupren/nal up to 3mg bupreno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59840","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Restorigin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4191","description":"Restorigin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ratchet assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0050","description":"Ratchet assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQA1","description":"ICD-LEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCE1","description":"ICD-AHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEE1","description":"ICD-JGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAA1","description":"ICD-GAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28C","description":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch for bar w flange/flt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4419","description":"Ost pch for bar w flange/flt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC45","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5A","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block cont infuse b plex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64416","description":"N block cont infuse b plex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vaginectomy partial w/nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57109","description":"Vaginectomy partial w/nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWE1","description":"ICD-KDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQC1","description":"ICD-LDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOD1","description":"ICD-LEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITF0","description":"ICD-CITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10mg (Darzalex)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9476","description":"Injection_ daratumumab_ 10mg (Darzalex)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABF1","description":"ICD-BABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric electric hand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7008","description":"Pediatric electric hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCF1","description":"ICD-NCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKE1","description":"ICD-NLKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1 pc ost pou w built-in conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5057","description":"1 pc ost pou w built-in conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUA1","description":"ICD-JGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administrat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0089","description":"Professional services_ initial visit_ for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXE0","description":"ICD-JEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVD0","description":"ICD-CAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMC1","description":"ICD-IFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRF1","description":"ICD-CDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision and drainage of soft tissue abscess_ subfascial (ie_ involves the soft tissue below the deep fascia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20005","description":"Incision and drainage of soft tissue abscess_ subfascial (ie_ involves the soft tissue below the deep fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthodontic procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8999","description":"Orthodontic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAA0","description":"ICD-GDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJB0","description":"ICD-JEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Six volt bat otto bock/eq ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7360","description":"Six volt bat otto bock/eq ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total cortisol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82533","description":"Total cortisol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove anal fist 2 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46285","description":"Remove anal fist 2 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAE0","description":"ICD-GEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit enzyme replace diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9357","description":"Hit enzyme replace diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICB1","description":"ICD-AICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKE1","description":"ICD-OIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDID0","description":"ICD-IDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAC0","description":"ICD-OJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33300","description":"Repair of heart wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWE1","description":"ICD-HCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0681U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681U","description":"CPT-0681U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAD0","description":"ICD-FFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYD0","description":"ICD-LIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0243","description":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECA1","description":"ICD-MECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical opening of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43500","description":"Surgical opening of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDE0","description":"ICD-MDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGD1","description":"ICD-GAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCE1","description":"ICD-MJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFA1","description":"ICD-JGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44406","description":"Colonoscopy w/ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHC1","description":"ICD-FFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVB0","description":"ICD-KIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFF0","description":"ICD-GAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast 1st strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19283","description":"Perq dev breast 1st strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr ang lwr ext w or w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73725","description":"Mr ang lwr ext w or w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01710","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","description":"CPT-01710","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVB0","description":"ICD-OHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAD1","description":"ICD-EGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFE1","description":"ICD-JFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFB0","description":"ICD-GFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac output measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93561","description":"Cardiac output measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHC1","description":"ICD-BCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1032T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1032T","description":"CPT-1032T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVB0","description":"ICD-CBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection into hemorrhoid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46500","description":"Injection into hemorrhoid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILE1","description":"ICD-EILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTC0","description":"ICD-AHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASB0","description":"ICD-PASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repr elbow lat ligmnt w/tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24343","description":"Repr elbow lat ligmnt w/tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXE1","description":"ICD-BDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB31","description":"ICD-1KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWA1","description":"ICD-KAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vit for macular hole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67042","description":"Vit for macular hole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTF0","description":"ICD-OCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTA1","description":"ICD-IFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Residential Habilitation 1-3 Supp 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0101","description":"Residential Habilitation 1-3 Supp 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0737","description":"HCPCS-E0737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKB1","description":"ICD-NHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAE0","description":"ICD-OLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEC1","description":"ICD-JAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUD1","description":"ICD-AFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telethx isodose plan cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77307","description":"Telethx isodose plan cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1283","description":"Patient screened for tobacco use and identified as a tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAD0","description":"ICD-EIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip disart canadian sach ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5331","description":"Hip disart canadian sach ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient not eligible due to active diagnosis of hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9744","description":"Patient not eligible due to active diagnosis of hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVF1","description":"ICD-KHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLD1","description":"ICD-OFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11470","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit7.6-12.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12044","description":"Intmd rpr n-hf/genit7.6-12.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFD0","description":"ICD-FHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDD0","description":"ICD-MKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA31","description":"Default_ /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLC1","description":"ICD-ABLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKD0","description":"ICD-NIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHB1","description":"ICD-GHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24B","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0505U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","description":"CPT-0505U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myomectomy abdom complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58146","description":"Myomectomy abdom complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69552","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXB1","description":"ICD-JCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation hemorrhoid w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0249T","description":"Ligation hemorrhoid w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIA0","description":"ICD-ACIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0301","description":"HCPCS-B0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Legion pneumo dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87540","description":"Legion pneumo dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBD0","description":"ICD-CCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPE1","description":"ICD-ODPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBC1","description":"ICD-GDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTE0","description":"ICD-IBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30999","description":"Nasal surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVA1","description":"ICD-KDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFC1","description":"ICD-NEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ibalizumab-uiyk_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1746","description":"Injection_ ibalizumab-uiyk_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPF1","description":"ICD-OKPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rev artific disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0098T","description":"Rev artific disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQD1","description":"ICD-OIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYA1","description":"ICD-LFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0469","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","description":"HCPCS-E0469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ neurostim test kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1897","description":"Lead_ neurostim test kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr); Following Liquid Enrichment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0302U","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr); Following Liquid Enrichment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVD1","description":"ICD-BCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJF1","description":"ICD-BEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood gases w/o2 saturation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82805","description":"Blood gases w/o2 saturation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye mvmt alys w/o calbrj i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0615T","description":"Eye mvmt alys w/o calbrj i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVA1","description":"ICD-BCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50081","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Velaglucerase alfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3385","description":"Velaglucerase alfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWD1","description":"ICD-OAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPF0","description":"ICD-GFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90999","description":"Dialysis procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prothrombin complex concentrate (human)_ kcentra_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7168","description":"Prothrombin complex concentrate (human)_ kcentra_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous auricular neurostimulation_ set-up_ calibration_ and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0783T","description":"Transcutaneous auricular neurostimulation_ set-up_ calibration_ and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Statin not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9442","description":"Statin not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had documentation of use of anticoagulant medications overlapping the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9724","description":"Patients who had documentation of use of anticoagulant medications overlapping the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMD0","description":"ICD-AAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduct simple facial bone fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7680","description":"Reduct simple facial bone fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid met uptake","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78020","description":"Thyroid met uptake","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00797","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","description":"CPT-00797","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc exten prosth addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34826","description":"Endovasc exten prosth addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARE0","description":"ICD-HARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAE0","description":"ICD-KEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJF0","description":"ICD-JFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBD0","description":"ICD-AIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC26","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMB0","description":"ICD-KGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC14","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKB0","description":"ICD-BGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sanopellis_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4308","description":"Sanopellis_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYD1","description":"ICD-CFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49429","description":"Removal of shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRB0","description":"ICD-OGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWB1","description":"ICD-DIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGE1","description":"ICD-JGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXD0","description":"ICD-NBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC31","description":"ICD-4EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUE1","description":"ICD-OKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ondansetron 4 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0119","description":"Ondansetron 4 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"U1 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2365","description":"U1 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDA0","description":"ICD-BHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARF1","description":"ICD-CARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC214","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5169","description":"HCPCS-Q5169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVC0","description":"ICD-CAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB11","description":"ICD-1HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1080","description":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alteplase recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2997","description":"Alteplase recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bladder irrigation tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4355","description":"Bladder irrigation tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHE1","description":"ICD-BHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBC0","description":"ICD-FGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUD0","description":"ICD-NEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYF1","description":"ICD-CGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKC1","description":"ICD-NCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVD1","description":"ICD-KAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC115","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWB0","description":"ICD-HAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABE1","description":"ICD-NABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep b ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90371","description":"Hep b ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABF1","description":"ICD-KABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC60","description":"Medium Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTD1","description":"ICD-CCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTC1","description":"ICD-NBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAD1","description":"ICD-AAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAC0","description":"ICD-IBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair extra toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28344","description":"Repair extra toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC25","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOE1","description":"ICD-KDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGC1","description":"ICD-FEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62324","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0216T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUF0","description":"ICD-OCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dist revas ligation hemo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36838","description":"Dist revas ligation hemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA21","description":"ICD-1EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46611","description":"Anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAF0","description":"ICD-NJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L5657","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","description":"HCPCS-L5657","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (heart transplant)_ mRNA gene expression profiling by microarray of 1283 genes_  transplant biopsy tissue_ allograft rejection and injury algorithm reported as a pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0087U","description":"Cardiology (heart transplant)_ mRNA gene expression profiling by microarray of 1283 genes_  transplant biopsy tissue_ allograft rejection and injury algorithm reported as a pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin pro/pos wc cus wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2607","description":"Skin pro/pos wc cus wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72147","description":"MRI chest spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Individual_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96158","description":"Health Behavior Intervention_ Individual_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA21","description":"ICD-1FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00912","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","description":"CPT-00912","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRA0","description":"ICD-GHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGF1","description":"ICD-GIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ bone-substitute material for bone and/or soft tissue hardware fixation augmentation_ including intraoperative imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0869T","description":"Injection(s)_ bone-substitute material for bone and/or soft tissue hardware fixation augmentation_ including intraoperative imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove collar bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23170","description":"Remove collar bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYF1","description":"ICD-DEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan (sodium hyaluronate) or derivative_ durolane_ intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7318","description":"Hyaluronan (sodium hyaluronate) or derivative_ durolane_ intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with endoluminal imaging of initial coronar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7516","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with endoluminal imaging of initial coronar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPB1","description":"ICD-BDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28293","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL52","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNA1","description":"ICD-OFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Listeria monocytogenes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86723","description":"Listeria monocytogenes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPD0","description":"ICD-OGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPA0","description":"ICD-BBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAF1","description":"ICD-BCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00563","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","description":"CPT-00563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHD0","description":"ICD-IBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQA0","description":"ICD-LDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDME1","description":"ICD-KDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAD1","description":"ICD-ODAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETC0","description":"ICD-IETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAED0","description":"ICD-CAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59400","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYE1","description":"ICD-LFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLE0","description":"ICD-CFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITC0","description":"ICD-AITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD244","description":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAF0","description":"ICD-OCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLD1","description":"ICD-KFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 14 targets (adenovirus_ coronavirus_ human metapneum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0098U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 14 targets (adenovirus_ coronavirus_ human metapneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB156","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures adjust cmplt maxil","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5410","description":"Dentures adjust cmplt maxil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; smears with interpretation (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0827T","description":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; smears with interpretation (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA41","description":"Low Rehab_ ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQD1","description":"ICD-PJQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJA1","description":"ICD-NFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28E","description":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEF0","description":"ICD-GHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation stating the patient has an active diagnosis of depression or has diagnosed bipolar disorder_ therefore screening or follow-up not required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9717","description":"Documentation stating the patient has an active diagnosis of depression or has diagnosed bipolar disorder_ therefore screening or follow-up not required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nose polyp(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30115","description":"Removal of nose polyp(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6536","description":"Gc stocking full lngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29881","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36902","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBD0","description":"ICD-KCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Duration of monitored anesthesia care(mac)or peripheral nerve block(pnb)without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9363","description":"Duration of monitored anesthesia care(mac)or peripheral nerve block(pnb)without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVF1","description":"ICD-GFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAD1","description":"ICD-IDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUD0","description":"ICD-IBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBB0","description":"ICD-BFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4271","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87627","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","description":"CPT-87627","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psych hlth fac svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2013","description":"Psych hlth fac svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAF0","description":"ICD-IDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTA1","description":"ICD-ICTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting_ isolation and preparation of harvested cells including incubation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0489T","description":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting_ isolation and preparation of harvested cells including incubation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRE0","description":"ICD-KHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAB0","description":"ICD-OHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGB0","description":"ICD-CGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXB0","description":"ICD-GDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl alkaline battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8622","description":"Repl alkaline battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAA0","description":"ICD-FEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoglobulin Light Chains (Ie_ Kappa_ Lambda)_ Free_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83521","description":"Immunoglobulin Light Chains (Ie_ Kappa_ Lambda)_ Free_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mannitol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2150","description":"Mannitol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL30","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0404","description":"HCPCS-C0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand_ finger_ single or double upright(s)_ includes microp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8702","description":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand_ finger_ single or double upright(s)_ includes microp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ atezolizumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9022","description":"Injection_ atezolizumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLA0","description":"ICD-IBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"DNA analysis_ fecal_ for colorectal cancer screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3890","description":"DNA analysis_ fecal_ for colorectal cancer screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy tubal block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58671","description":"Laparoscopy tubal block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biomechanical mapping_ transvaginal_ with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0487T","description":"Biomechanical mapping_ transvaginal_ with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain ostomy pouch w/flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5063","description":"Drain ostomy pouch w/flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILA0","description":"ICD-OILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLB1","description":"ICD-KGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap replace gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43773","description":"Lap replace gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom shape cvr knee disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5706","description":"Custom shape cvr knee disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9777","description":"Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACC1","description":"ICD-EACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIB1","description":"ICD-OIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUA0","description":"ICD-AHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replc sockt below e/w disa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6883","description":"Replc sockt below e/w disa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64565","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKF1","description":"ICD-ODKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBA1","description":"ICD-GDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33959","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQE0","description":"ICD-LAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMC0","description":"ICD-FHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of leg infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73592","description":"X-ray exam of leg infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst w/enterocele compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58294","description":"Vag hyst w/enterocele compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLE1","description":"ICD-FCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic shoe w/roller/rockr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5503","description":"Diabetic shoe w/roller/rockr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spec stains for microorganis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0476","description":"Spec stains for microorganis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 4mod sacro-scap pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0464","description":"Tlso 4mod sacro-scap pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVA0","description":"ICD-KEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHF1","description":"ICD-KIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22D","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hfo nontorsion jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3930","description":"Hfo nontorsion jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens single vision not oth c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2199","description":"Lens single vision not oth c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coupling gel or paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4559","description":"Coupling gel or paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Event recorder_ cardiac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1764","description":"Event recorder_ cardiac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip/thigh fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27025","description":"Incision of hip/thigh fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot exam performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2028F","description":"Foot exam performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPF0","description":"ICD-FHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAB0","description":"ICD-MDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYD0","description":"ICD-DEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin pump initiation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9145","description":"Insulin pump initiation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; not otherwise specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87899","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiography head w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70544","description":"Mr angiography head w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLC0","description":"ICD-IFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEND0","description":"ICD-GEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGA1","description":"ICD-KCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Volume deplete of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38214","description":"Volume deplete of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"H pylori (c-13) blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83009","description":"H pylori (c-13) blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Section recurrent laryngeal nerve_ therapeutic (separate procedure)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31595","description":"Section recurrent laryngeal nerve_ therapeutic (separate procedure)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOC0","description":"ICD-OLOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35142","description":"Repair artery rupture thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vis 20/40/> w/in 90 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4175F","description":"Vis 20/40/> w/in 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGB1","description":"ICD-OHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEB1","description":"ICD-OHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHA0","description":"ICD-EFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILA1","description":"ICD-JILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBA0","description":"ICD-ADBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWD0","description":"ICD-PKWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBE0","description":"ICD-AHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA11","description":"ICD-2HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBD1","description":"ICD-KDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEA1","description":"ICD-KHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq tcat intratrl septl sht","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0613T","description":"Perq tcat intratrl septl sht","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBC1","description":"ICD-EEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFA1","description":"ICD-OLFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMC0","description":"ICD-MEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic sentence test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92576","description":"Synthetic sentence test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc prosth delayed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33886","description":"Endovasc prosth delayed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFB1","description":"ICD-CFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEA1","description":"ICD-OAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin splt grft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15100","description":"Skin splt grft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCC1","description":"ICD-CBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGF0","description":"ICD-CAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB31","description":"Low Rehab_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJD1","description":"ICD-NKJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove blood clot from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65930","description":"Remove blood clot from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIB0","description":"ICD-AAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSB0","description":"ICD-PBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2042","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","description":"HCPCS-A2042","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTE0","description":"ICD-MDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKD1","description":"ICD-BDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver and spleen imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78215","description":"Liver and spleen imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0601U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","description":"CPT-0601U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1044","description":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKF1","description":"ICD-CHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acyclovir injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0133","description":"Acyclovir injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA21","description":"ICD-1KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Malig tumor > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7441","description":"Malig tumor > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove elbow joint implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24160","description":"Remove elbow joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYF0","description":"ICD-GBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18D","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93533","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMF0","description":"ICD-ABMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 xhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0854","description":"Pwc gp 3 xhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient spent less than three days in hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9860","description":"Patient spent less than three days in hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATF1","description":"ICD-MATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11311","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYB0","description":"ICD-PCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCE0","description":"ICD-EFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc back les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21930","description":"Exc back les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXB0","description":"ICD-OCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc abdl tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22901","description":"Exc abdl tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIB0","description":"ICD-NHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genetic testing for severe inherited conditions (eg_ cystic fibrosis_ Ashkenazi Jewish-associated disorders [eg_ Bloom syndrome_ Canavan disease_ Fanconi anemia type C_ mucoli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81443","description":"Genetic testing for severe inherited conditions (eg_ cystic fibrosis_ Ashkenazi Jewish-associated disorders [eg_ Bloom syndrome_ Canavan disease_ Fanconi anemia type C_ mucoli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25A","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1023","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1023","description":"HCPCS-E1023","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC21","description":"ICD-4KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPD1","description":"ICD-NFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retreat root canal bicuspid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3347","description":"Retreat root canal bicuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 19-9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86301","description":"Immunoassay tumor ca 19-9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC26","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASF1","description":"ICD-DASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Riboflavin 5_-phosphate_ ophthalmic solution_ up to 3 mL","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2787","description":"Riboflavin 5_-phosphate_ ophthalmic solution_ up to 3 mL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL45","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1609","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1609","description":"HCPCS-C1609","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECB1","description":"ICD-NECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","description":"HCPCS-L6038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEF0","description":"ICD-AFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLD0","description":"ICD-NHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lev 2 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0381","description":"Lev 2 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIC1","description":"ICD-IGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ transbronchial ablation of lesion(s) by microwave energy_ including fluoroscopic guidance_ whe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9751","description":"Bronchoscopy_ rigid or flexible_ transbronchial ablation of lesion(s) by microwave energy_ including fluoroscopic guidance_ whe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35151","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBE0","description":"ICD-IIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech/hearing therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92507","description":"Speech/hearing therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1128","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sacituzumab govitecan-hziy_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9066","description":"Injection_ sacituzumab govitecan-hziy_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29830","description":"Elbow arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGND0","description":"ICD-BGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Habil sup empl waiver 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2019","description":"Habil sup empl waiver 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITC1","description":"ICD-JITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWA1","description":"ICD-OEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trnscrv uterin fibroid abltj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0404T","description":"Trnscrv uterin fibroid abltj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIA1","description":"ICD-KFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCA1","description":"ICD-GFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFD1","description":"ICD-NFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFC1","description":"ICD-CBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPF0","description":"ICD-FEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis via av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4052F","description":"Hemodialysis via av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABA1","description":"ICD-EABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINF0","description":"ICD-BINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBF0","description":"ICD-OFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKD0","description":"ICD-JEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOC0","description":"ICD-CFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1466","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","description":"HCPCS-M1466","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCE1","description":"ICD-JGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCA0","description":"ICD-ACCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVE1","description":"ICD-JEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISE0","description":"ICD-LISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWE1","description":"ICD-LHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAB1","description":"ICD-NAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB141","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE211","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOB1","description":"ICD-KHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove carotid body lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60600","description":"Remove carotid body lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ suprapubic/cystoscopic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2627","description":"Cath_ suprapubic/cystoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of choroid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67220","description":"Treatment of choroid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed total electr w/ mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0265","description":"Hosp bed total electr w/ mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Completed epsdt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0302","description":"Completed epsdt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE111","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERE1","description":"ICD-KERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elisa hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0433","description":"Elisa hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOE1","description":"ICD-LCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKD1","description":"ICD-FHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27620","description":"Explore/treat ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHE0","description":"ICD-NLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMA0","description":"ICD-MFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRC0","description":"ICD-PBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy thru stoma spx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44388","description":"Colonoscopy thru stoma spx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIE0","description":"ICD-CGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40800","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25535","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Not >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9352","description":"Not >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB213","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEB0","description":"ICD-OBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tongue mouth neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41153","description":"Tongue mouth neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKME0","description":"ICD-OKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWF1","description":"ICD-DIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVE0","description":"ICD-KDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ventral hern init block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49561","description":"Rpr ventral hern init block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJA0","description":"ICD-CDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAA0","description":"ICD-NGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert pelv fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22848","description":"Insert pelv fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDND1","description":"ICD-KDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strattice tm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4130","description":"Strattice tm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anes spine tranthor w/o vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62559","description":"Anes spine tranthor w/o vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAE0","description":"ICD-IHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit est age 18-39","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99395","description":"Prev visit est age 18-39","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Services provided in urgent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9088","description":"Services provided in urgent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGC1","description":"ICD-JIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL50","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electro connect btw control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2310","description":"Electro connect btw control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diag bronchoscope/catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31643","description":"Diag bronchoscope/catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8F","description":"Very High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g. virtual check-in_ by a physician or other qualified health care professional who can report evaluation and management servic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2252","description":"Brief communication technology-based service_ e.g. virtual check-in_ by a physician or other qualified health care professional who can report evaluation and management servic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAD1","description":"ICD-JIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIE0","description":"ICD-GGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJED1","description":"ICD-NJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLE0","description":"ICD-ICLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXE1","description":"ICD-GEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No sig dep symp by dep tool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3352F","description":"No sig dep symp by dep tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHD1","description":"ICD-JBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHE0","description":"ICD-ACHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debride skin at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11010","description":"Debride skin at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQF0","description":"ICD-DCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult foster care per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5141","description":"Adult foster care per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCF1","description":"ICD-FCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smoking & 2nd hand assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1031F","description":"Smoking & 2nd hand assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGF1","description":"ICD-GGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOE0","description":"ICD-OCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCB1","description":"ICD-FCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHC1","description":"ICD-BEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epsd bk pain for 12 wks/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1136F","description":"Epsd bk pain for 12 wks/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOB1","description":"ICD-OEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0584T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMB0","description":"ICD-MAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28F","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPB1","description":"ICD-GAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKA0","description":"ICD-OGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fancc gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81242","description":"Fancc gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add proc construct new crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2971","description":"Add proc construct new crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUD1","description":"ICD-GHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB214","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1101","description":"CDT-D1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0A","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure of valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33600","description":"Closure of valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIE0","description":"ICD-EEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLE0","description":"ICD-CDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull (press relief)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61343","description":"Incise skull (press relief)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Varicella-zoster antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86787","description":"Varicella-zoster antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIF1","description":"ICD-BFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00546","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","description":"CPT-00546","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1 med visit in 24mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9247","description":"1 med visit in 24mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIF1","description":"ICD-IBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNE1","description":"ICD-KBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","description":"HCPCS-E1034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQF1","description":"ICD-OBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFF0","description":"ICD-FHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIED0","description":"ICD-OIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHC1","description":"ICD-ICHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBB1","description":"ICD-JIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXE1","description":"ICD-KGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24B","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stress breaker","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6940","description":"Stress breaker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRE0","description":"ICD-KIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tetanus immune globulin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1670","description":"Tetanus immune globulin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD213","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAB1","description":"ICD-ECAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGB0","description":"ICD-OGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10A","description":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTC1","description":"ICD-MHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGID1","description":"ICD-BGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWD1","description":"ICD-DGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nabilone oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8650","description":"Nabilone oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAID1","description":"ICD-IAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSC0","description":"ICD-OHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA250","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHB1","description":"ICD-MEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL55","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOC1","description":"ICD-PFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psych diagnostic evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90791","description":"Psych diagnostic evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ atezolizumab_ 10 mg (Tecentriq)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9483","description":"Injection_ atezolizumab_ 10 mg (Tecentriq)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient is dysarthric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3762F","description":"Patient is dysarthric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95927","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32100","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth pelvic organ surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84851","description":"Anesth pelvic organ surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLA0","description":"ICD-ACLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYA1","description":"ICD-CIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp<5 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99148","description":"Mod sed diff phys/qhp<5 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQA0","description":"ICD-GHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ non-coronary_ temporary_ with delivery system (propel)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1091","description":"Stent_ non-coronary_ temporary_ with delivery system (propel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDC1","description":"ICD-IDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLF1","description":"ICD-KBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOE1","description":"ICD-GDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLE1","description":"ICD-NLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXA0","description":"ICD-JBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin and muscle repair face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15845","description":"Skin and muscle repair face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBD1","description":"ICD-JIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resp suction oral interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7047","description":"Resp suction oral interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHED1","description":"ICD-AHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAB1","description":"ICD-ABAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64681","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLF0","description":"ICD-ODLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pdgfra gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81314","description":"Pdgfra gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9260","description":"Methotrexate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSD1","description":"ICD-CCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg >16<=48 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6243","description":"Hydrogel drg >16<=48 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exfoliative cytolog collect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7287","description":"Exfoliative cytolog collect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHE0","description":"ICD-AIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6610","description":"Gradient compression stocking_ below knee_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33237","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla typing dr/dq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86816","description":"Hla typing dr/dq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levalbuterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7614","description":"Levalbuterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDB0","description":"ICD-MIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERB1","description":"ICD-KERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4361","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","description":"HCPCS-Q4361","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAC1","description":"ICD-MJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing serologic abo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86900","description":"Blood typing serologic abo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC06","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSA1","description":"ICD-CBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln part mand lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5761","description":"Denture reln part mand lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISD0","description":"ICD-HISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90695","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","description":"CPT-90695","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heat quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0109T","description":"Heat quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBC1","description":"ICD-FBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53854","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBA0","description":"ICD-BCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAB1","description":"ICD-EBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4432","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","description":"HCPCS-Q4432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove aneurysm sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61613","description":"Remove aneurysm sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBF0","description":"ICD-ACBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAB0","description":"ICD-ICAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYD1","description":"ICD-PAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCD0","description":"ICD-IHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYB0","description":"ICD-CFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHB1","description":"ICD-JHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGC1","description":"ICD-KAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Placement Of Intra-Socket Biological Dressing To Aid In Hemostasis Or Clot Stabiliization_ Per Site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7922","description":"Placement Of Intra-Socket Biological Dressing To Aid In Hemostasis Or Clot Stabiliization_ Per Site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCE0","description":"ICD-JCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLD1","description":"ICD-ECLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJD0","description":"ICD-OJJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1383","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","description":"HCPCS-M1383","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cholangiography and/or pancreatography; through existing catheter_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74305","description":"Cholangiography and/or pancreatography; through existing catheter_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCC0","description":"ICD-BGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01200","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","description":"CPT-01200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOA1","description":"ICD-KBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continuous ppi or h2ra rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4185F","description":"Continuous ppi or h2ra rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBE0","description":"ICD-FHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKA0","description":"ICD-NBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUE1","description":"ICD-MIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL06","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKA0","description":"ICD-GFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITC/ITC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5214","description":"Hearing aid_ contralateral routing system_ binaural_ ITC/ITC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICD1","description":"ICD-JICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anes spine tranthor w/o vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62551","description":"Anes spine tranthor w/o vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKB0","description":"ICD-OKKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUF1","description":"ICD-KGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hgb lvl <11 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3281F","description":"Hgb lvl <11 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUA1","description":"ICD-EFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEB0","description":"ICD-OEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0928T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","description":"CPT-0928T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dynamic standing frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0642","description":"Dynamic standing frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUB1","description":"ICD-BIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTB1","description":"ICD-KBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g._ spirometry equipment not available at the time of the encounter)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1217","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g._ spirometry equipment not available at the time of the encounter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening pregabalin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80366","description":"Drug screening pregabalin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFC1","description":"ICD-GHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWE1","description":"ICD-CIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast supplies unlisted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4050","description":"Cast supplies unlisted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAC0","description":"ICD-JHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXC0","description":"ICD-BDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOA1","description":"ICD-LEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUE1","description":"ICD-IGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ofatumumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9302","description":"Ofatumumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHF0","description":"ICD-NKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFC0","description":"ICD-KCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNF1","description":"ICD-NDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWB1","description":"ICD-KCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDC0","description":"ICD-BHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHD1","description":"ICD-CDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med pt reas no hcc scrn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9456","description":"Doc med pt reas no hcc scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy unspecified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96549","description":"Chemotherapy unspecified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGA1","description":"ICD-CCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUB0","description":"ICD-OLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMC1","description":"ICD-GCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61305","description":"Open skull for exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCA0","description":"ICD-OJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDA0","description":"ICD-CCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19357","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc serum pretx incubj/inhib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86977","description":"Rbc serum pretx incubj/inhib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJB1","description":"ICD-BAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise/graft midfoot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28305","description":"Incise/graft midfoot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including target assessment_ initial motor threshold determination_ neuronavigati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0890T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including target assessment_ initial motor threshold determination_ neuronavigati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3406","description":"HCPCS-J3406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAE0","description":"ICD-MIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAA1","description":"ICD-EIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPE0","description":"ICD-BDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWC1","description":"ICD-CBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBF1","description":"ICD-FHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC15","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epcoritamab-bysp_ 0.16 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9155","description":"Injection_ epcoritamab-bysp_ 0.16 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAD1","description":"ICD-MLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNC0","description":"ICD-BCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSC0","description":"ICD-DFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1902","description":"HCPCS-B1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLC0","description":"ICD-CFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBC1","description":"ICD-EFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place endorectal app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9725","description":"Place endorectal app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUE1","description":"ICD-EEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMC0","description":"ICD-KGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGA1","description":"ICD-JEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEC1","description":"ICD-JGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUF0","description":"ICD-OAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTD1","description":"ICD-EFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJC0","description":"ICD-FAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ pelvis and hips_ infant or child_ minimum of two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73540","description":"Radiologic examination_ pelvis and hips_ infant or child_ minimum of two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0678U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678U","description":"CPT-0678U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Delay flap arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15610","description":"Delay flap arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1335","description":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC160","description":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQC0","description":"ICD-OGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLA0","description":"ICD-AGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth chest drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52451","description":"Anesth chest drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAD0","description":"ICD-OAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2005","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2005","description":"CDT-D2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEME0","description":"ICD-IEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagenase_ clost hist inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0775","description":"Collagenase_ clost hist inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSB0","description":"ICD-LDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENE1","description":"ICD-CENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEC0","description":"ICD-NJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDA0","description":"ICD-BIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESD1","description":"ICD-OESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36569","description":"Insert picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXD1","description":"ICD-BAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUC0","description":"ICD-EIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFME1","description":"ICD-JFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNF1","description":"ICD-OGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53020","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABE1","description":"ICD-OABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSB0","description":"ICD-HCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA INFLUENZA A/B EACH","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87400","description":"IAAD IA INFLUENZA A/B EACH","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWE1","description":"ICD-LGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOA0","description":"ICD-OIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWA0","description":"ICD-KAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBE0","description":"ICD-EBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOE1","description":"ICD-HAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0102","description":"HCPCS-A0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWF1","description":"ICD-CDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB13","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1263","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEC0","description":"ICD-MFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB154","description":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB125","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43621","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYA1","description":"ICD-PLYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLF0","description":"ICD-JGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQE0","description":"ICD-CFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meperidine hydrochl /100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2175","description":"Meperidine hydrochl /100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0150","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0150","description":"HCPCS-E0150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTF0","description":"ICD-CHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk removable medial brim sus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5672","description":"Bk removable medial brim sus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC22","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALD1","description":"ICD-CALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC105","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1026T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1026T","description":"CPT-1026T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2009","description":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","description":"CPT-00470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot arch supp longitud/meta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3060","description":"Foot arch supp longitud/meta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of copper","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82525","description":"Assay of copper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMA0","description":"ICD-IHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open femoral artery exposure for delivery of endovascular prosthesis_ by groin incision_ unilateral (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34812","description":"Open femoral artery exposure for delivery of endovascular prosthesis_ by groin incision_ unilateral (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES340","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Team conf w/pat by hc prof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99366","description":"Team conf w/pat by hc prof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPF1","description":"ICD-CIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place rt device/marker pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55876","description":"Place rt device/marker pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTC0","description":"ICD-KBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1100T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1100T","description":"CPT-1100T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC21","description":"ICD-3HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQC0","description":"ICD-PFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB21","description":"ICD-4EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47133","description":"Removal of donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUF0","description":"ICD-NAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCD0","description":"ICD-JFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEC1","description":"ICD-NLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQD1","description":"ICD-CEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMC1","description":"ICD-NDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj fem cont inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64448","description":"N block inj fem cont inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYA1","description":"ICD-OEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTA1","description":"ICD-MFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent repair of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64872","description":"Subsequent repair of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVA1","description":"ICD-JBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQB0","description":"ICD-GIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXA0","description":"ICD-GAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pressure sensor system_ includes all components (eg_ introducer sensor)_ intramuscular (imp)_ exc mobile (wireless) software app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1834","description":"Pressure sensor system_ includes all components (eg_ introducer sensor)_ intramuscular (imp)_ exc mobile (wireless) software app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB201","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rec antivir treat hep c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8461","description":"Pt rec antivir treat hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endothelial function assessment_ using peripheral vascular response to reactive hyperemia_ non-invasive (eg_ brachial artery ultrasound_ peripheral artery tonometry)_ unilater","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0337T","description":"Endothelial function assessment_ using peripheral vascular response to reactive hyperemia_ non-invasive (eg_ brachial artery ultrasound_ peripheral artery tonometry)_ unilater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD254","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFME1","description":"ICD-EFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper gi endo not barrtts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3141F","description":"Upper gi endo not barrtts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTF1","description":"ICD-CDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWF1","description":"ICD-OKWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAD0","description":"ICD-AAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMB1","description":"ICD-OEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQF1","description":"ICD-CEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWC1","description":"ICD-LGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBD1","description":"ICD-BIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport mini-bus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0120","description":"Noner transport mini-bus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43622","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILF1","description":"ICD-AILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFE1","description":"ICD-NCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRA0","description":"ICD-KGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMB1","description":"ICD-MBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNE1","description":"ICD-OJNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00942","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","description":"CPT-00942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDC1","description":"ICD-EIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRD0","description":"ICD-DBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9736","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQA0","description":"ICD-CDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLF1","description":"ICD-FHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMC0","description":"ICD-JCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37266","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","description":"CPT-37266","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOA1","description":"ICD-LGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL44","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dexrazoxane hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1190","description":"Dexrazoxane hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulp cap direct","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3110","description":"Pulp cap direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sc r pos/lat pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0633","description":"Lso sc r pos/lat pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBF0","description":"ICD-IDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRD1","description":"ICD-LIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open coronary endarterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33572","description":"Open coronary endarterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cuffs adj lock w/ active con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3740","description":"Cuffs adj lock w/ active con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-awwb_ biosimilar_ (Mvasi)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5107","description":"Injection_ bevacizumab-awwb_ biosimilar_ (Mvasi)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replantation digit complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20816","description":"Replantation digit complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUC1","description":"ICD-OAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral supply kit homemi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4222","description":"Parenteral supply kit homemi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9362","description":"Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUD1","description":"ICD-KHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHE0","description":"ICD-IHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPC0","description":"ICD-BGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAE0","description":"ICD-AEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERF0","description":"ICD-OERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSD1","description":"ICD-PGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIC1","description":"ICD-BCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tap block uni by infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64487","description":"Tap block uni by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKF0","description":"ICD-OJKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0567","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","description":"HCPCS-G0567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDME0","description":"ICD-KDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINF0","description":"ICD-OINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1653","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","description":"HCPCS-L1653","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1049T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1049T","description":"CPT-1049T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise/drain eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68020","description":"Incise/drain eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMD1","description":"ICD-BFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9949","description":"Leg pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHD0","description":"ICD-NIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRC0","description":"ICD-HIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imuglucerase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1786","description":"Imuglucerase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peri-Procedural Device Evaluation (In-Person) And Programming Of Device System Parameters Before Or After A Surgery_ Procedure_ Or Test With Analysis_ Review_ And Report By A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0684T","description":"Peri-Procedural Device Evaluation (In-Person) And Programming Of Device System Parameters Before Or After A Surgery_ Procedure_ Or Test With Analysis_ Review_ And Report By A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOE1","description":"ICD-OCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWB1","description":"ICD-DEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23C","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC112","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with stress im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9763","description":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with stress im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHE1","description":"ICD-OGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice or home hlth in home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5001","description":"Hospice or home hlth in home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13B","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAD0","description":"ICD-NGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemipelvect canad sing axis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5280","description":"Hemipelvect canad sing axis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Malig tumor exc to 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7440","description":"Malig tumor exc to 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRE0","description":"ICD-KGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACA0","description":"ICD-EACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44143","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMA1","description":"ICD-EHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACB1","description":"ICD-IACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD126","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFF1","description":"ICD-FHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8G","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEA1","description":"ICD-JBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMC1","description":"ICD-NKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47620","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSA0","description":"ICD-KBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIB0","description":"ICD-MLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision Or Removal Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Programming_ And Imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0588T","description":"Revision Or Removal Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Programming_ And Imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPA1","description":"ICD-BGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct lower extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73701","description":"Ct lower extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemostatic agent_ gastrointestinal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1052","description":"Hemostatic agent_ gastrointestinal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain aneurysm repr simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61700","description":"Brain aneurysm repr simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service for ages under 21 Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0312","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service for ages under 21 Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amp no reqd in48h ieler proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9639","description":"Amp no reqd in48h ieler proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin w/noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6722","description":"Crown resin w/noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECD0","description":"ICD-EECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBD1","description":"ICD-FDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINA1","description":"ICD-KINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49616","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-waterproof tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4450","description":"Non-waterproof tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJB0","description":"ICD-CAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLB1","description":"ICD-AFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPC0","description":"ICD-OKPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMF0","description":"ICD-BBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYA1","description":"ICD-OFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periodontal scaling & root","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4341","description":"Periodontal scaling & root","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exoskel hip ultra-light mate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5795","description":"Exoskel hip ultra-light mate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE216","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELD1","description":"ICD-FELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTB0","description":"ICD-EGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCE0","description":"ICD-OBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraor complete film series","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0210","description":"Intraor complete film series","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ spesolimab-sbzo_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1747","description":"Injection_ spesolimab-sbzo_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11646","description":"Exc f/e/e/n/l mal+mrg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0676T","description":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTD0","description":"ICD-AFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB11","description":"ICD-1CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQD0","description":"ICD-KBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYA0","description":"ICD-LFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLF1","description":"ICD-FCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exam/biopsy of vag w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57421","description":"Exam/biopsy of vag w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKC0","description":"ICD-NHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap enterolysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44180","description":"Lap enterolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPE1","description":"ICD-FCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITA0","description":"ICD-MITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITC0","description":"ICD-BITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; battery component only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0862T","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; battery component only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low extemity neur not perfor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8405","description":"Low extemity neur not perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB244","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIC0","description":"ICD-MEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAE1","description":"ICD-FGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed semi-electr w/o mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0261","description":"Hosp bed semi-electr w/o mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone imaging 3 phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78315","description":"Bone imaging 3 phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOF0","description":"ICD-PAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAE0","description":"ICD-BAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBND1","description":"ICD-GBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cervix/repair pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57545","description":"Remove cervix/repair pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHF1","description":"ICD-CFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44320","description":"Colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2030","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","description":"HCPCS-A2030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald transmitter microphone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5290","description":"Ald transmitter microphone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIC1","description":"ICD-KHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise spin&cord 2 stgs thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63199","description":"Incise spin&cord 2 stgs thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB115","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLD0","description":"ICD-NGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breath test analysis c-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78268","description":"Breath test analysis c-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54308","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEC0","description":"ICD-OIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANE0","description":"ICD-NANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBF0","description":"ICD-JFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25D","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVF0","description":"ICD-GCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPE1","description":"ICD-OGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYA0","description":"ICD-HGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDE0","description":"ICD-NEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41251","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWE1","description":"ICD-KBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for prescribing systemic antimicrobials","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9960","description":"Documentation of medical reason(s) for prescribing systemic antimicrobials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/insert drug implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11983","description":"Remove/insert drug implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hd bed tilted 1st day vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4167F","description":"Hd bed tilted 1st day vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace cover w/c seat cush","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2619","description":"Replace cover w/c seat cush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas biopsy not review","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8884","description":"Doc reas biopsy not review","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYC0","description":"ICD-PAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKA1","description":"ICD-OJKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFF0","description":"ICD-BHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Medicalis_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1003","description":"Clinical Decision Support Mechanism Medicalis_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAE1","description":"ICD-NAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIB0","description":"ICD-BAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sutures diff surgeon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15851","description":"Remove sutures diff surgeon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPD1","description":"ICD-NGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo guidance radiotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6001","description":"Echo guidance radiotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Number of patients screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1207","description":"Number of patients screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11641","description":"Exc f/e/e/n/l mal+mrg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67412","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMC1","description":"ICD-EGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser surgery of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52648","description":"Laser surgery of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAC0","description":"ICD-ODAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50240","description":"Partial removal of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC36","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGD0","description":"ICD-FIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99418","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQA0","description":"ICD-GDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHID0","description":"ICD-MHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTE0","description":"ICD-JBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rv5 vacc 3 dose live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90680","description":"Rv5 vacc 3 dose live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBF1","description":"ICD-NHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEE1","description":"ICD-OCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc limited","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9068","description":"Onc dx sclc/nsclc limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adj skin pro wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2623","description":"Adj skin pro wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4042","description":"Cast sup lng leg splnt fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58940","description":"Removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTE0","description":"ICD-CHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSF1","description":"ICD-LDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation physics consult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77336","description":"Radiation physics consult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0496U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","description":"CPT-0496U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEC0","description":"ICD-NAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion of cipaglucosidase alfa-atga_ including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of recei","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0138","description":"Intravenous infusion of cipaglucosidase alfa-atga_ including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of recei","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No tpa init w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8602","description":"No tpa init w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15935","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILA1","description":"ICD-EILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTA0","description":"ICD-CFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDTB&VINCULIN IGG ANTB IA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0176U","description":"CDTB&VINCULIN IGG ANTB IA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78835","description":"Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXB1","description":"ICD-GEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNE0","description":"ICD-KCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"alloPLY_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4323","description":"alloPLY_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary angioplasty_ single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intrav","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7533","description":"Percutaneous transluminal coronary angioplasty_ single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intrav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATB0","description":"ICD-EATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVC0","description":"ICD-JDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAB0","description":"ICD-MGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behav chng smoking > 10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99407","description":"Behav chng smoking > 10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level V_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0754T","description":"Digitization of glass microscope slides for level V_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDF0","description":"ICD-GEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIE0","description":"ICD-BAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJC0","description":"ICD-OHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine pregnancy test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81025","description":"Urine pregnancy test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDD0","description":"ICD-OJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBB1","description":"ICD-OIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0681","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","description":"HCPCS-G0681","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGB0","description":"ICD-OIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFD1","description":"ICD-CCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33957","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81185","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAD0","description":"ICD-NAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45123","description":"Partial proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood glucose monitor home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0607","description":"Blood glucose monitor home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIE1","description":"ICD-CAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWB0","description":"ICD-DAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGID0","description":"ICD-FGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat vagina infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57150","description":"Treat vagina infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA42","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWA0","description":"ICD-DHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASB0","description":"ICD-KASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGC1","description":"ICD-CIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N-et; stretcher van_ mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2049","description":"N-et; stretcher van_ mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAD0","description":"ICD-EBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGA1","description":"ICD-CDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCF1","description":"ICD-JCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth genitalia surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92051","description":"Anesth genitalia surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHB0","description":"ICD-NGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAE1","description":"ICD-BAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQF1","description":"ICD-OKQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deep sedation/general anesthesia-each additional 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9221","description":"Deep sedation/general anesthesia-each additional 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEME1","description":"ICD-FEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50572","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental case management - care coordination","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9992","description":"Dental case management - care coordination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDB0","description":"ICD-FGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKE0","description":"ICD-NFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEME1","description":"ICD-JEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricul","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7538","description":"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMA1","description":"ICD-OJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74775","description":"X-ray exam of perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0782T","description":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDB0","description":"ICD-OEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWA1","description":"ICD-PHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOE1","description":"ICD-CHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQD0","description":"ICD-KGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unscheduled dressing change","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4920","description":"Unscheduled dressing change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEE0","description":"ICD-AHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOD1","description":"ICD-CCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGE1","description":"ICD-KAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYA1","description":"ICD-CFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYE0","description":"ICD-PJYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVD0","description":"ICD-OCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) a","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX03","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","description":"HCPCS-Q4405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50610","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKA1","description":"ICD-BCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each additional single antibody stain procedure (List separately in addi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0761T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each additional single antibody stain procedure (List separately in addi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepa vacc ped/adol 2 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90633","description":"Hepa vacc ped/adol 2 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB136","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect hip tum incl acetabul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27076","description":"Resect hip tum incl acetabul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISF0","description":"ICD-OISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52318","description":"Remove bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92082","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLC0","description":"ICD-MJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJB1","description":"ICD-JCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert palate implants","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9727","description":"Insert palate implants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interferon alfa-2a inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9213","description":"Interferon alfa-2a inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCA0","description":"ICD-GGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Csf shunt evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78645","description":"Csf shunt evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMB0","description":"ICD-MCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXA0","description":"ICD-KBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWE0","description":"ICD-KEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPE1","description":"ICD-BDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWE0","description":"ICD-CFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epifix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4186","description":"Epifix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA141","description":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exposure behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by physician or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0363T","description":"Exposure behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by physician or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification_ methylated DNA markers_ including LASS4_ LRRC4 and PPP2R5C_ a reference marker ZDHHC1_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0464U","description":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification_ methylated DNA markers_ including LASS4_ LRRC4 and PPP2R5C_ a reference marker ZDHHC1_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWD0","description":"ICD-LGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFF1","description":"ICD-KFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMA0","description":"ICD-JIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYB1","description":"ICD-PKYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor ix recombinan rixubis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7200","description":"Factor ix recombinan rixubis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAC0","description":"ICD-IEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHC0","description":"ICD-NAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPF0","description":"ICD-NIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAF1","description":"ICD-OLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood type antigen donor ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86902","description":"Blood type antigen donor ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL26","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5149","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","description":"HCPCS-Q5149","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25525","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86849","description":"Immunology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOE0","description":"ICD-PKOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct angiography head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70496","description":"Ct angiography head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOB0","description":"ICD-PLOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGE0","description":"ICD-NGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flecainide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80181","description":"Flecainide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit anti-spasmotic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9363","description":"Hit anti-spasmotic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIB1","description":"ICD-ADIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIC0","description":"ICD-NAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair ortho appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8691","description":"Repair ortho appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ ep_ diag/abl_ 3d/vect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1732","description":"Cath_ ep_ diag/abl_ 3d/vect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNA0","description":"ICD-OBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10004","description":"Fine needle aspiration biopsy_ without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Potassium hydroxide preps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0112","description":"Potassium hydroxide preps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQA0","description":"ICD-HCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECC1","description":"ICD-BECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQB0","description":"ICD-DDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00550","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","description":"CPT-00550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVA1","description":"ICD-BIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEB1","description":"ICD-KDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; Each Additional 25 Cc Injectate_ Or P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15774","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; Each Additional 25 Cc Injectate_ Or P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cftr gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81221","description":"Cftr gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncotype MAP Pan-Cancer Tissue Test_ Paradigm Diagnostics_ Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0244U","description":"Oncotype MAP Pan-Cancer Tissue Test_ Paradigm Diagnostics_ Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Path consult introp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88329","description":"Path consult introp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4340","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","description":"HCPCS-Q4340","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair vessel defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33802","description":"Repair vessel defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACE0","description":"ICD-OACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Genicular Nerve Branches_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64454","description":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Genicular Nerve Branches_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVD1","description":"ICD-GBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bone for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20902","description":"Removal of bone for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHE1","description":"ICD-AGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPC0","description":"ICD-BBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75820","description":"Vein x-ray arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pafolacianine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9603","description":"Injection_ pafolacianine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIF1","description":"ICD-ADIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBA0","description":"ICD-KHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUB1","description":"ICD-NLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert card electrodes dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33211","description":"Insert card electrodes dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt education noc individ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9445","description":"Pt education noc individ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spine & skull spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22590","description":"Spine & skull spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIA1","description":"ICD-NBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21245","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHB0","description":"ICD-FCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPE1","description":"ICD-CBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCA0","description":"ICD-GCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUC0","description":"ICD-BIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHD1","description":"ICD-MKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of fetal fibronectin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82731","description":"Assay of fetal fibronectin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA160","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair anorectal fist w/plug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46707","description":"Repair anorectal fist w/plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAA0","description":"ICD-FAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydroxychloroquine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80220","description":"Hydroxychloroquine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXE0","description":"ICD-ODXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28H","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0235","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","description":"HCPCS-Q0235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g._ intestinal infection_ pertussis_ bacterial infection_ lyme disease_ otitis media_ acute sinu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9712","description":"Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g._ intestinal infection_ pertussis_ bacterial infection_ lyme disease_ otitis media_ acute sinu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAB1","description":"ICD-GAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARC0","description":"ICD-LARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0128U","description":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOF0","description":"ICD-OBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFD1","description":"ICD-NAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAD0","description":"ICD-KEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBF1","description":"ICD-MHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01926","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","description":"CPT-01926","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myelography l-s spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72265","description":"Myelography l-s spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHC0","description":"ICD-IDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCID0","description":"ICD-BCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0017","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWB1","description":"ICD-PDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFC0","description":"ICD-BCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tob user recd cess interv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9458","description":"Tob user recd cess interv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKD0","description":"ICD-JIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWF1","description":"ICD-CGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDB1","description":"ICD-CHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBE0","description":"ICD-ADBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26746","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAF0","description":"ICD-AEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXD1","description":"ICD-BHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDA0","description":"ICD-FGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIC1","description":"ICD-KGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVC0","description":"ICD-JIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDC0","description":"ICD-KBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iliac art angio_cardiac cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0278","description":"Iliac art angio_cardiac cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMB1","description":"ICD-FCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36571","description":"Insert picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93282","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIF1","description":"ICD-NKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEF1","description":"ICD-AGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICB0","description":"ICD-EICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAA0","description":"ICD-NEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25C","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:15)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1741","description":"Employment - Employment Skills Development (1:15)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDC1","description":"ICD-NKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCA0","description":"ICD-OCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVD0","description":"ICD-GAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBC0","description":"ICD-IFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/o&w/dye_ upper extr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8936","description":"Mra_ w/o&w/dye_ upper extr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nikaidoh proc w/ostia implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33783","description":"Nikaidoh proc w/ostia implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15A","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurectomy popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27326","description":"Neurectomy popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJE1","description":"ICD-KFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC31","description":"High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6074","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bath tub wall rail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0241","description":"Bath tub wall rail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a follow-up assessment within 120 days of the index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1363","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXA1","description":"ICD-OJXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11602","description":"Exc tr-ext mal+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRD1","description":"ICD-PGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES217","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of theophylline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80198","description":"Assay of theophylline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOF0","description":"ICD-GIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUD0","description":"ICD-CHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dorsiflexion assist each joi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2210","description":"Dorsiflexion assist each joi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVC1","description":"ICD-FFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g._ audit_ DAST)_ and brief intervention_ 5-14 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2011","description":"Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g._ audit_ DAST)_ and brief intervention_ 5-14 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHB0","description":"ICD-KGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUE1","description":"ICD-NCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVE1","description":"ICD-BCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24A","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBA0","description":"ICD-NGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLD1","description":"ICD-KHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQA1","description":"ICD-HFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVA1","description":"ICD-NLVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1422","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","description":"HCPCS-M1422","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial limited study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93888","description":"Intracranial limited study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDD0","description":"ICD-KIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism InveniQA semantic answers in medicine _ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1014","description":"Clinical decision support mechanism InveniQA semantic answers in medicine _ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adenoma not detect screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3776F","description":"Adenoma not detect screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGB1","description":"ICD-JGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med rsn no scr etoh use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9623","description":"Doc med rsn no scr etoh use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWC1","description":"ICD-LAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD241","description":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Granisetron 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0091","description":"Granisetron 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYD1","description":"ICD-LHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRB1","description":"ICD-CBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPE1","description":"ICD-GAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDB1","description":"ICD-IFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1081T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1081T","description":"CPT-1081T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13D","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRD0","description":"ICD-OKRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00402","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","description":"CPT-00402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLD1","description":"ICD-MGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt reas not rec hcv srn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9385","description":"Doc pt reas not rec hcv srn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVC1","description":"ICD-FCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ translumin_ drug-coat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2623","description":"Cath_ translumin_ drug-coat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31201","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNA0","description":"ICD-OLNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPC1","description":"ICD-FDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILF0","description":"ICD-JILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESE1","description":"ICD-DESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFF1","description":"ICD-KIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECA1","description":"ICD-JECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDA1","description":"ICD-ADDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abduction rotation bar shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3140","description":"Abduction rotation bar shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imaging of the head (CT or MRI) was obtained","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1027","description":"Imaging of the head (CT or MRI) was obtained","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX46","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITC/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5215","description":"Hearing aid_ contralateral routing system_ binaural_ ITC/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXB1","description":"ICD-KBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVC0","description":"ICD-JBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUF1","description":"ICD-GDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat neck spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22326","description":"Treat neck spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRD0","description":"ICD-KFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUB1","description":"ICD-BDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-2 piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21142","description":"Lefort i-2 piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLA1","description":"ICD-OKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9804","description":"HCPCS-C9804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLE1","description":"ICD-ABLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMD1","description":"ICD-BDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENB1","description":"ICD-OENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL36","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWD0","description":"ICD-LFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMF0","description":"ICD-CAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFD0","description":"ICD-KFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLE0","description":"ICD-ABLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cardiac electrophys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53751","description":"Anesth cardiac electrophys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATC0","description":"ICD-AATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of skull with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62146","description":"Repair of skull with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWC0","description":"ICD-OGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCND1","description":"ICD-CCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKD1","description":"ICD-GAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKE0","description":"ICD-KBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteochondral talus autogrft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28446","description":"Osteochondral talus autogrft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Itraconazole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1835","description":"Itraconazole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice continuous home care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2043","description":"Hospice continuous home care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply interstit radiat compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77778","description":"Apply interstit radiat compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPC1","description":"ICD-OIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBE1","description":"ICD-BBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD154","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51530","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc osmotic fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85557","description":"Rbc osmotic fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQB0","description":"ICD-LDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLE0","description":"ICD-IHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Door to punc time >2hr_ nrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9582","description":"Door to punc time >2hr_ nrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDB1","description":"ICD-GBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJA1","description":"ICD-GAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote retinal imaging mgmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92228","description":"Remote retinal imaging mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFF1","description":"ICD-NDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amalgam 4 or > surfaces perm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2161","description":"Amalgam 4 or > surfaces perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLD0","description":"ICD-NKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain shoulder bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23031","description":"Drain shoulder bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Motor function mapping ntms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0310T","description":"Motor function mapping ntms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mltispectrl digital les alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0400T","description":"Mltispectrl digital les alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJC1","description":"ICD-FDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sulfamethoxazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0039","description":"Injection_ sulfamethoxazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5A","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8E","description":"Medium Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mucopolysaccharides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83864","description":"Mucopolysaccharides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXC0","description":"ICD-JCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temp obturator prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5936","description":"Temp obturator prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total kt/v less than 1. 7 per week (total clearance of urea [kt] / volume [v])_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8720","description":"Total kt/v less than 1. 7 per week (total clearance of urea [kt] / volume [v])_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0525","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","description":"HCPCS-J0525","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7684","description":"Triamcinolone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72132","description":"Ct lumbar spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0505","description":"HCPCS-A0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physical medicine procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97139","description":"Physical medicine procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSB1","description":"ICD-DFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group psychotherapy service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7903","description":"Group psychotherapy service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKA0","description":"ICD-KEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKE1","description":"ICD-CFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 25MCG/0.25ML1ST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111A","description":"ADM SARSCOV2 25MCG/0.25ML1ST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ piperacillin sodi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0081","description":"Injection_ piperacillin sodi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKE0","description":"ICD-CDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automated leukocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85048","description":"Automated leukocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60225","description":"Partial removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21B","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47600","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIB0","description":"ICD-BIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRE1","description":"ICD-GBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAB0","description":"ICD-JEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis_ interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95251","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis_ interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPA1","description":"ICD-BFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAB1","description":"ICD-IIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1076","description":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obtaining screen pap smear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0091","description":"Obtaining screen pap smear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98008","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","description":"CPT-98008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary plastic pouch w fcpl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4379","description":"Urinary plastic pouch w fcpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Systemic antimicrobials prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9961","description":"Systemic antimicrobials prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0A","description":"High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA31","description":"ICD-3IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC43","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNF0","description":"ICD-GCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain image w/flow < 4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78601","description":"Brain image w/flow < 4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac MRI for morph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75557","description":"Cardiac MRI for morph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50574","description":"Kidney endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ caplacizumab-yhdp_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9047","description":"Injection_ caplacizumab-yhdp_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anterior thoracic extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1220","description":"Anterior thoracic extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0601","description":"HCPCS-B0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMB1","description":"ICD-AAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair wrist joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25447","description":"Repair wrist joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGD1","description":"ICD-CGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVE0","description":"ICD-KHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXD0","description":"ICD-FBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUB1","description":"ICD-EGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5099","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","description":"HCPCS-Q5099","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEB1","description":"ICD-GDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI joint upr extrem w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73222","description":"MRI joint upr extrem w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95976","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDB1","description":"ICD-FFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAE1","description":"ICD-EEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERA1","description":"ICD-OERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITB0","description":"ICD-GITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eyelid fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67715","description":"Incision of eyelid fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia)_ same leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36471","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia)_ same leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc abd tum over 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49204","description":"Exc abd tum over 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC113","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEB0","description":"ICD-EEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl exhalation port for pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7045","description":"Repl exhalation port for pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDE1","description":"ICD-GDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBB0","description":"ICD-JEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-ophthalmic fva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9733","description":"Non-ophthalmic fva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVB0","description":"ICD-KEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0185","description":"Injection_ aprepitant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17262","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIE1","description":"ICD-OCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX26","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0519","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0519","description":"HCPCS-Q0519","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILC0","description":"ICD-AILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enzyme cell activity ra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82658","description":"Enzyme cell activity ra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLE0","description":"ICD-NLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pml/raralpha com breakpoints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81315","description":"Pml/raralpha com breakpoints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJF0","description":"ICD-CDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blink reflex test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95933","description":"Blink reflex test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36565","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIC0","description":"ICD-JDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB33","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUF0","description":"ICD-CIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIF1","description":"ICD-MJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54861","description":"Removal of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assistive Technology","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0138","description":"Assistive Technology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dronabinol 2.5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0167","description":"Dronabinol 2.5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dil retina exam interp rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2022F","description":"Dil retina exam interp rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1134","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8870","description":"Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTC1","description":"ICD-NFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIF0","description":"ICD-BHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"R hrt art/grft angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93457","description":"R hrt art/grft angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB250","description":"Special Care Low _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0104","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0104","description":"CDT-D0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ low complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes a brief history including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97165","description":"Occupational therapy evaluation_ low complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes a brief history including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGME0","description":"ICD-OGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1161","description":"Patient had anaphylaxis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATC1","description":"ICD-EATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAA1","description":"ICD-BBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYD0","description":"ICD-PBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBC1","description":"ICD-OKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2109","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx multple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21347","description":"Opn tx nasomax fx multple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDB1","description":"ICD-MGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Measles virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90705","description":"Measles virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLED0","description":"ICD-OLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sewho erbs palsey design abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3962","description":"Sewho erbs palsey design abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAD0","description":"ICD-CIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurectomy hamstring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27325","description":"Neurectomy hamstring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lenticular lens_ trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2321","description":"Lenticular lens_ trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23A","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIF0","description":"ICD-AIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Appendico-vesicostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50845","description":"Appendico-vesicostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skilled services of a licensed practical nurse (LPN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0496","description":"Skilled services of a licensed practical nurse (LPN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auditory function + 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92621","description":"Auditory function + 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Loudness balance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92562","description":"Loudness balance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGE0","description":"ICD-JBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPF1","description":"ICD-JAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUC1","description":"ICD-JFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVF1","description":"ICD-KFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Odontics endosteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6010","description":"Odontics endosteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGF1","description":"ICD-NDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYB0","description":"ICD-PIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBC0","description":"ICD-OEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGE0","description":"ICD-FEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remv/replc penis pros compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54417","description":"Remv/replc penis pros compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA01","description":"Very High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUB1","description":"ICD-MEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJF0","description":"ICD-KBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRE0","description":"ICD-HBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Battery charger_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1357","description":"Battery charger_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHB1","description":"ICD-CDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1602","description":"HCPCS-C1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61690","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx cml acceler phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9124","description":"Onc dx cml acceler phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plt_ aph/pher_ l/r_ cmv-neg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9055","description":"Plt_ aph/pher_ l/r_ cmv-neg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDC Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0001","description":"CDC Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAD1","description":"ICD-BCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAD1","description":"ICD-EHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing 1 antigen lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81374","description":"Hla i typing 1 antigen lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS DELTA ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87380","description":"IAAD IA HEPATITIS DELTA ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUC0","description":"ICD-ADUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB210","description":"Special Care High _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKF0","description":"ICD-NFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJB0","description":"ICD-CIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft femur head/neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27170","description":"Repair/graft femur head/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITB1","description":"ICD-AITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hepatic)_ mRNA expression levels of 161 genes_ utilizing fresh he","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0110U","description":"Oncology (hepatic)_ mRNA expression levels of 161 genes_ utilizing fresh he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4043","description":"Cast sup lng leg splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHD1","description":"ICD-JEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88161","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOB0","description":"ICD-DBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair spigelian hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49590","description":"Repair spigelian hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBF1","description":"ICD-GBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2194","description":"Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLD1","description":"ICD-ACLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC110","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWC0","description":"ICD-DEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANF1","description":"ICD-GANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQA1","description":"ICD-OFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMF1","description":"ICD-AGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0244T","description":"Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMA1","description":"ICD-GEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAA0","description":"ICD-IDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"General Inpatient Care - A flat per diem rates before area wage adjustment for inpatient acute care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0605","description":"General Inpatient Care - A flat per diem rates before area wage adjustment for inpatient acute care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACA0","description":"ICD-IACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ini phq9 >9 not assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9396","description":"Ini phq9 >9 not assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCF1","description":"ICD-EHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54125","description":"Removal of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXE0","description":"ICD-JGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAC1","description":"ICD-EDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3D","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAD1","description":"ICD-JBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBD1","description":"ICD-IBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUC1","description":"ICD-JGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOE1","description":"ICD-CCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove part of temporal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69535","description":"Remove part of temporal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYE0","description":"ICD-GAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telavancin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3095","description":"Telavancin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIE0","description":"ICD-BIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSB0","description":"ICD-DBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injections of stem cell product into perianal perifistular soft tissue_ including fistula preparation (eg_ removal of setons_ fistula curettage_ closure of internal openings)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0748T","description":"Injections of stem cell product into perianal perifistular soft tissue_ including fistula preparation (eg_ removal of setons_ fistula curettage_ closure of internal openings)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHE1","description":"ICD-MJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD212","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise spinal cord vsls crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63250","description":"Revise spinal cord vsls crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQD0","description":"ICD-PEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL03","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart damage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33545","description":"Repair of heart damage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of rectal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45160","description":"Excision of rectal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACB1","description":"ICD-BACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinal male jug-type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0325","description":"Urinal male jug-type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Io anal gast n-stim init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95980","description":"Io anal gast n-stim init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBF1","description":"ICD-EEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debride nail 6 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11721","description":"Debride nail 6 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOC1","description":"ICD-HHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCB0","description":"ICD-CDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0980T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","description":"CPT-0980T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENE0","description":"ICD-FENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Work hardening add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97546","description":"Work hardening add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEA0","description":"ICD-GAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBA0","description":"ICD-MEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVD0","description":"ICD-FIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBF0","description":"ICD-FGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSE0","description":"ICD-HBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJD1","description":"ICD-GFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg digital analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95957","description":"Eeg digital analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIE1","description":"ICD-IAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray aorta leg arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75630","description":"X-ray aorta leg arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traditional healing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0051","description":"Traditional healing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBB0","description":"ICD-EBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTD1","description":"ICD-JDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg strap each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0038","description":"Leg strap each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD250","description":"Reduced Physical Function _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVF0","description":"ICD-BEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC101","description":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCE1","description":"ICD-OJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7524","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7524","description":"HCPCS-J7524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26548","description":"Reconstruct finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASC1","description":"ICD-DASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXC1","description":"ICD-JEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVE0","description":"ICD-NLVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colectomy w/ileoanal anast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44157","description":"Colectomy w/ileoanal anast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIB1","description":"ICD-KIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"F2 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81240","description":"F2 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0B","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiesse injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2026","description":"Radiesse injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolong clincl staff svc add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99416","description":"Prolong clincl staff svc add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHA0","description":"ICD-OLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVC0","description":"ICD-JFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hh respiratory thrpy nos/day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5181","description":"Hh respiratory thrpy nos/day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98009","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","description":"CPT-98009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVA0","description":"ICD-OCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00300","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","description":"CPT-00300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETC0","description":"ICD-NETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61533","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest compression gen system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0483","description":"Chest compression gen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOB0","description":"ICD-GCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reaching/grabbing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9281","description":"Reaching/grabbing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA21","description":"ICD-2FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDB0","description":"ICD-OHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJC0","description":"ICD-GCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0789T","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD224","description":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQB0","description":"ICD-PLQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hyoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21495","description":"Treat hyoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLE1","description":"ICD-OJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81518","description":"Oncology (breast)_ mRNA_ gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPE1","description":"ICD-NGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARF1","description":"ICD-KARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSB0","description":"ICD-PFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21247","description":"Reconstruct lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Miglustat_ oral_ 65 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1202","description":"Miglustat_ oral_ 65 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21196","description":"Reconst lwr jaw w/fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB11","description":"ICD-2AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNB1","description":"ICD-CCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPA1","description":"ICD-FGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1C","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEF1","description":"ICD-IBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore and drain kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50125","description":"Explore and drain kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEA0","description":"ICD-MFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRC1","description":"ICD-GBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDC1","description":"ICD-GIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27640","description":"Partial removal of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTA0","description":"ICD-OLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecg record/review","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93268","description":"Ecg record/review","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy flex remove fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43215","description":"Esophagoscopy flex remove fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of heel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73650","description":"X-ray exam of heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOB1","description":"ICD-HCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQA1","description":"ICD-PIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDB0","description":"ICD-BIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHE0","description":"ICD-MLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWC1","description":"ICD-DGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFE1","description":"ICD-OAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cst bse mtl inlay >= 3 surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6605","description":"Cst bse mtl inlay >= 3 surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEF0","description":"ICD-FDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYA1","description":"ICD-LCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TPMT (thiopurine S-methyltransferase)_ NUDT15 (nudix hydroxylase 15)(eg_ thiopurine metabolism)_ gene analysis_ common variants (ie_ TPMT *2_ *3A_ *3B_ *3C_ *4_ *5_ *6_ *8_ *1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0034U","description":"TPMT (thiopurine S-methyltransferase)_ NUDT15 (nudix hydroxylase 15)(eg_ thiopurine metabolism)_ gene analysis_ common variants (ie_ TPMT *2_ *3A_ *3B_ *3C_ *4_ *5_ *6_ *8_ *1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKND0","description":"ICD-NKND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAME1","description":"ICD-BAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pos elder mal scrn plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8733","description":"Doc pos elder mal scrn plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML17","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained without diagnostic magnetic r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0723T","description":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained without diagnostic magnetic r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost skn barr w/o conv >4 sqi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4415","description":"Ost skn barr w/o conv >4 sqi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete wheel lock assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2206","description":"Complete wheel lock assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24D","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tubing used w suction pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7002","description":"Tubing used w suction pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESB1","description":"ICD-KESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tubing (oxygen) per foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4616","description":"Tubing (oxygen) per foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB35","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCC1","description":"ICD-FCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPD1","description":"ICD-BBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood Component Or Product Not Otherwise Classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9099","description":"Blood Component Or Product Not Otherwise Classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTF1","description":"ICD-BDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES341","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD135","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDID1","description":"ICD-GDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBC0","description":"ICD-EIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vert bitewings-sev to eight","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0277","description":"Vert bitewings-sev to eight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJB0","description":"ICD-BHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","description":"HCPCS-E1808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0492U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","description":"CPT-0492U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDF1","description":"ICD-MHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEF0","description":"ICD-BDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analysis tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88358","description":"Analysis tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHB0","description":"ICD-ECHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cervical semi-rigid adjustab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0140","description":"Cervical semi-rigid adjustab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23616","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA11","description":"ICD-4AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy clamp_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4363","description":"Ostomy clamp_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC231","description":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOF1","description":"ICD-CFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Physiologic Monitoring Treatment Management Services_ Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring Interactive C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99458","description":"Remote Physiologic Monitoring Treatment Management Services_ Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring Interactive C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFD0","description":"ICD-OAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44100","description":"Biopsy of bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srs cran les complex addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61799","description":"Srs cran les complex addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWC0","description":"ICD-OEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHD1","description":"ICD-FDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CT/MRI chest follup not rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9556","description":"CT/MRI chest follup not rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYE0","description":"ICD-KGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAC1","description":"ICD-BBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYE0","description":"ICD-HGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDE0","description":"ICD-CCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXF0","description":"ICD-NFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26665","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triptorelin_ extended-release_ 3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3316","description":"Injection_ triptorelin_ extended-release_ 3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteoarthritis assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1006F","description":"Osteoarthritis assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21194","description":"Reconst lwr jaw w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEC0","description":"ICD-KBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with pregnancy during adjuvant treatment course","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2205","description":"Patients with pregnancy during adjuvant treatment course","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Card tamp w/in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9408","description":"Card tamp w/in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXA1","description":"ICD-KEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cervical traction equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0855","description":"Cervical traction equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ taliglucerase alfa_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3060","description":"Injection_ taliglucerase alfa_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPE0","description":"ICD-JIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQA1","description":"ICD-OJQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB226","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block other peripheral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64450","description":"N block other peripheral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOE1","description":"ICD-PEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGF1","description":"ICD-GDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood transfusion service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36430","description":"Blood transfusion service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remov/replc ur sphinctr comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53448","description":"Remov/replc ur sphinctr comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMC0","description":"ICD-OLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYF0","description":"ICD-LCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80412","description":"Crh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVB0","description":"ICD-NKVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADD0","description":"ICD-MADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCND1","description":"ICD-JCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt/caregiver queried falls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6080F","description":"Pt/caregiver queried falls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73120","description":"X-ray exam of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Set up port xray equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0092","description":"Set up port xray equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHE0","description":"ICD-OGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endometrial cryoablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58356","description":"Endometrial cryoablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA26","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28X","description":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTC1","description":"ICD-CFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKB1","description":"ICD-GGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15931","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47360","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen III b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0279U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen III b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOD0","description":"ICD-CHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE201","description":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARC1","description":"ICD-HARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC53","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAB0","description":"ICD-ABAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDE1","description":"ICD-AGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epidural lysis mult sessions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62263","description":"Epidural lysis mult sessions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Habil prevoc waiver_ per d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2014","description":"Habil prevoc waiver_ per d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTD0","description":"ICD-NDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including inte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2010","description":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including inte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTF0","description":"ICD-KDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES355","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTE1","description":"ICD-GDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio hrt w/3d image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75574","description":"Ct angio hrt w/3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9806","description":"HCPCS-C9806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGA0","description":"ICD-BDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55842","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration for testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54550","description":"Exploration for testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko adj jnt pos r sup pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1832","description":"Ko adj jnt pos r sup pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSB1","description":"ICD-PHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv4 vaccine 3 yrs plus im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90688","description":"Iiv4 vaccine 3 yrs plus im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct capture tmj","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0384","description":"Cone beam ct capture tmj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92288","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","description":"CPT-92288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aphakia prosth service temp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92358","description":"Aphakia prosth service temp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bowel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44605","description":"Repair of bowel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone/skin graft metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20972","description":"Bone/skin graft metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANE1","description":"ICD-NANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJB0","description":"ICD-BAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADB1","description":"ICD-JADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHB0","description":"ICD-ODHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glucagon hydrochloride (fresenius kabi)_ not therapeutically equivalent to j1610_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1611","description":"Injection_ glucagon hydrochloride (fresenius kabi)_ not therapeutically equivalent to j1610_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJF1","description":"ICD-JGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMD0","description":"ICD-AGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUF1","description":"ICD-GAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69725","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFF0","description":"ICD-GHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Job Finding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1735","description":"Employment - Job Finding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8A","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATF1","description":"ICD-GATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tail bone ulcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15920","description":"Removal of tail bone ulcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46601","description":"Diagnostic anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients With A Catheter That Have Limited Life Expectancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0050","description":"Patients With A Catheter That Have Limited Life Expectancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70559","description":"MRI brain w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCC0","description":"ICD-IBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjust knee ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1810","description":"Adjust knee ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis training complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90989","description":"Dialysis training complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDD1","description":"ICD-FFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVC1","description":"ICD-NIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31575","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTF0","description":"ICD-FFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermabrasion suprfl any site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15783","description":"Dermabrasion suprfl any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr fem hernia init blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49553","description":"Rpr fem hernia init blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUC0","description":"ICD-FHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing care not clinically indicated because the patient needed a home program only_ referral to another provider or facility_ or consultation only_ as documented in the medi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1146","description":"Ongoing care not clinically indicated because the patient needed a home program only_ referral to another provider or facility_ or consultation only_ as documented in the medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJD0","description":"ICD-OIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo femoral fx cast soft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2132","description":"Kafo femoral fx cast soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTA0","description":"ICD-CCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRD1","description":"ICD-KCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28D","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl trach puncture dilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8514","description":"Repl trach puncture dilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB11","description":"ICD-3CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Habil ed waiver_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2012","description":"Habil ed waiver_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDA0","description":"ICD-KDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCD1","description":"ICD-KHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv/aids measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8491","description":"Hiv/aids measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAA0","description":"ICD-FHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLB0","description":"ICD-GBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Portable peak flow meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8096","description":"Portable peak flow meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bilateral hip_ knee_ ankle_ foot device_ powered_ includes pelvic component_ single or double upright(s)_ knee joints any type_ with or without ankle joints any type_ includes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1007","description":"Bilateral hip_ knee_ ankle_ foot device_ powered_ includes pelvic component_ single or double upright(s)_ knee joints any type_ with or without ankle joints any type_ includes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Audiometry air & bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0209T","description":"Audiometry air & bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8004","description":"HCPCS-C8004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Toilet seat raised","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0244","description":"Toilet seat raised","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEED0","description":"ICD-NEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43108","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stereotactic biopsy_ aspiration_ or excision of lesion_ spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63615","description":"Stereotactic biopsy_ aspiration_ or excision of lesion_ spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKF1","description":"ICD-BAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEA1","description":"ICD-OFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65850","description":"Incision of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt biliary drainage cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47533","description":"Plmt biliary drainage cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coping","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2975","description":"Coping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microvolt t-wave assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93025","description":"Microvolt t-wave assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEB1","description":"ICD-ICEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enteral feed supp pump per d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4035","description":"Enteral feed supp pump per d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise finger joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26135","description":"Revise finger joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGF1","description":"ICD-JBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYB0","description":"ICD-GDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast Material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0633T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast Material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair_ any appr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49623","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair_ any appr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heinz bodies direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85441","description":"Heinz bodies direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nervous system surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64999","description":"Nervous system surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87478","description":"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTA1","description":"ICD-CDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWD1","description":"ICD-DBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBF1","description":"ICD-BDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabazitaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9043","description":"Cabazitaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12A","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBF1","description":"ICD-KCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen drsg>16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6022","description":"Collagen drsg>16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28D","description":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 4 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0870","description":"Pwc gp 4 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGB0","description":"ICD-FCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA21","description":"ICD-4GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALE1","description":"ICD-FALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEE0","description":"ICD-EIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coude tip urinary catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4352","description":"Coude tip urinary catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMF0","description":"ICD-AHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1040","description":"Patients with a diagnosis of lumbar idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVF0","description":"ICD-OHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSF0","description":"ICD-CCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0880T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPB0","description":"ICD-JBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB11","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKA1","description":"ICD-OFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC244","description":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Polycentric hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6600","description":"Polycentric hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHA0","description":"ICD-JFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Systemic antimicrobials not prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9959","description":"Systemic antimicrobials not prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem nonodonto cyst to 1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7460","description":"Rem nonodonto cyst to 1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKD0","description":"ICD-BHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRE1","description":"ICD-CGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMC1","description":"ICD-FFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD215","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOA1","description":"ICD-PAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDB0","description":"ICD-JIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSB0","description":"ICD-PGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUB0","description":"ICD-FFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKF1","description":"ICD-FAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal biophys profile w/nst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76818","description":"Fetal biophys profile w/nst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHE0","description":"ICD-NJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0970T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","description":"CPT-0970T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0501","description":"HCPCS-B0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVE0","description":"ICD-CHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0802","description":"HCPCS-B0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11604","description":"Exc tr-ext mal+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEID1","description":"ICD-KEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc stroke after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9258","description":"Doc stroke after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVD1","description":"ICD-OFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27650","description":"Repair achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of astigmatism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65772","description":"Correction of astigmatism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTA1","description":"ICD-KBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Instillation_ hexaminolevulinate hydrochloride_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9589","description":"Instillation_ hexaminolevulinate hydrochloride_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCD0","description":"ICD-BBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUF0","description":"ICD-NCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp screen mammogram add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77052","description":"Comp screen mammogram add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGA0","description":"ICD-OCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allergen specific IgE; quantitative or semiquantitative_ recombinant or purified component_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86008","description":"Allergen specific IgE; quantitative or semiquantitative_ recombinant or purified component_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung ventilat&perfus imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78582","description":"Lung ventilat&perfus imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIA0","description":"ICD-MIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUE0","description":"ICD-FAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTF0","description":"ICD-OLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBD0","description":"ICD-NHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Addition of walker to cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29440","description":"Addition of walker to cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Atrial Septostomy (Tas) For Congenital Cardiac Anomalies To Create Effective Atrial Flow_ Including All Imaging Guidance By The Proceduralist_ When Performed_ An","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33741","description":"Transcatheter Atrial Septostomy (Tas) For Congenital Cardiac Anomalies To Create Effective Atrial Flow_ Including All Imaging Guidance By The Proceduralist_ When Performed_ An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1051T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1051T","description":"CPT-1051T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove tonsils and adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42820","description":"Remove tonsils and adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWA0","description":"ICD-DEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Augmentative AI-based facial phenotype analysis with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0731T","description":"Augmentative AI-based facial phenotype analysis with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAF1","description":"ICD-EFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onco (ovar) five proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81503","description":"Onco (ovar) five proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of phenylketones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84035","description":"Assay of phenylketones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tah rad dissect for debulk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58953","description":"Tah rad dissect for debulk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg 41-60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95812","description":"Eeg 41-60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40510","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB16","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0926T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","description":"CPT-0926T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWB0","description":"ICD-LAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPF1","description":"ICD-FBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLD0","description":"ICD-MKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Additional switch_ ext power","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6611","description":"Additional switch_ ext power","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGF1","description":"ICD-BHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXD1","description":"ICD-GHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adj motion knee jnt lerman t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2186","description":"Adj motion knee jnt lerman t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66225","description":"Repair/graft eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogate crtd sns w/pgrmg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0273T","description":"Interrogate crtd sns w/pgrmg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETB0","description":"ICD-OETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ S100A8 and S100A9_ by enzyme-linked immunosorbent assay (ELISA)_ tear fluid with age_ algorithm reported as a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0458U","description":"Oncology (breast cancer)_ S100A8 and S100A9_ by enzyme-linked immunosorbent assay (ELISA)_ tear fluid with age_ algorithm reported as a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXA0","description":"ICD-OGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood sulfhemoglobin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83060","description":"Blood sulfhemoglobin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1131","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/lithotripsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52353","description":"Cystouretero w/lithotripsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post fusion </6 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22800","description":"Post fusion </6 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism LogicNets_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1019","description":"Clinical decision support mechanism LogicNets_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Midface flap (ie_ zygomaticofacial flap) with preservation of vascular pedicle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15730","description":"Midface flap (ie_ zygomaticofacial flap) with preservation of vascular pedicle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTE1","description":"ICD-BBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ buccal specimen_ gene-drug interactions_ variant analysis of 33 genes_ including deletion/duplication analysis of C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0438U","description":"Drug metabolism (adverse drug reactions and drug response)_ buccal specimen_ gene-drug interactions_ variant analysis of 33 genes_ including deletion/duplication analysis of C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHD0","description":"ICD-IIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Azithromycin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0456","description":"Azithromycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOC0","description":"ICD-CCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brief (20 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2006","description":"Brief (20 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening performed and negative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9920","description":"Screening performed and negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLC0","description":"ICD-ADLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8X","description":"Very High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQB1","description":"ICD-HDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEC1","description":"ICD-GDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1025","description":"Nonpneumatic sequential compression garment_ full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA20","description":"High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67010","description":"Partial removal of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of calcitonin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82308","description":"Assay of calcitonin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA31","description":"ICD-3FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of urinary leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53080","description":"Drainage of urinary leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMD0","description":"ICD-EFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBA1","description":"ICD-BHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEE1","description":"ICD-IHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69915","description":"Incise inner ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAD1","description":"ICD-OHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETF1","description":"ICD-OETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35302","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLA0","description":"ICD-FFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFF0","description":"ICD-OFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKF1","description":"ICD-BCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKE1","description":"ICD-OFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDE0","description":"ICD-BEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIF1","description":"ICD-IHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD210","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22B","description":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare fecal microbiota","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44705","description":"Prepare fecal microbiota","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMC0","description":"ICD-KCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIF0","description":"ICD-AFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not die within 30 days of the procedure or during the index hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9813","description":"Patient did not die within 30 days of the procedure or during the index hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFC1","description":"ICD-CIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUE1","description":"ICD-AHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANC0","description":"ICD-KANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteochondral knee allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27415","description":"Osteochondral knee allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis c revrs trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87522","description":"Hepatitis c revrs trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incontinence treatment systm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0740","description":"Incontinence treatment systm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDB0","description":"ICD-IDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score knee not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8650","description":"Fun stat score knee not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOD0","description":"ICD-KBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDD1","description":"ICD-OJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Angiotensin i enzyme test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82164","description":"Angiotensin i enzyme test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx done w/colposcopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58110","description":"Bx done w/colposcopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove pituit tumor w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62165","description":"Remove pituit tumor w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g._ inadequate time for follow-up_ patients who received a prior intravitreal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1325","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g._ inadequate time for follow-up_ patients who received a prior intravitreal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41250","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGED0","description":"ICD-IGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavior identification assessment_ by the physician or other qualified health care professional_ face-to-face with patient and caregiver(s)_ includes administration of standa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0359T","description":"Behavior identification assessment_ by the physician or other qualified health care professional_ face-to-face with patient and caregiver(s)_ includes administration of standa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo plastic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1930","description":"Afo plastic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Specimen handling pt-lab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99001","description":"Specimen handling pt-lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBA1","description":"ICD-BFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPE0","description":"ICD-OBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPD1","description":"ICD-NKPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (panzyga)_ intravenous_ non-lyophilized (e.g._ liquid)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1576","description":"Injection_ immune globulin (panzyga)_ intravenous_ non-lyophilized (e.g._ liquid)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUF1","description":"ICD-KFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHB1","description":"ICD-GGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAID0","description":"ICD-NAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TOTAL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4330","description":"TOTAL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE213","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quadrilateral brim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2188","description":"Quadrilateral brim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0951T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","description":"CPT-0951T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj arthroscopy disc reposit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7874","description":"Tmj arthroscopy disc reposit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33512","description":"Cabg vein three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31256","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lisocabtagene maraleucel_ up to 110 million autologous anti  CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2054","description":"Lisocabtagene maraleucel_ up to 110 million autologous anti  CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0442T","description":"Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFE1","description":"ICD-OIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMF0","description":"ICD-ACMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXD1","description":"ICD-KDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rare constitutional and other heritable disorders_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0267U","description":"Rare constitutional and other heritable disorders_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery w/tunnel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33505","description":"Repair artery w/tunnel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJF0","description":"ICD-BFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVB0","description":"ICD-OEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4417","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","description":"HCPCS-Q4417","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENC1","description":"ICD-FENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRA1","description":"ICD-HFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RegeneLink Amniotic Membrane Allograft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4315","description":"RegeneLink Amniotic Membrane Allograft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQF0","description":"ICD-CBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEF1","description":"ICD-GIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit periton dialysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9339","description":"Hit periton dialysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYA0","description":"ICD-KAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15017","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","description":"CPT-15017","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCB1","description":"ICD-OHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWA0","description":"ICD-OIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj cutting of a muscle","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7856","description":"Tmj cutting of a muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt neurostim elctr each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8680","description":"Implt neurostim elctr each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27596","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIND1","description":"ICD-FIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVC1","description":"ICD-KDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 1 visit p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90962","description":"Esrd serv 1 visit p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIA0","description":"ICD-OEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEE1","description":"ICD-FCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enteral supp not otherwise c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9998","description":"Enteral supp not otherwise c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDF1","description":"ICD-IDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Environmental manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90882","description":"Environmental manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUA1","description":"ICD-OIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDD1","description":"ICD-EEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gallium Ga-68 gozetotide_ diagnostic_ (Locametz)_1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9800","description":"Gallium Ga-68 gozetotide_ diagnostic_ (Locametz)_1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB36","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ evinacumab-dgnb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9079","description":"Injection_ evinacumab-dgnb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKE1","description":"ICD-GDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9305","description":"HCPCS-C9305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE134","description":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPC1","description":"ICD-NJPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit tpn total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9364","description":"Hit tpn total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB154","description":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBC0","description":"ICD-OIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seo mobile arm sup att to wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2626","description":"Seo mobile arm sup att to wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise low back nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64714","description":"Revise low back nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement Of Lost Or Broken Retainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8703","description":"Replacement Of Lost Or Broken Retainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove prostate regrowth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52630","description":"Remove prostate regrowth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSC1","description":"ICD-DHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBB0","description":"ICD-MDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Novafix dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4254","description":"Novafix dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27591","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALD1","description":"ICD-GALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIB1","description":"ICD-KBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRB1","description":"ICD-DHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLA0","description":"ICD-NHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine specimen collect mult","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9615","description":"Urine specimen collect mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18A","description":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDD1","description":"ICD-CDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vaginal procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94051","description":"Anesth vaginal procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRC0","description":"ICD-GHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inlay porcelain/ceramic 1 su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2610","description":"Inlay porcelain/ceramic 1 su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBC0","description":"ICD-KIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt_ pn_ hist grade not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8724","description":"Pt_ pn_ hist grade not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEC0","description":"ICD-OBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX33","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHF0","description":"ICD-JEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKD0","description":"ICD-JCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMF0","description":"ICD-IBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKC1","description":"ICD-KEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other counselor at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9475","description":"Other counselor at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autgrft implnt knee w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29866","description":"Autgrft implnt knee w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJC0","description":"ICD-NCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUD1","description":"ICD-EEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMA1","description":"ICD-AFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRF0","description":"ICD-OCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak open end sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5321","description":"Ak open end sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44312","description":"Revision of ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWC0","description":"ICD-PFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAD0","description":"ICD-ODAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUD1","description":"ICD-JHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device without flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7300","description":"Removal of temporary anchorage device without flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inlay composite/resin two su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2651","description":"Inlay composite/resin two su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYE0","description":"ICD-CIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOF1","description":"ICD-HHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB115","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prostatectomy (turp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52601","description":"Prostatectomy (turp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Msh2 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81296","description":"Msh2 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPA0","description":"ICD-CAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerv artific diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22856","description":"Cerv artific diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dicyclomine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0500","description":"Dicyclomine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thi/glut/ischia wgt bearing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2500","description":"Thi/glut/ischia wgt bearing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96171","description":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMC1","description":"ICD-MFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62303","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24615","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRE0","description":"ICD-DGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFB0","description":"ICD-KHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens pmma-toric/prism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2501","description":"Cntct lens pmma-toric/prism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDF1","description":"ICD-NLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closd rductn splint alveolus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7670","description":"Closd rductn splint alveolus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANF1","description":"ICD-NANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subtemporal decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61340","description":"Subtemporal decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLC0","description":"ICD-MKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTF1","description":"ICD-MDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preop asses 4 cataract surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3325F","description":"Preop asses 4 cataract surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpt doc class histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9422","description":"Rpt doc class histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC206","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preputial stretching","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54450","description":"Preputial stretching","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision graft extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35903","description":"Excision graft extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXB1","description":"ICD-NCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 1-2 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP02","description":"Auto.test pane pricing code_ 1-2 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Water softening system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1625","description":"Water softening system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy & polypectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44392","description":"Colonoscopy & polypectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone-material quality testing by microindentation(s) of the tibia(s)_ with results reported as a score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0547T","description":"Bone-material quality testing by microindentation(s) of the tibia(s)_ with results reported as a score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE260","description":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCD1","description":"ICD-NCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE214","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Overdenture partial max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5864","description":"Overdenture partial max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWF1","description":"ICD-HGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGF1","description":"ICD-OFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB256","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inhalation solution for dme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7699","description":"Inhalation solution for dme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7526","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX43","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGF1","description":"ICD-OGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTF1","description":"ICD-OHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIC0","description":"ICD-KFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTA0","description":"ICD-BCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNA1","description":"ICD-BFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCE0","description":"ICD-GBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Novosorb Synpath Dermal Matrix_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2006","description":"Novosorb Synpath Dermal Matrix_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAD0","description":"ICD-BHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVC1","description":"ICD-GGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHB0","description":"ICD-GCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair fistula w/colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45825","description":"Repair fistula w/colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E3200","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","description":"HCPCS-E3200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bioimpedance cv analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93701","description":"Bioimpedance cv analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSA1","description":"ICD-PJSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIF1","description":"ICD-JGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid seat support base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2231","description":"Solid seat support base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBC1","description":"ICD-GHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCA1","description":"ICD-OBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not achieve flat retinas six months post surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9379","description":"Patient did not achieve flat retinas six months post surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPF0","description":"ICD-GGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOE0","description":"ICD-GHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE106","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lancet device each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4258","description":"Lancet device each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stress mgmt class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9454","description":"Stress mgmt class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYA0","description":"ICD-OGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCC0","description":"ICD-AFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIA0","description":"ICD-JIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation_ comprehensive_ with review of records and specimens_ with report on referred material (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0840T","description":"Digitization of glass microscope slides for consultation_ comprehensive_ with review of records and specimens_ with report on referred material (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNA0","description":"ICD-FBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ scalp_ arms and/or legs; defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2023F","description":"Adjacent tissue transfer or rearrangement_ scalp_ arms and/or legs; defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPA0","description":"ICD-FHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin dispos pen 3 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5571","description":"Insulin dispos pen 3 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNF1","description":"ICD-BCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6066","description":"Implant supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLE0","description":"ICD-NHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Storage/year sperm/semen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89343","description":"Storage/year sperm/semen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSB1","description":"ICD-OGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHA0","description":"ICD-BGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOF0","description":"ICD-OIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHB0","description":"ICD-FDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTF0","description":"ICD-NDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHC1","description":"ICD-JCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASD1","description":"ICD-GASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hot/cold h2obot/cap/col/wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9273","description":"Hot/cold h2obot/cap/col/wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compre dental tx transition","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8070","description":"Compre dental tx transition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEC1","description":"ICD-EGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIF1","description":"ICD-MBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHF1","description":"ICD-BIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUB1","description":"ICD-AAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQE0","description":"ICD-KCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ brachytx seed adm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1728","description":"Cath_ brachytx seed adm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-pkrb_ biosimilar_ (herzuma)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5113","description":"Injection_ trastuzumab-pkrb_ biosimilar_ (herzuma)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0626U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","description":"CPT-0626U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIC0","description":"ICD-BEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5158","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","description":"HCPCS-Q5158","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid met imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78015","description":"Thyroid met imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC55","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glasses binaural hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5150","description":"Glasses binaural hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNE1","description":"ICD-KHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16373","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16373","description":"CPT-16373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9024","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","description":"HCPCS-J9024","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPA1","description":"ICD-GHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEB1","description":"ICD-GFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSB0","description":"ICD-ODSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIED0","description":"ICD-CIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1837","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","description":"HCPCS-J1837","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy excise lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58662","description":"Laparoscopy excise lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Benesch boot pair child","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3213","description":"Benesch boot pair child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sc r ant/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0650","description":"Lso sc r ant/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGC0","description":"ICD-KCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSE0","description":"ICD-CHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv eccrine glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64650","description":"Chemodenerv eccrine glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3471","description":"Surgical repair of root resorption - anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8003","description":"HCPCS-C8003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFB0","description":"ICD-GAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECD0","description":"ICD-AECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rad dos limts b/4 3d rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0520F","description":"Rad dos limts b/4 3d rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2107","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Palliative Care Services Used By Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9992","description":"Palliative Care Services Used By Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"2high risk med ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9367","description":"2high risk med ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE217","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57520","description":"Conization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87451","description":"IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74480","description":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAB0","description":"ICD-KBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIID1","description":"ICD-IIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6064","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHA0","description":"ICD-AFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle transfer shoulder/arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23395","description":"Muscle transfer shoulder/arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBD0","description":"ICD-ODBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic shoe w/off set heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5506","description":"Diabetic shoe w/off set heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUC1","description":"ICD-IDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI joint upr extrem w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73221","description":"MRI joint upr extrem w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIF0","description":"ICD-FDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0407","description":"HCPCS-C0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWD0","description":"ICD-KBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee Ankle Foot Device_ Any Material_ Single Or Double Upright_ Swing And/Or Stance Phase Microprocessor Control With Adjustability_ Includes All Components (E.G._ Sensors_ Ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2006","description":"Knee Ankle Foot Device_ Any Material_ Single Or Double Upright_ Swing And/Or Stance Phase Microprocessor Control With Adjustability_ Includes All Components (E.G._ Sensors_ Ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36510","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLE0","description":"ICD-MJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIB0","description":"ICD-IDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28G","description":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPD1","description":"ICD-OEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEF0","description":"ICD-MEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOD1","description":"ICD-DBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace afo soft interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4392","description":"Replace afo soft interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMC1","description":"ICD-NGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneum walk boot pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4386","description":"Non-pneum walk boot pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRB0","description":"ICD-LGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAF0","description":"ICD-CDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEC0","description":"ICD-CCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOD1","description":"ICD-KEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGF0","description":"ICD-OKGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILF0","description":"ICD-AILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11446","description":"Exc face-mm b9+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMC0","description":"ICD-NEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMD0","description":"ICD-FIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55710","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","description":"CPT-55710","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5D","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Select picture audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92583","description":"Select picture audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUD1","description":"ICD-AHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBD0","description":"ICD-MGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWE1","description":"ICD-OFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpnt stay radiolabeled item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9898","description":"Inpnt stay radiolabeled item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retain crown resin w hi nble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6720","description":"Retain crown resin w hi nble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACA1","description":"ICD-JACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFA1","description":"ICD-KFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap mobil splenic fl add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44213","description":"Lap mobil splenic fl add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYA1","description":"ICD-GBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ldh enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83625","description":"Assay of ldh enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKB0","description":"ICD-CAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEB0","description":"ICD-NGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJID1","description":"ICD-NJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAE1","description":"ICD-MFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANB0","description":"ICD-KANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX21","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tongue nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64740","description":"Incision of tongue nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVE0","description":"ICD-KEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57410","description":"Pelvic examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7521","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","description":"HCPCS-J7521","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOF1","description":"ICD-KCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL36","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer skin pedicle flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15650","description":"Transfer skin pedicle flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNB0","description":"ICD-FFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQF0","description":"ICD-GDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98979","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","description":"CPT-98979","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWE1","description":"ICD-PLWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC124","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUF1","description":"ICD-OAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC21","description":"ICD-2BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKA0","description":"ICD-GCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLA0","description":"ICD-CFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"A finding of an incidental pulmonary nodule","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9754","description":"A finding of an incidental pulmonary nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth one lung ventilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54151","description":"Anesth one lung ventilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE210","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOE1","description":"ICD-DIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBD0","description":"ICD-OBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microbe susceptible mlc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87187","description":"Microbe susceptible mlc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ONC BRST CA DNA PIK3CA 11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0177U","description":"ONC BRST CA DNA PIK3CA 11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Development of cognitive skills to improve attention_ memory_ problem solving (includes compensatory training)_ direct (one-on-one) patient contact_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0515","description":"Development of cognitive skills to improve attention_ memory_ problem solving (includes compensatory training)_ direct (one-on-one) patient contact_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inc for vagus n elect impl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64568","description":"Inc for vagus n elect impl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICC1","description":"ICD-NICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng anti r-viral thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4271F","description":"Pt rcvng anti r-viral thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRA1","description":"ICD-GCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99380","description":"Nursing fac care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0A","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sunglass frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0518","description":"Sunglass frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lenticular lens_ bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2221","description":"Lenticular lens_ bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB205","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMD0","description":"ICD-MKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJA0","description":"ICD-GFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIC1","description":"ICD-JIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62321","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEE0","description":"ICD-JIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKD0","description":"ICD-ODKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap w/omentopexy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49326","description":"Lap w/omentopexy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bilirubin direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82248","description":"Bilirubin direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUE0","description":"ICD-ACUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILD0","description":"ICD-BILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cult skin graft f/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15155","description":"Cult skin graft f/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01772","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","description":"CPT-01772","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMA1","description":"ICD-GCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Underarm crutch pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4635","description":"Underarm crutch pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace chst cmprss sys hose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7026","description":"Replace chst cmprss sys hose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31205","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Swallow current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8996","description":"Swallow current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rad w backup invasive intrfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0472","description":"Rad w backup invasive intrfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX56","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prim art m-thrmbc sbsq vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37185","description":"Prim art m-thrmbc sbsq vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFID1","description":"ICD-FFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDE0","description":"ICD-FCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27253","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTE0","description":"ICD-FDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAF1","description":"ICD-AGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair elbow w/deb open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24358","description":"Repair elbow w/deb open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECA0","description":"ICD-IECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAB0","description":"ICD-CCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31020","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPD0","description":"ICD-NJPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28C","description":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63650","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUD0","description":"ICD-JBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ex h rate sz 30+ day ri only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0386T","description":"Ex h rate sz 30+ day ri only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso corset front","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0972","description":"Lso corset front","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temporary tear duct plug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4262","description":"Temporary tear duct plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8A","description":"Very High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0902T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","description":"CPT-0902T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adhesion barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1765","description":"Adhesion barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXF0","description":"ICD-OLXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25B","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIED0","description":"ICD-JIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOC1","description":"ICD-HAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61020","description":"Remove brain cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEB1","description":"ICD-AFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELA1","description":"ICD-CELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJF1","description":"ICD-KDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBME0","description":"ICD-NBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUA0","description":"ICD-JFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compatibility test electric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86923","description":"Compatibility test electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOC0","description":"ICD-OAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGF1","description":"ICD-FEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Menacwy vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90734","description":"Menacwy vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13D","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGC0","description":"ICD-NGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove lung artery emboli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33915","description":"Remove lung artery emboli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNE1","description":"ICD-JGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQC0","description":"ICD-DAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3C","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ elranatamab-bcmm_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1323","description":"Injection_ elranatamab-bcmm_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; partial (anterior)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31254","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; partial (anterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10B","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNB1","description":"ICD-BBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Depression screen annual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0444","description":"Depression screen annual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKC1","description":"ICD-NJKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILB0","description":"ICD-GILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zanamivir_inhalation pwd 10m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9018","description":"Zanamivir_inhalation pwd 10m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSF1","description":"ICD-OCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFC0","description":"ICD-GIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKD0","description":"ICD-FFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWA1","description":"ICD-PJWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone hexacetonl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3303","description":"Triamcinolone hexacetonl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture bacterial urine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P7001","description":"Culture bacterial urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBF1","description":"ICD-EDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWF0","description":"ICD-GBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAC0","description":"ICD-NCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRB1","description":"ICD-GBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRC1","description":"ICD-LBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise ventricle muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33416","description":"Revise ventricle muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLC1","description":"ICD-BHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECE1","description":"ICD-MECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIE1","description":"ICD-IFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADB0","description":"ICD-CADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay for infectious agent antibody(ies)_ qualitative or semi-quantitative_ single step method (eg. reagent strip); severe acute respiratory system coronavirus 2 (SARS C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86328","description":"Immunoassay for infectious agent antibody(ies)_ qualitative or semi-quantitative_ single step method (eg. reagent strip); severe acute respiratory system coronavirus 2 (SARS C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDB1","description":"ICD-NBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKD1","description":"ICD-NDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX05","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDC0","description":"ICD-BEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2002","description":"HCPCS-A2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMA1","description":"ICD-GHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCC0","description":"ICD-KDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01480","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","description":"CPT-01480","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNC0","description":"ICD-OFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit hydra 3 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9376","description":"Hit hydra 3 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo transthoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93304","description":"Echo transthoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMA0","description":"ICD-GIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epidurography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72275","description":"Epidurography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAA0","description":"ICD-JEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBB0","description":"ICD-JBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc antibio not given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4042F","description":"Doc antibio not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJF1","description":"ICD-NJJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0805","description":"HCPCS-A0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth sternal debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55051","description":"Anesth sternal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHB1","description":"ICD-NHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILD0","description":"ICD-CILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd guide wire insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43248","description":"Egd guide wire insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGC1","description":"ICD-FFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30000","description":"Drainage of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imaging coil_ mr_ insertable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1770","description":"Imaging coil_ mr_ insertable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE250","description":"Special Care Low _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert pulse gen sngl lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33212","description":"Insert pulse gen sngl lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHC0","description":"ICD-MLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA11","description":"ICD-1IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy salpingostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58673","description":"Laparoscopy salpingostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBC1","description":"ICD-MHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLA1","description":"ICD-FBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATF1","description":"ICD-BATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0555T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJB0","description":"ICD-NAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHD0","description":"ICD-GAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect face/scalp tum < 2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21015","description":"Resect face/scalp tum < 2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEC0","description":"ICD-CFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB210","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRB0","description":"ICD-KFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio abd&pelv w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74174","description":"Ct angio abd&pelv w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg <=16 in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6242","description":"Hydrogel drg <=16 in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNE1","description":"ICD-OCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVF0","description":"ICD-OIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Budesonide comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7627","description":"Budesonide comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBC1","description":"ICD-MEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVE1","description":"ICD-JAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64742","description":"Incision of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25635","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEB0","description":"ICD-OHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair nose to lip fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42260","description":"Repair nose to lip fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQC0","description":"ICD-OAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNE0","description":"ICD-KBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 std port seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0820","description":"Pwc gp 2 std port seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8009","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8009","description":"HCPCS-C8009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX54","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEA1","description":"ICD-EEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWF1","description":"ICD-CHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mapcp demo physician","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9153","description":"Mapcp demo physician","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMC1","description":"ICD-MDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQC0","description":"ICD-GGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUF0","description":"ICD-KCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLE0","description":"ICD-EBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user_ reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9624","description":"Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user_ reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUE1","description":"ICD-BAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCME1","description":"ICD-BCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ercp w/specimen collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43260","description":"Ercp w/specimen collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDD1","description":"ICD-FCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHE0","description":"ICD-ABHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJC1","description":"ICD-NEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0653U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0653U","description":"CPT-0653U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQD0","description":"ICD-HIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAC1","description":"ICD-IGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITF0","description":"ICD-KITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cyclosporine oral 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7515","description":"Cyclosporine oral 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathogen reduced plasma pool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9070","description":"Pathogen reduced plasma pool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHD0","description":"ICD-MCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77049","description":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITB1","description":"ICD-MITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0580U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","description":"CPT-0580U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thrombomodulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85337","description":"Thrombomodulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt reas no hospice refer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9525","description":"Doc pt reas no hospice refer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84651","description":"Anesth hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc no daily aspirin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9278","description":"Doc no daily aspirin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc comp or mort w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9267","description":"Doc comp or mort w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0923T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","description":"CPT-0923T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQD1","description":"ICD-GIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFF0","description":"ICD-JGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGED0","description":"ICD-NGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter w/o bag 2-way latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4311","description":"Catheter w/o bag 2-way latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove interim implant component","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6198","description":"Remove interim implant component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHC1","description":"ICD-NAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGA0","description":"ICD-GAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANA0","description":"ICD-FANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chore services per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5121","description":"Chore services per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28190","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACF1","description":"ICD-CACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIC0","description":"ICD-GHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjunctive procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9999","description":"Adjunctive procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALB1","description":"ICD-KALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWA0","description":"ICD-PLWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove epididymis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54830","description":"Remove epididymis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGB0","description":"ICD-BEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMC0","description":"ICD-EEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYF0","description":"ICD-GIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo spiral molded to pt plas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1950","description":"Afo spiral molded to pt plas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRE1","description":"ICD-LBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay tumor qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86294","description":"Immunoassay tumor qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIED0","description":"ICD-IIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt support & positioning sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0636","description":"Pt support & positioning sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWD1","description":"ICD-PFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pms2 gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81319","description":"Pms2 gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCE0","description":"ICD-GFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD244","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXB1","description":"ICD-OIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWD0","description":"ICD-PHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQF1","description":"ICD-PKQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone replacement graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7953","description":"Bone replacement graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ophth us quant a only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76511","description":"Ophth us quant a only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVA0","description":"ICD-OKVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronch thermoplsty 1 lobe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31660","description":"Bronch thermoplsty 1 lobe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc membranes fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111T","description":"Rbc membranes fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dimethadione","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6048","description":"Dimethadione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leuprolide acetate suspnsion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9217","description":"Leuprolide acetate suspnsion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00500","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","description":"CPT-00500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAE0","description":"ICD-KFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJE0","description":"ICD-NLJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kit gene targeted seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81272","description":"Kit gene targeted seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67025","description":"Replace eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBF1","description":"ICD-IDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69603","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHA0","description":"ICD-EEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphere bifocal 4.12-7.0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2201","description":"Lens sphere bifocal 4.12-7.0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSC1","description":"ICD-CCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWA1","description":"ICD-GHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICC1","description":"ICD-CICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGD1","description":"ICD-FBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown lengthen hard tissue","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4249","description":"Crown lengthen hard tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXF1","description":"ICD-KEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp geriatr assmt team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0250","description":"Comp geriatr assmt team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ difelikefalin_ 0.1 microgram_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0879","description":"Injection_ difelikefalin_ 0.1 microgram_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUE1","description":"ICD-OGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQE0","description":"ICD-CHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC21","description":"ICD-3KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55725","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUC1","description":"ICD-MDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHE0","description":"ICD-EHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0504","description":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1901","description":"HCPCS-A1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21700","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNA0","description":"ICD-BFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Normal Native Connection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93593","description":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Normal Native Connection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC135","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELC0","description":"ICD-AELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIB1","description":"ICD-EEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUC0","description":"ICD-FGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML51","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUE1","description":"ICD-JBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAD0","description":"ICD-EFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAE1","description":"ICD-EAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20B","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCA0","description":"ICD-NCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAF1","description":"ICD-CGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXD0","description":"ICD-OHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13A","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin pneum/swg pha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5830","description":"Endo knee-shin pneum/swg pha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDD0","description":"ICD-MFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDB1","description":"ICD-FHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJD1","description":"ICD-CGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMA0","description":"ICD-AIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHF1","description":"ICD-FAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","description":"HCPCS-J0169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWB0","description":"ICD-OLWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMC1","description":"ICD-KAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct elbow lat ligmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24344","description":"Reconstruct elbow lat ligmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGE1","description":"ICD-BFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDD0","description":"ICD-JIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"XWRAP_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4204","description":"XWRAP_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver image (3d) with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78206","description":"Liver image (3d) with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHF1","description":"ICD-ABHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEA1","description":"ICD-EHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYC1","description":"ICD-LFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bld inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9625","description":"Bld inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 22 targets (Campylobacter [C. jejuni/C. coli/C.","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0097U","description":"Gastrointestinal pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 22 targets (Campylobacter [C. jejuni/C. coli/C.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nandrolone decanoate 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2320","description":"Nandrolone decanoate 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx head/neck t3-4 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9110","description":"Onc dx head/neck t3-4 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9369","description":"Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ pacing_ transesoph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1756","description":"Cath_ pacing_ transesoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCD0","description":"ICD-KDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYC1","description":"ICD-PKYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCE0","description":"ICD-ODCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDF0","description":"ICD-GDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFB1","description":"ICD-KCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAA1","description":"ICD-IDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOB0","description":"ICD-DAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTC1","description":"ICD-IHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTF0","description":"ICD-BGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSF0","description":"ICD-KGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trach care kit for new trach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4625","description":"Trach care kit for new trach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOA0","description":"ICD-CDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26372","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients Under Hospice Care In The Current Reporting Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0051","description":"Patients Under Hospice Care In The Current Reporting Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PMS2 (PMS1 homolog 2_ mismatch repair system component) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0161U","description":"PMS2 (PMS1 homolog 2_ mismatch repair system component) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3473","description":"Surgical repair of root resorption - molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHD1","description":"ICD-BCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUC1","description":"ICD-FEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEE1","description":"ICD-JIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHD0","description":"ICD-OKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMB1","description":"ICD-EAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair pulmonary atresia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33920","description":"Repair pulmonary atresia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-86581","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","description":"CPT-86581","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Palliative Care Services Provided To Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9988","description":"Palliative Care Services Provided To Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo radical nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50545","description":"Laparo radical nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB241","description":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDC0","description":"ICD-OIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBA1","description":"ICD-CCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22A","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQE0","description":"ICD-PDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIF0","description":"ICD-IDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9897","description":"Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ carmustine (accord)_ not therapeutically equivalent to j9050_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9052","description":"Injection_ carmustine (accord)_ not therapeutically equivalent to j9050_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFF1","description":"ICD-FBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJA1","description":"ICD-OCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clofarabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9027","description":"Clofarabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKE1","description":"ICD-KCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk back check","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5686","description":"Bk back check","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pump uninterrupted infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0455","description":"Pump uninterrupted infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthoped ladies shoes dpth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3216","description":"Orthoped ladies shoes dpth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exam/biopsy of vulva w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56821","description":"Exam/biopsy of vulva w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFB1","description":"ICD-BCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-38226","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","description":"CPT-38226","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXA1","description":"ICD-OKXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RenoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4321","description":"RenoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert epicard eltrd open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33202","description":"Insert epicard eltrd open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ca tx e-stim electr/transduc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4555","description":"Ca tx e-stim electr/transduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1470","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","description":"HCPCS-M1470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33681","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath report nongyn spcmn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0550F","description":"Cytopath report nongyn spcmn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGF0","description":"ICD-CEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLB1","description":"ICD-NFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVE1","description":"ICD-GBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tens suppl 2 lead per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4595","description":"Tens suppl 2 lead per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHD0","description":"ICD-ICHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGF0","description":"ICD-KEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration; with imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10022","description":"Fine needle aspiration; with imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA31","description":"ICD-4IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAD0","description":"ICD-NFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture bacteria anaerobic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87073","description":"Culture bacteria anaerobic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"12-24hr sealed lead acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0733","description":"12-24hr sealed lead acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99242","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Current tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1316","description":"Current tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85018","description":"Hemoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKB0","description":"ICD-GCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMB1","description":"ICD-BGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICA1","description":"ICD-FICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOA1","description":"ICD-DAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQF0","description":"ICD-LEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHB0","description":"ICD-IBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXD0","description":"ICD-NLXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5C","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5147","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","description":"HCPCS-Q5147","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGD1","description":"ICD-CBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLE1","description":"ICD-MHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intra-atrial recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93602","description":"Intra-atrial recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIE1","description":"ICD-GCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28X","description":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sc r ant/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0637","description":"Lso sc r ant/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCD0","description":"ICD-OFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDF1","description":"ICD-ODDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUB0","description":"ICD-EEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23A","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAA0","description":"ICD-GGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBE1","description":"ICD-OEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDB0","description":"ICD-KCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/pseudobulb affect/als","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3756F","description":"Pt w/pseudobulb affect/als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUB1","description":"ICD-MIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin suppl 100 caps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0194","description":"Vitamin suppl 100 caps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient has a reactive hcv antibody test_ and has a follow up hcv viral test that does not detect hcv viremia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1234","description":"Patient has a reactive hcv antibody test_ and has a follow up hcv viral test that does not detect hcv viremia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct angiography chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71275","description":"Ct angiography chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 2 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64494","description":"Inj paravert f jnt l/s 2 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQD1","description":"ICD-OEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE210","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODED0","description":"ICD-ODED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72148","description":"MRI lumbar spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC31","description":"ICD-1CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroconvulsive therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90870","description":"Electroconvulsive therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA31","description":"Low Rehab_ ADL Index 0-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUD1","description":"ICD-MLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCF1","description":"ICD-JDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Group (2 Or More Individuals)_ At Least 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0593T","description":"Health And Well-Being Coaching Face-To-Face; Group (2 Or More Individuals)_ At Least 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art or venous blood tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4750","description":"Art or venous blood tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPE1","description":"ICD-FEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ moderate complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0520","description":"Management of new patient-caregiver dyad with dementia_ moderate complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Preparation And Transmission","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0711T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Preparation And Transmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge resin base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6251","description":"Bridge resin base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX12","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMF0","description":"ICD-EFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress fingers/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26037","description":"Decompress fingers/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEB0","description":"ICD-CGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBC0","description":"ICD-FCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand/finger surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26989","description":"Hand/finger surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2070","description":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal kidney open complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50225","description":"Removal kidney open complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILC1","description":"ICD-EILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ toe caps_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6572","description":"Gradient compression garment_ toe caps_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERC0","description":"ICD-DERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC35","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow inter loc elbow forarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6250","description":"Elbow inter loc elbow forarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKE0","description":"ICD-FHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct extra finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26587","description":"Reconstruct extra finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJC0","description":"ICD-CIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMF0","description":"ICD-OIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYB0","description":"ICD-DEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOF0","description":"ICD-GDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWA1","description":"ICD-KDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWE0","description":"ICD-CIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65285","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal neck/armpit lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38550","description":"Removal neck/armpit lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28H","description":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBD1","description":"ICD-GIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRF0","description":"ICD-CDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUD1","description":"ICD-FBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMB1","description":"ICD-NLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYF1","description":"ICD-LFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","description":"HCPCS-J9174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthe <60 min as docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4256F","description":"Anesthe <60 min as docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFD1","description":"ICD-KDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAD0","description":"ICD-ACAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD120","description":"Special Care Low _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIE1","description":"ICD-GGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50961","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSB0","description":"ICD-OBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCME0","description":"ICD-GCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDD0","description":"ICD-EGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Certolizumab pegol inj 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0717","description":"Certolizumab pegol inj 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPF1","description":"ICD-NEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt no hx act drain 90 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8562","description":"Pt no hx act drain 90 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRC1","description":"ICD-PFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVB1","description":"ICD-CEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCE1","description":"ICD-KDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21423","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht inj noc per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9542","description":"Ht inj noc per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvef>=40% doc normal or mild","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8395","description":"Lvef>=40% doc normal or mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALB1","description":"ICD-EALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQE0","description":"ICD-OFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16376","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16376","description":"CPT-16376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOD1","description":"ICD-OHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJE0","description":"ICD-CCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24A","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTF1","description":"ICD-ADTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWE1","description":"ICD-GDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWC1","description":"ICD-CCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95834","description":"Body muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dem severity classified mod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1491F","description":"Dem severity classified mod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPE1","description":"ICD-BEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag r an/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0648","description":"Lso sag r an/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sealant_ pulmonary_ liquid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2615","description":"Sealant_ pulmonary_ liquid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98970","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO general orthopedic intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibilit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9739","description":"Patient unable to complete the FOTO general orthopedic intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPD1","description":"ICD-CCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHF1","description":"ICD-ODHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKA0","description":"ICD-GDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 30 MCG/0.3 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91312","description":"SARSCOV2 VACCINE BIVALENT 30 MCG/0.3 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25370","description":"Revise radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYD1","description":"ICD-HBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/tr/ext >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12037","description":"Intmd rpr s/tr/ext >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQA0","description":"ICD-OFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhc rn e&m plan svs_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0162","description":"Hhc rn e&m plan svs_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDD1","description":"ICD-GCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Motor speech d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9158","description":"Motor speech d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOB0","description":"ICD-KAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58410","description":"Suspension of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj diagnostic arthroscopy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7872","description":"Tmj diagnostic arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC141","description":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEID1","description":"ICD-GEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68815","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA31","description":"ICD-2FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUF0","description":"ICD-NBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWA0","description":"ICD-GAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDA1","description":"ICD-MGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collect blood from picc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36592","description":"Collect blood from picc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRD0","description":"ICD-PJRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (cervix)_ mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16_ 18_ 31_ 33_ 45_ 52_ 58)_ by real-time nu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0463U","description":"Oncology (cervix)_ mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16_ 18_ 31_ 33_ 45_ 52_ 58)_ by real-time nu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","description":"HCPCS-J2802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anterior gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8002","description":"Anterior gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVB0","description":"ICD-CEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thumb fusion with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26820","description":"Thumb fusion with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0407","description":"HCPCS-A0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB206","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBA0","description":"ICD-NHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2117","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRA0","description":"ICD-LBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMF0","description":"ICD-GEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICC1","description":"ICD-AICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"OPH AMD ALYS 3 GENE VARIANTS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0205U","description":"OPH AMD ALYS 3 GENE VARIANTS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evaluate speech production","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92522","description":"Evaluate speech production","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6517","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","description":"HCPCS-A6517","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA131","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXC1","description":"ICD-CDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFND0","description":"ICD-FFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOF1","description":"ICD-KFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLC0","description":"ICD-MLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28F","description":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAC0","description":"ICD-FBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPD1","description":"ICD-JHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indic for head ct not valid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9533","description":"Indic for head ct not valid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vertebral axial decompressio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9090","description":"Vertebral axial decompressio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral infusion pump sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0791","description":"Parenteral infusion pump sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUC0","description":"ICD-IHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJB1","description":"ICD-NLJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infect control supplies nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8301","description":"Infect control supplies nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELA0","description":"ICD-NELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iv oct for proc addl vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0292T","description":"Iv oct for proc addl vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1042","description":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNF1","description":"ICD-BBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIF0","description":"ICD-NLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0D","description":"Medium Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNC0","description":"ICD-OKNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thorabd diaphr hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43337","description":"Thorabd diaphr hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVE1","description":"ICD-BAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB250","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on eye; iridectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0121U","description":"Anesthesia for procedures on eye; iridectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skilled services of a registered nurse (RN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0495","description":"Skilled services of a registered nurse (RN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXA1","description":"ICD-OEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Co2 breathing response curve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94400","description":"Co2 breathing response curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEB0","description":"ICD-JAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revitalon 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4157","description":"Revitalon 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDB0","description":"ICD-ADDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBB1","description":"ICD-BBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSE1","description":"ICD-HCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev cardrehab qualcardevent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4510F","description":"Prev cardrehab qualcardevent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPE1","description":"ICD-KEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYC0","description":"ICD-GHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX52","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWF1","description":"ICD-CIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIF1","description":"ICD-BCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC101","description":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sp bone algrft struct add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20931","description":"Sp bone algrft struct add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plumb/elec wk hm hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4870","description":"Plumb/elec wk hm hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amino acids mult qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82128","description":"Amino acids mult qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Positional nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92532","description":"Positional nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIB0","description":"ICD-IIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTC1","description":"ICD-CGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXF0","description":"ICD-GCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVD1","description":"ICD-FFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENF1","description":"ICD-NENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ver doc hear loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8565","description":"Ver doc hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nortriptyline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6037","description":"Nortriptyline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETC1","description":"ICD-IETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYB1","description":"ICD-LHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB225","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTB1","description":"ICD-EDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBB0","description":"ICD-IFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWD1","description":"ICD-HHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00212","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","description":"CPT-00212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPC1","description":"ICD-KFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl& replc pulse gen 1 lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33262","description":"Rmvl& replc pulse gen 1 lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatobil syst image w/drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78227","description":"Hepatobil syst image w/drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVF0","description":"ICD-KCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBC0","description":"ICD-EEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5278","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSF1","description":"ICD-GBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUD1","description":"ICD-MGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVF1","description":"ICD-KCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWB0","description":"ICD-GBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYE1","description":"ICD-OJYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQF1","description":"ICD-OIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBF0","description":"ICD-MDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M.pneumon dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87580","description":"M.pneumon dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44360","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTA0","description":"ICD-EDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMC1","description":"ICD-MJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ewho rigid w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3763","description":"Ewho rigid w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGC0","description":"ICD-GEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXE0","description":"ICD-CFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNC1","description":"ICD-NDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQA0","description":"ICD-PFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCC1","description":"ICD-BCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11B","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast adjuvant chemotherapy administered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9829","description":"Breast adjuvant chemotherapy administered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYD1","description":"ICD-LBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKF1","description":"ICD-OCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBME0","description":"ICD-GBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAE1","description":"ICD-KFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66170","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC31","description":"ICD-2JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23550","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLC1","description":"ICD-MHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRA1","description":"ICD-PIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ascorbic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82180","description":"Assay of ascorbic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSD0","description":"ICD-LFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7528","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","description":"HCPCS-J7528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vancomycin hcl (xellia) not therapeutically equivalent to j3370_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3372","description":"Injection_ vancomycin hcl (xellia) not therapeutically equivalent to j3370_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6980","description":"Bridge repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAF0","description":"ICD-BDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSF0","description":"ICD-KCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0910T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","description":"CPT-0910T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYD1","description":"ICD-GCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63103","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services for patient received any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9723","description":"Hospice services for patient received any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove fix space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1555","description":"Remove fix space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEF0","description":"ICD-ADEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tumor imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78802","description":"Tumor imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRE1","description":"ICD-LGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETA0","description":"ICD-AETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLC1","description":"ICD-AGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTF1","description":"ICD-MCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply finger cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29086","description":"Apply finger cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unplnd ret to surg w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9308","description":"Unplnd ret to surg w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46753","description":"Reconstruction of anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt disch to home by day#7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8818","description":"Pt disch to home by day#7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXB1","description":"ICD-FAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACC1","description":"ICD-OACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0501","description":"HCPCS-C0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization admin by intramuscular injection of s (SARS-CoV-2)  vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose form first dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051A","description":"Immunization admin by intramuscular injection of s (SARS-CoV-2)  vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose form first dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA11","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKF0","description":"ICD-GHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55709","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","description":"CPT-55709","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUD0","description":"ICD-AIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYD1","description":"ICD-DIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mobility d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8980","description":"Mobility d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0175","description":"Commode chair foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26185","description":"Remove finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJC0","description":"ICD-NAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUD1","description":"ICD-BHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHF1","description":"ICD-JDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0567U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","description":"CPT-0567U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s)_ with endoscopic cannulation of papilla with direct visual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7544","description":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s)_ with endoscopic cannulation of papilla with direct visual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVA0","description":"ICD-GGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHE0","description":"ICD-AHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPE0","description":"ICD-BFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m bicisate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9557","description":"Tc99m bicisate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq cardiac angio addl art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92921","description":"Prq cardiac angio addl art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hydroceles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55041","description":"Removal of hydroceles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compress burn mask face/neck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6513","description":"Compress burn mask face/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJA0","description":"ICD-BGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00840","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","description":"CPT-00840","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUD1","description":"ICD-GBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWB0","description":"ICD-DCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEE1","description":"ICD-KBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYB0","description":"ICD-CEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICA0","description":"ICD-JICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1023T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","description":"CPT-1023T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHND1","description":"ICD-BHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATC1","description":"ICD-GATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ includes specimen verification including DNA authentication in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0007U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ includes specimen verification including DNA authentication in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPD0","description":"ICD-CAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKC1","description":"ICD-FGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mycophenolate mofetil_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7519","description":"Injection_ mycophenolate mofetil_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYD1","description":"ICD-CGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGC0","description":"ICD-GAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33901","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Docrsn no comm comorb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9232","description":"Docrsn no comm comorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNB1","description":"ICD-OBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release thumb contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26508","description":"Release thumb contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCF0","description":"ICD-KCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABA1","description":"ICD-MABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRA0","description":"ICD-PHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMC1","description":"ICD-KDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFE0","description":"ICD-KHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFME1","description":"ICD-NFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTA1","description":"ICD-MGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDD1","description":"ICD-ACDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart infarct image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78466","description":"Heart infarct image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYF1","description":"ICD-KCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive brief counseling if identified as an unhealthy alcohol user_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2202","description":"Patient did not receive brief counseling if identified as an unhealthy alcohol user_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0696T","description":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEA0","description":"ICD-OCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWF0","description":"ICD-CDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hypertonic saline sol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7131","description":"Hypertonic saline sol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-60660","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","description":"CPT-60660","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal)_ microRNA_ RT-PCR expression profiling of miR-31-3p_ formalin-fixed paraffin-embedded tissue_ algorithm reported as an expression score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0069U","description":"Oncology (colorectal)_ microRNA_ RT-PCR expression profiling of miR-31-3p_ formalin-fixed paraffin-embedded tissue_ algorithm reported as an expression score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37244","description":"Vasc embolize/occlude bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAA1","description":"ICD-CFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pooling blood platelets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86965","description":"Pooling blood platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited dental tx transition","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8020","description":"Limited dental tx transition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIB1","description":"ICD-FDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22214","description":"Incis 1 vertebral seg lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIC1","description":"ICD-OFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect enlarged toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28341","description":"Resect enlarged toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEF1","description":"ICD-CHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"corticotomy - one to three teeth or tooth spaces_ per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7296","description":"corticotomy - one to three teeth or tooth spaces_ per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVB1","description":"ICD-NIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5942","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5942","description":"CDT-D5942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB225","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elevating whlchair leg rests","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0195","description":"Elevating whlchair leg rests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx esophageal mets recur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9098","description":"Onc dx esophageal mets recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumo imm status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1022F","description":"Pneumo imm status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITB0","description":"ICD-AITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42200","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEB0","description":"ICD-JCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDE1","description":"ICD-OGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25690","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp carotid-vertebral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35642","description":"Art byp carotid-vertebral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXC0","description":"ICD-OAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALA1","description":"ICD-MALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gi prophylaxis for nsaid rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4017F","description":"Gi prophylaxis for nsaid rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cellesta cord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4214","description":"Cellesta cord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Services provided as part of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9990","description":"Services provided as part of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOE1","description":"ICD-GEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9483","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27310","description":"Exploration of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red cell survival kinetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78135","description":"Red cell survival kinetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES326","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFC0","description":"ICD-JCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20B","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAB1","description":"ICD-AEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPC0","description":"ICD-FFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB136","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fecal microbiota prep instil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0455","description":"Fecal microbiota prep instil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCB0","description":"ICD-ADCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD135","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQF0","description":"ICD-LDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQE0","description":"ICD-OEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLD1","description":"ICD-OHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd endo mucosal resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43254","description":"Egd endo mucosal resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDC0","description":"ICD-MCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXF1","description":"ICD-GFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68328","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB43","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNC1","description":"ICD-GHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIC1","description":"ICD-JHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lancets per box","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4259","description":"Lancets per box","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFB1","description":"ICD-NGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLC0","description":"ICD-AFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQE1","description":"ICD-OEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15958","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orion_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4276","description":"Orion_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Azacitidine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9025","description":"Azacitidine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEC1","description":"ICD-EAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Ocular (Ovemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92518","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Ocular (Ovemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVC0","description":"ICD-FIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQC0","description":"ICD-OJQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXB1","description":"ICD-FIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace/irrigate catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62225","description":"Replace/irrigate catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunofluorescence_ per specimen; each additional single antibody stain procedure (List separately in addition to code for primary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0846T","description":"Digitization of glass microscope slides for immunofluorescence_ per specimen; each additional single antibody stain procedure (List separately in addition to code for primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMB1","description":"ICD-MGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX56","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEA1","description":"ICD-GAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope procedure liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47379","description":"Laparoscope procedure liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWF1","description":"ICD-HEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11106","description":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99305","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYD0","description":"ICD-KHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat eyelid by injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68200","description":"Treat eyelid by injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCE1","description":"ICD-NHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUB0","description":"ICD-JIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGE0","description":"ICD-CFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE117","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBC0","description":"ICD-EDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMC0","description":"ICD-OHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUA1","description":"ICD-GFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIF1","description":"ICD-EBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I131 tositumomab_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9545","description":"I131 tositumomab_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRB1","description":"ICD-KGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEF0","description":"ICD-EAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mohs 1 stage h/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17311","description":"Mohs 1 stage h/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraop oct breast cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0353T","description":"Intraop oct breast cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exoskeletal ak ultra-light m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5790","description":"Exoskeletal ak ultra-light m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj bulking agent anal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8605","description":"Inj bulking agent anal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSD0","description":"ICD-HGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRC0","description":"ICD-HGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRD1","description":"ICD-HCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMF0","description":"ICD-FGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6090","description":"Repair implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal abdomen lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38564","description":"Removal abdomen lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUD1","description":"ICD-CIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18A","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIE0","description":"ICD-ICIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFC0","description":"ICD-ODFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMA1","description":"ICD-JFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFF1","description":"ICD-KGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPA1","description":"ICD-OFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit alpha-1-proteinas diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9346","description":"Hit alpha-1-proteinas diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMC0","description":"ICD-BCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75451","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45379","description":"Colonoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAA1","description":"ICD-MFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD211","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXA0","description":"ICD-BHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPC0","description":"ICD-GCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNA1","description":"ICD-FCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepc mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8549","description":"Hepc mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCE0","description":"ICD-OJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41822","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlh w/t/o 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58571","description":"Tlh w/t/o 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGE1","description":"ICD-KBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC245","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKB0","description":"ICD-BEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43652","description":"Laparoscopy vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELE1","description":"ICD-FELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMA0","description":"ICD-MAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTD1","description":"ICD-NCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQF1","description":"ICD-PIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31505","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair rect/bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45800","description":"Repair rect/bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVE1","description":"ICD-OBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX14","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTD0","description":"ICD-GFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18E","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj tbo filgrastim 1 microg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1447","description":"Inj tbo filgrastim 1 microg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAB0","description":"ICD-BAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0302","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0302","description":"CDT-D0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0752","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","description":"HCPCS-J0752","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKC0","description":"ICD-GAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMC1","description":"ICD-EBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie_ ex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81211","description":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie_ ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dtap-ipv/hib vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90698","description":"Dtap-ipv/hib vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icut allergy test-delayed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95028","description":"Icut allergy test-delayed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXB0","description":"ICD-FAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker wheel attachment_pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0155","description":"Walker wheel attachment_pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUB1","description":"ICD-EHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech lang d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9176","description":"Speech lang d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2110","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGF1","description":"ICD-NJGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC31","description":"ICD-4IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/4.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2309","description":"Lens sphc trifocal 4.25-7/4.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant connecting bar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6055","description":"Implant connecting bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; BILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53451","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; BILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24575","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD120","description":"Clinically Complex _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPC1","description":"ICD-JDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGC1","description":"ICD-NHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMF1","description":"ICD-MGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pi volunteer ambulance co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0432","description":"Pi volunteer ambulance co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1 bodytemp >=35.5cw/in 30min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4559F","description":"1 bodytemp >=35.5cw/in 30min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0660","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","description":"HCPCS-G0660","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIB0","description":"ICD-EEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radxps in end rprt4fluro pxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6045F","description":"Radxps in end rprt4fluro pxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJF1","description":"ICD-FHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICE0","description":"ICD-KICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETB0","description":"ICD-KETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23C","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2]_ oxyhemoglobin [ctHbO2]_ deoxyhemoglobin [ctHbR]_ papillary and reticular dermal hemoglobin concentrat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0061U","description":"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2]_ oxyhemoglobin [ctHbO2]_ deoxyhemoglobin [ctHbR]_ papillary and reticular dermal hemoglobin concentrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPA0","description":"ICD-FAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental inlay metalic 1 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2510","description":"Dental inlay metalic 1 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5C","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m pyrophosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9538","description":"Tc99m pyrophosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rprt bone scint xref w xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3570F","description":"Rprt bone scint xref w xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14D","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAD1","description":"ICD-KGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mapcp demo state","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9151","description":"Mapcp demo state","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHE1","description":"ICD-NLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDC0","description":"ICD-BCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited autopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88036","description":"Limited autopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIE0","description":"ICD-CBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe molded plastazote cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3253","description":"Shoe molded plastazote cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abscess imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78806","description":"Abscess imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAD0","description":"ICD-NJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj foramen epidural l/s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64483","description":"Inj foramen epidural l/s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJD0","description":"ICD-FDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXA0","description":"ICD-JAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJB1","description":"ICD-JIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIA1","description":"ICD-KCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61520","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete aa_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4303","description":"Complete aa_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","description":"CPT-00635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for lef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7539","description":"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for lef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8G","description":"Medium Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD105","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQE1","description":"ICD-OHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNE1","description":"ICD-GDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clean rem part denture mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9935","description":"Clean rem part denture mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9615","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","description":"HCPCS-A9615","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg thorac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22212","description":"Incis 1 vertebral seg thorac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion/graft of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25810","description":"Fusion/graft of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Histochemical stains add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88314","description":"Histochemical stains add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whole mitochondrial genome","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81465","description":"Whole mitochondrial genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUB0","description":"ICD-EDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNA0","description":"ICD-GBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXF1","description":"ICD-NCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAND0","description":"ICD-GAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHB1","description":"ICD-CIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNC1","description":"ICD-BBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auricular electrostimulation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8930","description":"Auricular electrostimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQC0","description":"ICD-DBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUC1","description":"ICD-NFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPD0","description":"ICD-GGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC241","description":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDC1","description":"ICD-GHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVF0","description":"ICD-JFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59841","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHF0","description":"ICD-GDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSB0","description":"ICD-OJSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIC0","description":"ICD-MLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSD0","description":"ICD-GBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc mechanical fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85547","description":"Rbc mechanical fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBA0","description":"ICD-CBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE135","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIE0","description":"ICD-OKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAA1","description":"ICD-EGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNE0","description":"ICD-GDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 100","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88249","description":"Chromosome analysis 100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA241","description":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVB0","description":"ICD-NEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGA1","description":"ICD-OEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6794","description":"Crown titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of breast tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19300","description":"Removal of breast tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opioid &opiate analog 5/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80364","description":"Opioid &opiate analog 5/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGE0","description":"ICD-OCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree_ derived from coronary angiogram data_ for re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0523T","description":"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree_ derived from coronary angiogram data_ for re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUD0","description":"ICD-CFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQA1","description":"ICD-OGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRA0","description":"ICD-CBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16030","description":"Dress/debrid p-thick burn l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMF0","description":"ICD-ODMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDC1","description":"ICD-FIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUC1","description":"ICD-CFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIF0","description":"ICD-OKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthodont high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6210","description":"Prosthodont high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pten gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81322","description":"Pten gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gas system stationary compre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0425","description":"Gas system stationary compre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pros sock single ply bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8470","description":"Pros sock single ply bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHE0","description":"ICD-IAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2047","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2047","description":"HCPCS-A2047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHC1","description":"ICD-BIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKA1","description":"ICD-NJKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9191","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9191","description":"HCPCS-J9191","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLD1","description":"ICD-NKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGC1","description":"ICD-NAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1608","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1608","description":"HCPCS-C1608","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0485T","description":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMF1","description":"ICD-OAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOC1","description":"ICD-KDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brca1 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81215","description":"Brca1 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFB0","description":"ICD-JHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIF0","description":"ICD-MDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37289","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","description":"CPT-37289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEE0","description":"ICD-BHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIE1","description":"ICD-IDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Derm autograft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15131","description":"Derm autograft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj facial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64402","description":"N block inj facial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOB1","description":"ICD-PIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiograph head w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70546","description":"Mr angiograph head w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKC0","description":"ICD-CHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTB0","description":"ICD-BCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBB1","description":"ICD-ODBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Measles and rubella virus vaccine_ live_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90708","description":"Measles and rubella virus vaccine_ live_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKE0","description":"ICD-GIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/sm tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34800","description":"Endovas aaa repr w/sm tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSE0","description":"ICD-DGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clin node stgng docdb/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3323F","description":"Clin node stgng docdb/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJA0","description":"ICD-NBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent motor threshold re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0892T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent motor threshold re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHA1","description":"ICD-IAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIC0","description":"ICD-EIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABC1","description":"ICD-IABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJA1","description":"ICD-NBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1388","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","description":"HCPCS-M1388","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef blenderized foods","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4149","description":"Ef blenderized foods","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCB1","description":"ICD-CFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of feces/urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84577","description":"Assay of feces/urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLB1","description":"ICD-JHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8F","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIE0","description":"ICD-OCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66999","description":"Eye surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Received At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2154","description":"Patient Received At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (Stress Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 72 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0292U","description":"Psychiatry (Stress Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 72 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDD0","description":"ICD-FHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGME1","description":"ICD-GGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00542","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","description":"CPT-00542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOD0","description":"ICD-OAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCB1","description":"ICD-IGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evasc rpr iliac art bifr s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0255T","description":"Evasc rpr iliac art bifr s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bevacizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9257","description":"Bevacizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMF1","description":"ICD-GBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFD1","description":"ICD-OCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28430","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSE0","description":"ICD-GHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Outpt iv insulin tx any mea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9147","description":"Outpt iv insulin tx any mea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUD1","description":"ICD-BDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUD0","description":"ICD-OGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISB0","description":"ICD-DISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family/couple counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1006","description":"Family/couple counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9096","description":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ ep_ cool-tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2630","description":"Cath_ ep_ cool-tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair anal fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46288","description":"Repair anal fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEB1","description":"ICD-FDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dsm-5 info mdd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1040F","description":"Dsm-5 info mdd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Beta-bloc rx pt w/abn lvef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8450","description":"Beta-bloc rx pt w/abn lvef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transposition of vein valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34510","description":"Transposition of vein valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid trnso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43180","description":"Esophagoscopy rigid trnso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA32","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medroxyprogesterone acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1050","description":"Medroxyprogesterone acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of serotonin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84260","description":"Assay of serotonin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANC1","description":"ICD-NANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temp anchorage dev w/o flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7294","description":"Temp anchorage dev w/o flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKB1","description":"ICD-BHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAA1","description":"ICD-AFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDD1","description":"ICD-IDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLE0","description":"ICD-NJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ganciclovir sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1570","description":"Ganciclovir sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cogenex Flowable Amnion_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4230","description":"Cogenex Flowable Amnion_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAE1","description":"ICD-FHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBD0","description":"ICD-BEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX07","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lo sag ri an/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0642","description":"Lo sag ri an/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66160","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC210","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSD0","description":"ICD-CGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of foot tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28222","description":"Release of foot tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELA0","description":"ICD-AELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILD0","description":"ICD-GILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPE1","description":"ICD-GDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reposition l ventric lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33226","description":"Reposition l ventric lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1118","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRE1","description":"ICD-KCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVA1","description":"ICD-CGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coordinated specialty care_ team-based_ for first episode psychosis_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2040","description":"Coordinated specialty care_ team-based_ for first episode psychosis_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlh w/t/o uterus over 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58573","description":"Tlh w/t/o uterus over 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPB0","description":"ICD-BAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10C","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9626","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPA0","description":"ICD-BEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTD1","description":"ICD-BGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antisperm antibodies test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3655","description":"Antisperm antibodies test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCC0","description":"ICD-NCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External radiation dosimetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77399","description":"External radiation dosimetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL51","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86408","description":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xray control catheter change","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75984","description":"Xray control catheter change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLD1","description":"ICD-MFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interstitial radiation source application; intermediate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77777","description":"Interstitial radiation source application; intermediate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBD1","description":"ICD-FFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27005","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ot evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97003","description":"Ot evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKA0","description":"ICD-NLKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral speech device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92597","description":"Oral speech device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEE0","description":"ICD-EGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKE1","description":"ICD-NKKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDA1","description":"ICD-KDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC106","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self care mngment training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97535","description":"Self care mngment training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILC1","description":"ICD-BILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagosc flex trnsn biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43198","description":"Esophagosc flex trnsn biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQA0","description":"ICD-PLQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9170","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9170","description":"HCPCS-C9170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dostarlimab-gxly_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9272","description":"Injection_ dostarlimab-gxly_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGE1","description":"ICD-NLGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKE0","description":"ICD-CHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAC1","description":"ICD-EAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFC1","description":"ICD-JHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9311","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9311","description":"HCPCS-C9311","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUB0","description":"ICD-CFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMD1","description":"ICD-ABMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Darbepoetin alfa_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0882","description":"Darbepoetin alfa_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKD1","description":"ICD-KCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDD1","description":"ICD-ECDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNE0","description":"ICD-NJNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXB1","description":"ICD-NLXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUB0","description":"ICD-JDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDD0","description":"ICD-EFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Medication Not Otherwise Specified; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group The","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2075","description":"Medication Assisted Treatment_ Medication Not Otherwise Specified; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUF0","description":"ICD-IBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Counterimmunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86185","description":"Counterimmunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1030","description":"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIND1","description":"ICD-GIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42425","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPC1","description":"ICD-FIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1705","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1705","description":"HCPCS-A1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSE1","description":"ICD-GBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8D","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASF1","description":"ICD-HASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00794","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","description":"CPT-00794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOF0","description":"ICD-PEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0966T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","description":"CPT-0966T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ elotuzumab_ 1mg (Empliciti)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9477","description":"Injection_ elotuzumab_ 1mg (Empliciti)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPE0","description":"ICD-BIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2181","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHD1","description":"ICD-BGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNE0","description":"ICD-BCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLE0","description":"ICD-EFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEF0","description":"ICD-IBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICE0","description":"ICD-CICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvef >/=40% systolic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3022F","description":"Lvef >/=40% systolic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKE1","description":"ICD-NGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tonsils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42825","description":"Removal of tonsils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption study (eg_ Schilling test); with intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78271","description":"Vitamin B-12 absorption study (eg_ Schilling test); with intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1947","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1947","description":"HCPCS-J1947","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55110","description":"Explore scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00906","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","description":"CPT-00906","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA16","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76828","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup gauntlet plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4013","description":"Cast sup gauntlet plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70487","description":"Ct maxillofacial w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay infectious agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86317","description":"Immunoassay infectious agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nutritional support offered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4551F","description":"Nutritional support offered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWA1","description":"ICD-DFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Semen anal sperm detection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89321","description":"Semen anal sperm detection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65780","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0804","description":"HCPCS-C0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMD0","description":"ICD-AIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45120","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGME0","description":"ICD-NGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTF1","description":"ICD-EBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABF0","description":"ICD-FABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDD0","description":"ICD-CIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc iliac repr w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34900","description":"Endovasc iliac repr w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALC0","description":"ICD-GALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26428","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELB1","description":"ICD-EELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVF0","description":"ICD-BFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTB1","description":"ICD-EHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ect provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4066F","description":"Ect provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEE0","description":"ICD-OKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQE0","description":"ICD-DDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFB0","description":"ICD-GGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNC1","description":"ICD-BFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATA1","description":"ICD-FATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no follow imag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9549","description":"Doc med reas no follow imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD110","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA211","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Procainamide hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2690","description":"Procainamide hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRF1","description":"ICD-DFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSB0","description":"ICD-LFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAC1","description":"ICD-MCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Youth size brief/diaper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4533","description":"Youth size brief/diaper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1607","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1607","description":"HCPCS-C1607","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Front caster assem complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0077","description":"Front caster assem complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clsd red simpl mandible fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7640","description":"Clsd red simpl mandible fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUA1","description":"ICD-IHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEB1","description":"ICD-BBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v auto redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88166","description":"Cytopath tbs c/v auto redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITD0","description":"ICD-KITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heat lamp with stand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0205","description":"Heat lamp with stand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral con def inter plt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5958","description":"Intraoral con def inter plt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye/attach implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65105","description":"Remove eye/attach implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision/drain abscess extra","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7521","description":"Incision/drain abscess extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGC0","description":"ICD-FIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Support broker waiver/15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2041","description":"Support broker waiver/15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRF1","description":"ICD-DDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0041A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit interim cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5502","description":"Hit interim cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescrl fuse w/ instr l5-s1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22586","description":"Prescrl fuse w/ instr l5-s1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB140","description":"Special Care High _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd w/transmural drain cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43240","description":"Egd w/transmural drain cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dissect brain w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62161","description":"Dissect brain w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ avelumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9023","description":"Injection_ avelumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAD1","description":"ICD-FEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHE0","description":"ICD-OAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXD1","description":"ICD-BGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0549U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","description":"CPT-0549U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lyse chest fibrin subq day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32562","description":"Lyse chest fibrin subq day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUA1","description":"ICD-EEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKF1","description":"ICD-JEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFF1","description":"ICD-GHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUD0","description":"ICD-BIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25605","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms and identification of 16 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0321U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms and identification of 16 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYF1","description":"ICD-HCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6005","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALD1","description":"ICD-IALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBE1","description":"ICD-EFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Modification of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92325","description":"Modification of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTC1","description":"ICD-NGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25040","description":"Explore/treat wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDA0","description":"ICD-NLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMC0","description":"ICD-ADMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFF0","description":"ICD-KFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYC0","description":"ICD-PGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJB0","description":"ICD-JBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA21","description":"ICD-2IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQD0","description":"ICD-OJQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alefacept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0215","description":"Alefacept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)–based antimicrobial susceptibility for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0311U","description":"Infectious disease (bacterial)_ quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)–based antimicrobial susceptibility for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYE0","description":"ICD-GIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA31","description":"ICD-2AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUF1","description":"ICD-NIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prefabricated porcelain/ceramic crown - permanent tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2928","description":"Prefabricated porcelain/ceramic crown - permanent tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOC1","description":"ICD-GGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGB1","description":"ICD-KEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0121A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Csit perf sx or high chd rsk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8966","description":"Csit perf sx or high chd rsk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPE0","description":"ICD-KFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPA1","description":"ICD-JDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upr/l xtremity art 2 levels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93922","description":"Upr/l xtremity art 2 levels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWF1","description":"ICD-KHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLF1","description":"ICD-OFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAF1","description":"ICD-FGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWE1","description":"ICD-OCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCF1","description":"ICD-IBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Forehead flap w/vasc pedicle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15731","description":"Forehead flap w/vasc pedicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply rigid leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29445","description":"Apply rigid leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise tendon forearm/wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25109","description":"Excise tendon forearm/wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"User adjustable heel height","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5990","description":"User adjustable heel height","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOA1","description":"ICD-PHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQA0","description":"ICD-LEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart vessel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33500","description":"Repair heart vessel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOA1","description":"ICD-GFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heparin-protamine tolerance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85530","description":"Heparin-protamine tolerance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNB1","description":"ICD-OHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCE1","description":"ICD-MGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHA1","description":"ICD-FDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse pancreas cyst and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48540","description":"Fuse pancreas cyst and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDD1","description":"ICD-AIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBF1","description":"ICD-OFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMC1","description":"ICD-BIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64658","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","description":"CPT-64658","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTA1","description":"ICD-CHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFE0","description":"ICD-JEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAE1","description":"ICD-AAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr fe/e/en/l/m 20.1-30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12017","description":"Rpr fe/e/en/l/m 20.1-30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUC1","description":"ICD-MAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post >=4srfc resinbase cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2394","description":"Post >=4srfc resinbase cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXF0","description":"ICD-OEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBA0","description":"ICD-MDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILF1","description":"ICD-EILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIC1","description":"ICD-KAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methocarbamol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2800","description":"Methocarbamol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGF1","description":"ICD-BBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA21","description":"ICD-4BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJD0","description":"ICD-FHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETC1","description":"ICD-OETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33465","description":"Replace tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILA0","description":"ICD-CILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJF0","description":"ICD-KEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICA1","description":"ICD-JICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy for lvrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32672","description":"Thoracoscopy for lvrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGC1","description":"ICD-FGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA160","description":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic incision larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31320","description":"Diagnostic incision larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bleomycin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9040","description":"Bleomycin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-eval post-op visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0171","description":"Re-eval post-op visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAB1","description":"ICD-MHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX21","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of volatiles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84600","description":"Assay of volatiles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQF1","description":"ICD-KAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"remove erupted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7210","description":"remove erupted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl bat t.e.n.s. own by pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4630","description":"Repl bat t.e.n.s. own by pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIB0","description":"ICD-EDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAB0","description":"ICD-IGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE206","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHB0","description":"ICD-OEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4393","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","description":"HCPCS-Q4393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMF1","description":"ICD-NGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGC0","description":"ICD-GDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Homemaker service nos /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5131","description":"Homemaker service nos /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES116","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEF1","description":"ICD-CGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of urethra abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53060","description":"Drainage of urethra abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPD0","description":"ICD-OKPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAE0","description":"ICD-IFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gjb2 gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81253","description":"Gjb2 gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIC0","description":"ICD-NLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28F","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA121","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLF0","description":"ICD-FGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGE0","description":"ICD-JAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mesna injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9209","description":"Mesna injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCID0","description":"ICD-KCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whfo w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3809","description":"Whfo w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlorothiazide sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1205","description":"Chlorothiazide sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDD0","description":"ICD-GBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSA1","description":"ICD-CDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBD1","description":"ICD-OEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko derot ant cruciate custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1840","description":"Ko derot ant cruciate custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1552","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","description":"HCPCS-J1552","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28605","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9879","description":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icm device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93290","description":"Icm device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrcp talk b/4 antiv txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4159F","description":"Contrcp talk b/4 antiv txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise excessive skin leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15833","description":"Excise excessive skin leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLB0","description":"ICD-FFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAD1","description":"ICD-MJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNB0","description":"ICD-KBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ includes angiopla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9764","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ includes angiopla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Restrata minimatrix_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2026","description":"Restrata minimatrix_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJE1","description":"ICD-NDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser surgery eye strands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67031","description":"Laser surgery eye strands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJC1","description":"ICD-JEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRD1","description":"ICD-LCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDF0","description":"ICD-BGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","description":"HCPCS-J0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-corrosive finish","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2780","description":"Non-corrosive finish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Determine refractive state","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92015","description":"Determine refractive state","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mogamulizumab-kpkc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9038","description":"Injection_ mogamulizumab-kpkc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNB1","description":"ICD-OKNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUD1","description":"ICD-ODUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilated macul exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2019F","description":"Dilated macul exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVF1","description":"ICD-GEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr e/n/e/l10.1-30sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14061","description":"Tis trnfr e/n/e/l10.1-30sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFB0","description":"ICD-KIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj ceftolozane tazobactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0695","description":"Inj ceftolozane tazobactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) that follow-up imaging is indicated (e.g._ patient has a known malignancy that can metastasize_ other medical reason(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9755","description":"Documentation of medical reason(s) that follow-up imaging is indicated (e.g._ patient has a known malignancy that can metastasize_ other medical reason(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ elastic long stretch_ linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6597","description":"Gradient compression bandage roll_ elastic long stretch_ linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAND0","description":"ICD-KAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMF0","description":"ICD-NIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJA0","description":"ICD-JGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHD0","description":"ICD-KHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cognitive test by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96125","description":"Cognitive test by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICC0","description":"ICD-CICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation toe & metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28810","description":"Amputation toe & metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVA0","description":"ICD-NBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCA0","description":"ICD-BCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"WoundPlus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4326","description":"WoundPlus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq tx nasoethmoid fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21340","description":"Perq tx nasoethmoid fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX42","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc serum pretx incubj drugs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86975","description":"Rbc serum pretx incubj drugs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBB1","description":"ICD-BFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not rcvng warf thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4301F","description":"Pt not rcvng warf thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUB1","description":"ICD-NAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interferential stim 4 chan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8131","description":"Interferential stim 4 chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine incon plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0509F","description":"Urine incon plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVE1","description":"ICD-KDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLE0","description":"ICD-OBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52305","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHE0","description":"ICD-GBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHA1","description":"ICD-GGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFF1","description":"ICD-CGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB255","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWE1","description":"ICD-GFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUF1","description":"ICD-FEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77063","description":"Breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare heart-aorta conduit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33404","description":"Prepare heart-aorta conduit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCC0","description":"ICD-BCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPF1","description":"ICD-JFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHC1","description":"ICD-BAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBE0","description":"ICD-NCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADF0","description":"ICD-OADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relieve pressure on nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64722","description":"Relieve pressure on nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear exam of tear flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78660","description":"Nuclear exam of tear flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29044","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA31","description":"ICD-3LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38510","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQB0","description":"ICD-GBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I&d abscess p-spine l/s/ls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22015","description":"I&d abscess p-spine l/s/ls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27485","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain bl w/cath insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51102","description":"Drain bl w/cath insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALD1","description":"ICD-EALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77412","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert xdrl body thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63302","description":"Remove vert xdrl body thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct thorax w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71270","description":"Ct thorax w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cus elbo skt in for con/atyp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6696","description":"Cus elbo skt in for con/atyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47610","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin-oxygen affinity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82820","description":"Hemoglobin-oxygen affinity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXE0","description":"ICD-OEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFA0","description":"ICD-OJFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ non-duplicated gene when duplication/multip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0074U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ non-duplicated gene when duplication/multip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAF0","description":"ICD-OEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33665","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng arm splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4019","description":"Cast sup lng arm splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special eye evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92060","description":"Special eye evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56605","description":"Biopsy of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBF1","description":"ICD-BGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1271","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","description":"HCPCS-J1271","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4C","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBC1","description":"ICD-OJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99379","description":"Nursing fac care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAC0","description":"ICD-FCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHB1","description":"ICD-OAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cushioned headrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0955","description":"Cushioned headrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55840","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQE1","description":"ICD-CFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHB1","description":"ICD-EIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD205","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWE0","description":"ICD-OGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWC0","description":"ICD-KGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGC0","description":"ICD-NDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYC0","description":"ICD-GEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina wall complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57110","description":"Remove vagina wall complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEA0","description":"ICD-JDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUC0","description":"ICD-GAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0597U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","description":"CPT-0597U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20705","description":"Removal Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No screening performed_ partial screening performed or positive screen without recommendations and reason is not given or otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9921","description":"No screening performed_ partial screening performed or positive screen without recommendations and reason is not given or otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPB1","description":"ICD-FGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt=d(rh)- and unsensitized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3290F","description":"Pt=d(rh)- and unsensitized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHC1","description":"ICD-IGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICF1","description":"ICD-MICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelets Pathogen Reduced Ea Unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9988","description":"Platelets Pathogen Reduced Ea Unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDA1","description":"ICD-NIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUD1","description":"ICD-BEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRE0","description":"ICD-PBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33845","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thrombolytic art therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37211","description":"Thrombolytic art therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen crosslinks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82523","description":"Collagen crosslinks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPF1","description":"ICD-KFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRA1","description":"ICD-OBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFF0","description":"ICD-BCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ATXN10 (ataxin 10) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81183","description":"ATXN10 (ataxin 10) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other pt/ot  d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8992","description":"Other pt/ot  d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMC0","description":"ICD-NJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18C","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX32","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXD0","description":"ICD-KDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVB1","description":"ICD-OAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl trifocal over 12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2314","description":"Lens sphcyl trifocal over 12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vacc 2 dose adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90739","description":"Hepb vacc 2 dose adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLA0","description":"ICD-JHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay activated protein c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85307","description":"Assay activated protein c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi_ antibody detection of 5 recombinant protein groups_ by immunoblot_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0041U","description":"Borrelia burgdorferi_ antibody detection of 5 recombinant protein groups_ by immunoblot_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESA1","description":"ICD-CESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIB0","description":"ICD-EFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMB0","description":"ICD-CDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA21","description":"ICD-4JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of brain tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61545","description":"Excision of brain tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBF0","description":"ICD-IGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt offered tx for pseudobulb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4541F","description":"Pt offered tx for pseudobulb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPE0","description":"ICD-OFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBF0","description":"ICD-NGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUC0","description":"ICD-KFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Igh gene rearrange amp meth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81261","description":"Igh gene rearrange amp meth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deliver placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59414","description":"Deliver placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA22","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluorescent antibody titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86256","description":"Fluorescent antibody titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preparation for bladder xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51605","description":"Preparation for bladder xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDC1","description":"ICD-CCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYC1","description":"ICD-DBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC31","description":"ICD-1BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stereotactic body radiation therapy_ treatment delivery_ per fraction to 1 or more lesions_ including image guidance and real-time positron emissions-based delivery adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9795","description":"Stereotactic body radiation therapy_ treatment delivery_ per fraction to 1 or more lesions_ including image guidance and real-time positron emissions-based delivery adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optx medial ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27766","description":"Optx medial ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESA1","description":"ICD-HESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRD0","description":"ICD-OBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWB1","description":"ICD-OLWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma_ sessile serrated polyp_ or sessile serrated adenoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9934","description":"Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma_ sessile serrated polyp_ or sessile serrated adenoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLD1","description":"ICD-OKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIC0","description":"ICD-CFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of large bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44025","description":"Incision of large bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAB0","description":"ICD-MKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOB0","description":"ICD-OLOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAB0","description":"ICD-OFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7558","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESE0","description":"ICD-PESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBF0","description":"ICD-KHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lanreotide_ (Cipla)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1932","description":"Injection_ lanreotide_ (Cipla)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHE1","description":"ICD-AFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE235","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Appendectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44955","description":"Appendectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51520","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear rx intracav admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79200","description":"Nuclear rx intracav admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lodging per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9976","description":"Lodging per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86409","description":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA136","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1349","description":"Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anticoag thx rx at dischrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4075F","description":"Anticoag thx rx at dischrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELE0","description":"ICD-MELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYE0","description":"ICD-KDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNF0","description":"ICD-OKNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAND1","description":"ICD-CAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGC1","description":"ICD-CGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vabra aspirator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4480","description":"Vabra aspirator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDA1","description":"ICD-OIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0563","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","description":"HCPCS-G0563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colon ca screen;barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0106","description":"Colon ca screen;barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0534U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","description":"CPT-0534U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCF0","description":"ICD-JBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVA1","description":"ICD-OFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjust bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20693","description":"Adjust bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCD1","description":"ICD-EFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAF0","description":"ICD-CEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Isch containmt/narrow m-l so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5649","description":"Isch containmt/narrow m-l so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYC0","description":"ICD-PKYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay 17- ketosteroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83586","description":"Assay 17- ketosteroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bitolterol mesylate comp unt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7629","description":"Bitolterol mesylate comp unt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEB0","description":"ICD-FBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOA0","description":"ICD-LFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla class i phenotype qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86830","description":"Hla class i phenotype qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD124","description":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQC1","description":"ICD-LEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anastomosis/artery-aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33606","description":"Anastomosis/artery-aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIC0","description":"ICD-JEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth kidney transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86851","description":"Anesth kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAD1","description":"ICD-NCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQA0","description":"ICD-PKQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heredtry nurondcrn tum dsrdr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81438","description":"Heredtry nurondcrn tum dsrdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVA1","description":"ICD-NDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI w/cont_ breast_  uni","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8903","description":"MRI w/cont_ breast_  uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHC1","description":"ICD-BGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISC1","description":"ICD-CISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTD0","description":"ICD-NCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWA0","description":"ICD-GGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99202","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDE0","description":"ICD-MEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22D","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYB0","description":"ICD-PKYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVB1","description":"ICD-JBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAA1","description":"ICD-FFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping)_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0314U","description":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping)_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6541","description":"Gc stocking waistlngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cva device obstruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75901","description":"Remove cva device obstruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18C","description":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCB1","description":"ICD-FFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laminate labial veneer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2960","description":"Laminate labial veneer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHC0","description":"ICD-CIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4425","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","description":"HCPCS-Q4425","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject trigger points 3/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20553","description":"Inject trigger points 3/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGB0","description":"ICD-GIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFF0","description":"ICD-JBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTB0","description":"ICD-AFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSB0","description":"ICD-PKSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Over-bed table","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0274","description":"Over-bed table","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vertebroplasty addl inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22512","description":"Vertebroplasty addl inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tagraxofusp-erzs_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9269","description":"Injection_ tagraxofusp-erzs_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPC0","description":"ICD-GGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj fe-based mr contrast_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9953","description":"Inj fe-based mr contrast_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCE0","description":"ICD-GCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33400","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGB1","description":"ICD-KIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18G","description":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth skull drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21451","description":"Anesth skull drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSB1","description":"ICD-CDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTD0","description":"ICD-GGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQB0","description":"ICD-KIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIB1","description":"ICD-CIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGID0","description":"ICD-AGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYC1","description":"ICD-LDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB112","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ efgartigimod alfa-fcab_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9332","description":"Injection_ efgartigimod alfa-fcab_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22C","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transect artery sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61611","description":"Transect artery sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUB0","description":"ICD-GIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam unilat ribs/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71101","description":"X-ray exam unilat ribs/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj for sacroiliac jt anesth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0260","description":"Inj for sacroiliac jt anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/treat lung lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32141","description":"Remove/treat lung lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNF1","description":"ICD-FCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHD1","description":"ICD-AIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardioversion electric ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92960","description":"Cardioversion electric ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder-vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57330","description":"Repair bladder-vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEA0","description":"ICD-OEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIF1","description":"ICD-GBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOF0","description":"ICD-CEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQD1","description":"ICD-PAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB244","description":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50660","description":"Removal of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC21","description":"ICD-1AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDE1","description":"ICD-OFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMD1","description":"ICD-KFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86756","description":"Respiratory virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGE1","description":"ICD-GEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSD1","description":"ICD-GDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWA0","description":"ICD-LIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ ha_ i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2634","description":"Brachytx_ non-str_ ha_ i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYD0","description":"ICD-GBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLB1","description":"ICD-IFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDD1","description":"ICD-NJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5145","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","description":"HCPCS-Q5145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB11","description":"ICD-3LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLA0","description":"ICD-IHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of androsterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82160","description":"Assay of androsterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Personal care item nos each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5199","description":"Personal care item nos each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUC1","description":"ICD-CCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFD0","description":"ICD-NDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEC0","description":"ICD-NEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFE0","description":"ICD-JHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUD0","description":"ICD-EHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal vaccine admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8864","description":"Pneumococcal vaccine admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKB1","description":"ICD-CGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cult skin grft t/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15150","description":"Cult skin grft t/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25D","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscope_ single-use (i.e. disposable)_ urinary tract_ imaging/illumination device (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1747","description":"Endoscope_ single-use (i.e. disposable)_ urinary tract_ imaging/illumination device (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOC0","description":"ICD-PAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDB1","description":"ICD-FDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTF1","description":"ICD-BGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDC0","description":"ICD-CCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fo pip dip no jt spr pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3927","description":"Fo pip dip no jt spr pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special service/proc/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99199","description":"Special service/proc/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADD0","description":"ICD-JADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatobiliary system imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78226","description":"Hepatobiliary system imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lyme disease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86618","description":"Lyme disease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Hyalgan_ Supartz or Visco-3_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7321","description":"Hyaluronan or derivative_ Hyalgan_ Supartz or Visco-3_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Voice d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9173","description":"Voice d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95145","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRC1","description":"ICD-KCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXF1","description":"ICD-JHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGC0","description":"ICD-OFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calculus analysis qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82355","description":"Calculus analysis qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSF1","description":"ICD-DCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDF1","description":"ICD-MGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj test 13/> studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95913","description":"Nrv cndj test 13/> studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD230","description":"Special Care High _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78608","description":"Brain imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clin sig dep sym by dep tool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3354F","description":"Clin sig dep sym by dep tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drive belt power wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0098","description":"Drive belt power wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal Vaccine Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9991","description":"Pneumococcal Vaccine Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18C","description":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frozen plasma_ pooled_ sd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9023","description":"Frozen plasma_ pooled_ sd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLB0","description":"ICD-BGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laronidase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1931","description":"Laronidase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB151","description":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKC0","description":"ICD-OBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUB0","description":"ICD-CAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWC0","description":"ICD-GHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8D","description":"High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOE1","description":"ICD-PHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMA0","description":"ICD-EAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSC0","description":"ICD-PKSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNF0","description":"ICD-KHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97710","description":"","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct neck spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72125","description":"Ct neck spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rectum surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45999","description":"Rectum surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTB1","description":"ICD-JFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUC0","description":"ICD-NDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27832","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVA1","description":"ICD-KIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALB1","description":"ICD-OALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFC0","description":"ICD-CGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiography neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70547","description":"Mr angiography neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc of non tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9275","description":"Doc of non tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAE1","description":"ICD-EHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC36","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUA1","description":"ICD-NCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARE1","description":"ICD-OARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIB1","description":"ICD-MDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sbsq Plmt Drug Eluting Ocular Insert Uni/Bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0445T","description":"Sbsq Plmt Drug Eluting Ocular Insert Uni/Bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIED1","description":"ICD-FIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKE0","description":"ICD-KEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB144","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMA0","description":"ICD-OCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAD0","description":"ICD-MDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor ix non-recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7193","description":"Factor ix non-recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDB1","description":"ICD-JIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTA0","description":"ICD-OHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBE0","description":"ICD-CFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng periton dialysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4055F","description":"Pt rcvng periton dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPE1","description":"ICD-OEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27690","description":"Revise lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHC1","description":"ICD-FCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90965","description":"Esrd home pt serv p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBD1","description":"ICD-MLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVA1","description":"ICD-FEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADB1","description":"ICD-KADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11426","description":"Exc h-f-nk-sp b9+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB217","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmi is documented within normal parameters and no follow-up plan is required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1296","description":"Bmi is documented within normal parameters and no follow-up plan is required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVE1","description":"ICD-GCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLF0","description":"ICD-KCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVB1","description":"ICD-BHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYC0","description":"ICD-OBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUF0","description":"ICD-EFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy with injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9742","description":"Laryngoscopy with injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDD1","description":"ICD-FBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIID1","description":"ICD-EIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHC1","description":"ICD-BBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96931","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMC0","description":"ICD-ACMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGB0","description":"ICD-GDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTF0","description":"ICD-KBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMD0","description":"ICD-BHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraocular fomivirsen na","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1452","description":"Intraocular fomivirsen na","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0542T","description":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSA1","description":"ICD-OHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKE0","description":"ICD-NKKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB24","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDF0","description":"ICD-NFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGE0","description":"ICD-KAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJC1","description":"ICD-OCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOA0","description":"ICD-CIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRB0","description":"ICD-PCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYE1","description":"ICD-LCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTF1","description":"ICD-BHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINC0","description":"ICD-OINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lipid panel doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3011F","description":"Lipid panel doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUF0","description":"ICD-BBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33788","description":"Revision of pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot plas heel stabi pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3170","description":"Foot plas heel stabi pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","description":"HCPCS-M1406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87502","description":"Influenza dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPE1","description":"ICD-FIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plan of care 4 pain docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0521F","description":"Plan of care 4 pain docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCD0","description":"ICD-FDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Msh6 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81300","description":"Msh6 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD220","description":"Special Care High _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Csf shunt reprogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62252","description":"Csf shunt reprogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXF1","description":"ICD-BHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGND1","description":"ICD-GGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venous pressure clamp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4918","description":"Venous pressure clamp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNB1","description":"ICD-FCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB124","description":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sign lang/oral interpreter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1013","description":"Sign lang/oral interpreter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVA0","description":"ICD-NLVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUB1","description":"ICD-AIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung function test (mbc/mvv)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94200","description":"Lung function test (mbc/mvv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAC0","description":"ICD-NBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIC0","description":"ICD-KDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLD1","description":"ICD-ODLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB21","description":"ICD-1HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB235","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHF0","description":"ICD-MDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ ep_ othr than cool-tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1733","description":"Cath_ ep_ othr than cool-tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADA1","description":"ICD-JADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHD1","description":"ICD-ICHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGC1","description":"ICD-JHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVD1","description":"ICD-CFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHE1","description":"ICD-CEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGB0","description":"ICD-OEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTD1","description":"ICD-KGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunohisto antb addl slide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88341","description":"Immunohisto antb addl slide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBE0","description":"ICD-FCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ BTE/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5221","description":"Hearing aid_ contralateral routing system_ binaural_ BTE/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81166","description":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph fundoplasty thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43328","description":"Esoph fundoplasty thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25230","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRE0","description":"ICD-OJRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61538","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMA0","description":"ICD-NGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supp for self-adm injections","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4211","description":"Supp for self-adm injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSC0","description":"ICD-LDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWB1","description":"ICD-ODWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asthma kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8097","description":"Asthma kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTF1","description":"ICD-AFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACB0","description":"ICD-NACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCA1","description":"ICD-IDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMB1","description":"ICD-JGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-osseointegrated snd proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8692","description":"Non-osseointegrated snd proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLD1","description":"ICD-JGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTB0","description":"ICD-IBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGE1","description":"ICD-OBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group II_ all other (eg_ iron_ trichrome)_ except stain for microorganisms_ sta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0757T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group II_ all other (eg_ iron_ trichrome)_ except stain for microorganisms_ sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTF1","description":"ICD-OBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot press off load supp dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9283","description":"Foot press off load supp dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neg press wnd tx </=50 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97607","description":"Neg press wnd tx </=50 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35221","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALA0","description":"ICD-MALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gs mg intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9237","description":"Gs mg intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx pancreatc p r0 res no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9105","description":"Onc dx pancreatc p r0 res no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phleb veins - extrem 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37766","description":"Phleb veins - extrem 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0661T","description":"Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (e.g._ monkeypox virus_ cowpox virus_ vaccinia virus)_ amplified probe technique_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87593","description":"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (e.g._ monkeypox virus_ cowpox virus_ vaccinia virus)_ amplified probe technique_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVD1","description":"ICD-BEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX42","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHE1","description":"ICD-KDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRB0","description":"ICD-PGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suction socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6686","description":"Suction socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKD1","description":"ICD-GIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOF1","description":"ICD-DCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRD1","description":"ICD-OLRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXE1","description":"ICD-GAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUF0","description":"ICD-KGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPC0","description":"ICD-NBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0667T","description":"Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13D","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue culture skin/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88233","description":"Tissue culture skin/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tooth splitting","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3920","description":"Tooth splitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin for insulin pump use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1817","description":"Insulin for insulin pump use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of creatine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82540","description":"Assay of creatine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBD1","description":"ICD-GFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pancreatic)_ 59 methylation haplotype block markers_ next-generation sequencing_ plasma_ reported as cancer signal detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0405U","description":"Oncology (pancreatic)_ 59 methylation haplotype block markers_ next-generation sequencing_ plasma_ reported as cancer signal detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32994","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCC0","description":"ICD-KGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHD1","description":"ICD-IAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47122","description":"Extensive removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Csf leakage imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78650","description":"Csf leakage imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGA1","description":"ICD-FIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB24","description":"Medium Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1420","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","description":"HCPCS-M1420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEC1","description":"ICD-OJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult electric hand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7007","description":"Adult electric hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCF1","description":"ICD-CDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0457","description":"Chest shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSA0","description":"ICD-DCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLD0","description":"ICD-CDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAID0","description":"ICD-JAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOC0","description":"ICD-LBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMD1","description":"ICD-IFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAE0","description":"ICD-MCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWF0","description":"ICD-HFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"G6pc gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81250","description":"G6pc gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery for urethra pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53240","description":"Surgery for urethra pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFF1","description":"ICD-GAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ampho b cholesteryl sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0288","description":"Ampho b cholesteryl sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEA1","description":"ICD-MDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSD0","description":"ICD-KDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 hd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0862","description":"Pwc gp3 hd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crutch substitute","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0118","description":"Crutch substitute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Healthcare Professional Online Assessment_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 5-10 Minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2061","description":"Qualified Nonphysician Healthcare Professional Online Assessment_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 5-10 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine eltrd plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63662","description":"Remove spine eltrd plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology hrt trnspl mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81595","description":"Cardiology hrt trnspl mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTC0","description":"ICD-ICTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx l/r atrial fib addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93657","description":"Tx l/r atrial fib addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSB1","description":"ICD-HDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M.tuberculo dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87555","description":"M.tuberculo dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES136","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc leukocytes reduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9016","description":"Rbc leukocytes reduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFC0","description":"ICD-FAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Axolotl Graft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4331","description":"Axolotl Graft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUB0","description":"ICD-OGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise excessive skin hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15834","description":"Excise excessive skin hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENC0","description":"ICD-NENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap myotomy heller","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43279","description":"Lap myotomy heller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg pulmon sequest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2403","description":"Fetal surg pulmon sequest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi_ antibody detection of 12 recombinant protein groups_ by immunoblot_ IgG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042U","description":"Borrelia burgdorferi_ antibody detection of 12 recombinant protein groups_ by immunoblot_ IgG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21249","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible_ proximal to splenic flexure; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6025","description":"Colonoscopy_ flexible_ proximal to splenic flexure; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSA0","description":"ICD-PFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJB0","description":"ICD-CHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81285","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLF1","description":"ICD-ECLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACD0","description":"ICD-CACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB204","description":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco nonsmoker nor 2ndhnd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1033F","description":"Tobacco nonsmoker nor 2ndhnd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYF0","description":"ICD-CAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Site no lung or lung cx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9424","description":"Site no lung or lung cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLD0","description":"ICD-BFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB214","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFD1","description":"ICD-OLFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlamydia culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87110","description":"Chlamydia culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHA0","description":"ICD-MDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACB1","description":"ICD-EACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15950","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat sternum fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21820","description":"Treat sternum fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXA0","description":"ICD-CAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise esophagus & stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43325","description":"Revise esophagus & stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCA1","description":"ICD-MFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0703","description":"HCPCS-B0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00214","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","description":"CPT-00214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15C","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt dischg >2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9254","description":"Doc pt dischg >2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pain screened as moderate to severe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1000","description":"Pain screened as moderate to severe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1419","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","description":"HCPCS-M1419","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IFNL3 (interferon_ lambda 3) (eg_ drug response)_ gene analysis_ rs12979860 variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81283","description":"IFNL3 (interferon_ lambda 3) (eg_ drug response)_ gene analysis_ rs12979860 variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWA0","description":"ICD-CCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOA1","description":"ICD-LAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWE0","description":"ICD-PHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPE1","description":"ICD-FAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Basic vestibular evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92540","description":"Basic vestibular evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEE1","description":"ICD-OFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Msh2 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81297","description":"Msh2 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJB1","description":"ICD-JAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1416","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","description":"HCPCS-M1416","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBE0","description":"ICD-GGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLC0","description":"ICD-JBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAF0","description":"ICD-CHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Symes type medial opening so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5636","description":"Symes type medial opening so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATF0","description":"ICD-FATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spine disk surgery thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63078","description":"Spine disk surgery thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANB0","description":"ICD-BANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace g-j tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49452","description":"Replace g-j tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRC1","description":"ICD-KGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQC1","description":"ICD-LBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQD1","description":"ICD-LHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPA1","description":"ICD-NEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nondisposable pump canister","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7001","description":"Nondisposable pump canister","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWC1","description":"ICD-DHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAE0","description":"ICD-EHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric electrophysiology mapping with simultaneous patient symptom profiling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9787","description":"Gastric electrophysiology mapping with simultaneous patient symptom profiling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22C","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50694","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGA0","description":"ICD-GHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOA0","description":"ICD-DCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Free myo/skin flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15756","description":"Free myo/skin flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pm/icd remote tech serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93296","description":"Pm/icd remote tech serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Als1-emergency","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0427","description":"Als1-emergency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAME0","description":"ICD-CAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res Uti  Bill Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9684","description":"Onsite Ac C Tx Nsg Fac Res Uti  Bill Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: positional headaches","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2191","description":"Patients with clinical indications for imaging of the head: positional headaches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thyroglobulin antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86800","description":"Thyroglobulin antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ear mold/insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5264","description":"Ear mold/insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYA1","description":"ICD-KIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFE1","description":"ICD-CIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGA1","description":"ICD-OAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLB1","description":"ICD-CGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefepime hydrochloride (baxter)_ not therapeutically equivalent to maxipime_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0701","description":"Injection_ cefepime hydrochloride (baxter)_ not therapeutically equivalent to maxipime_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBF1","description":"ICD-AEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQD0","description":"ICD-GAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zneuroendoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62163","description":"Zneuroendoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIB0","description":"ICD-FAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 5/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73523","description":"X-ray exam hips bi 5/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUF1","description":"ICD-ODUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX30","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01444","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","description":"CPT-01444","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGC1","description":"ICD-NEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTC0","description":"ICD-ODTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99205","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr f/c/c/m/n/a/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14040","description":"Tis trnfr f/c/c/m/n/a/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24925","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8D","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDB1","description":"ICD-EHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTD0","description":"ICD-GDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol 74-100 gm pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4197","description":"Parenteral sol 74-100 gm pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for future fall risk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1069","description":"Patient screened for future fall risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rails bed side full length","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0310","description":"Rails bed side full length","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28210","description":"Repair/graft of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJA0","description":"ICD-FIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCB0","description":"ICD-ABCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg <=16 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6254","description":"Absorpt drg <=16 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHB0","description":"ICD-GIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEC0","description":"ICD-OHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAB1","description":"ICD-JFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24130","description":"Removal of head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emr pwr source combo vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0491","description":"Emr pwr source combo vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCA1","description":"ICD-KGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9769","description":"Cystourethroscopy_ with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAB0","description":"ICD-EDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phys exam for college","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0622","description":"Phys exam for college","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evaluate swallowing function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92610","description":"Evaluate swallowing function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNB0","description":"ICD-NGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL31","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Tissue Harvesting And Cellular Implant Creation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0565T","description":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Tissue Harvesting And Cellular Implant Creation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma_ Including Local Exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49013","description":"Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma_ Including Local Exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLD1","description":"ICD-GBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGC1","description":"ICD-FBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemophilia clot factor noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7199","description":"Hemophilia clot factor noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJA0","description":"ICD-GAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHC1","description":"ICD-MAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVA0","description":"ICD-JAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5B","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB46","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKC1","description":"ICD-NDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occlusal orthotic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7880","description":"Occlusal orthotic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bile duct cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47715","description":"Excision of bile duct cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt post facet implt lumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0221T","description":"Plmt post facet implt lumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00632","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","description":"CPT-00632","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPF0","description":"ICD-FGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0697T","description":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metabolic panel ionized ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80047","description":"Metabolic panel ionized ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ivf package","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4011","description":"Ivf package","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLE0","description":"ICD-GDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27842","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCC1","description":"ICD-FBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulpal regeneration complete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3357","description":"Pulpal regeneration complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3933","description":"Fo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMC1","description":"ICD-JEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No unpln rup post cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9390","description":"No unpln rup post cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIE1","description":"ICD-EHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUD0","description":"ICD-BBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01382","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","description":"CPT-01382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19330","description":"Removal of implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXB1","description":"ICD-FEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including fluoroscopic guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10007","description":"Fine needle aspiration biopsy_ including fluoroscopic guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDB0","description":"ICD-JBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exercise test for bronchospasm_ including pre- and post-spirometry_ electrocardiographic recording(s)_ and pulse oximetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94617","description":"Exercise test for bronchospasm_ including pre- and post-spirometry_ electrocardiographic recording(s)_ and pulse oximetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81450","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEA0","description":"ICD-CHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0574","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0574","description":"HCPCS-G0574","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB255","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1072T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1072T","description":"CPT-1072T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLB0","description":"ICD-NLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hard protect helmet prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8001","description":"Hard protect helmet prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACC0","description":"ICD-IACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBA0","description":"ICD-CHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEB0","description":"ICD-ECEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Space maintainer fxd unilat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1510","description":"Space maintainer fxd unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC256","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic wrist rotator any","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7259","description":"Electronic wrist rotator any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJB0","description":"ICD-CGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99244","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC226","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rout foot care per visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0390","description":"Rout foot care per visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILF1","description":"ICD-JILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNA0","description":"ICD-FHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHA1","description":"ICD-JGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX34","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB42","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEB1","description":"ICD-BAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clearance of tear duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68530","description":"Clearance of tear duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVE1","description":"ICD-OFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKC1","description":"ICD-OBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAD1","description":"ICD-OIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHD1","description":"ICD-GEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWF1","description":"ICD-GAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLME0","description":"ICD-NLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRC1","description":"ICD-OIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFE0","description":"ICD-BIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1154","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPC0","description":"ICD-NEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental occlusal guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9940","description":"Dental occlusal guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGC0","description":"ICD-NHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJC0","description":"ICD-FHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJB0","description":"ICD-FIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAE0","description":"ICD-KDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ra measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8490","description":"Ra measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lacosamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80235","description":"Lacosamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA60","description":"Very High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNE1","description":"ICD-FBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXB0","description":"ICD-NCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 6/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72052","description":"X-ray exam neck spine 6/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB41","description":"High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUA1","description":"ICD-IBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray bile ducts/pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74300","description":"X-ray bile ducts/pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE151","description":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJC0","description":"ICD-KEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC31","description":"ICD-3JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA11","description":"ICD-3KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJC1","description":"ICD-JHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERF1","description":"ICD-PERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRD1","description":"ICD-GIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA32","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34051","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region cancer at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1037","description":"Patients with a diagnosis of lumbar spine region cancer at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Death occurring during the index acute care hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9814","description":"Death occurring during the index acute care hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJD0","description":"ICD-GFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMD1","description":"ICD-BEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD213","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28261","description":"Revision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01936","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01936","description":"CPT-01936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBC0","description":"ICD-IIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVF0","description":"ICD-BDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECD0","description":"ICD-OECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXC1","description":"ICD-FEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUB0","description":"ICD-FAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFED1","description":"ICD-KFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12D","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUA1","description":"ICD-JAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1603","description":"HCPCS-A1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLC1","description":"ICD-CDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients admitted to a skilled nursing facility (snf)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1266","description":"Patients admitted to a skilled nursing facility (snf)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMD0","description":"ICD-CIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls initiation venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33946","description":"Ecmo/ecls initiation venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00124","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","description":"CPT-00124","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSB0","description":"ICD-HDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient with diagnosis of osteoporosis on date of encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1153","description":"Patient with diagnosis of osteoporosis on date of encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teclistamab-cqyv_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9148","description":"Injection_ teclistamab-cqyv_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1044T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1044T","description":"CPT-1044T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trabectedin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9352","description":"Injection_ trabectedin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLE0","description":"ICD-CBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYA0","description":"ICD-CBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD216","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smokeless tobacco user","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1035F","description":"Smokeless tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD115","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHB0","description":"ICD-GBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE101","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDA0","description":"ICD-OHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26121","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIC0","description":"ICD-KGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC121","description":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy premal lesions 15/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17004","description":"Destroy premal lesions 15/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26420","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9053","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9053","description":"HCPCS-J9053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 81 Years Of Age And Older With Evidence Of Frailty During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2125","description":"Patients 81 Years Of Age And Older With Evidence Of Frailty During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUD0","description":"ICD-MJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Not ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8858","description":"Not ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADA0","description":"ICD-KADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIB0","description":"ICD-FFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sc ther infusion up to 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96369","description":"Sc ther infusion up to 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAE0","description":"ICD-FCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63102","description":"Remove vert body dcmprn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No 1dose meni vac btwn 11&13","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9415","description":"No 1dose meni vac btwn 11&13","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDD1","description":"ICD-AEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sitz type bath or equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0160","description":"Sitz type bath or equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8G","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETC1","description":"ICD-NETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ptrsn no gc chl syp test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9229","description":"Ptrsn no gc chl syp test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Had Prior Pneumococcal Vaccine Adverse Reaction Any Time During Or Before The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2158","description":"Patient Had Prior Pneumococcal Vaccine Adverse Reaction Any Time During Or Before The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTD0","description":"ICD-MHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cadaver donor kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50300","description":"Remove cadaver donor kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC255","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEF0","description":"ICD-CHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay thyroid stim hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84443","description":"Assay thyroid stim hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERA0","description":"ICD-DERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHF1","description":"ICD-BBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pros sheath/sock w gel cushn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8417","description":"Pros sheath/sock w gel cushn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLA1","description":"ICD-NJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61606","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPB0","description":"ICD-JEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0605","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","description":"HCPCS-J0605","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHE0","description":"ICD-NAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/over 6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2110","description":"Spherocylinder 4.25d/over 6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Residential Habilitation 4-8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0102","description":"Residential Habilitation 4-8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lungcx bx rpt docs class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9418","description":"Lungcx bx rpt docs class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93243","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPB0","description":"ICD-JFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 2)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1714","description":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFC1","description":"ICD-OCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Basic support routine suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0382","description":"Basic support routine suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuromuscular electrical stimulator (nmes)_ disposable_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4560","description":"Neuromuscular electrical stimulator (nmes)_ disposable_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD231","description":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aor ane 5.5-5.9 cm max diam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9598","description":"Aor ane 5.5-5.9 cm max diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWB0","description":"ICD-GFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Renal biopsy open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50205","description":"Renal biopsy open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHC0","description":"ICD-KAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWA1","description":"ICD-HBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCB0","description":"ICD-FBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIC1","description":"ICD-AEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBB1","description":"ICD-BEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Md inr test revie inter mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0250","description":"Md inr test revie inter mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBA1","description":"ICD-NGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRC0","description":"ICD-OKRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38572","description":"Laparoscopy lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove & treat brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61544","description":"Remove & treat brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC31","description":"ICD-2FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE251","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATC0","description":"ICD-JATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALD1","description":"ICD-BALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert needle cath bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44015","description":"Insert needle cath bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHD0","description":"ICD-CHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELB0","description":"ICD-GELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self-help/peer svc per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0038","description":"Self-help/peer svc per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLA1","description":"ICD-NBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15D","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMC1","description":"ICD-ABMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0770T","description":"Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISF1","description":"ICD-HISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLB1","description":"ICD-MLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPF0","description":"ICD-JIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99155","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDF0","description":"ICD-AHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect foot/toe tumor < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28046","description":"Resect foot/toe tumor < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acne surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10040","description":"Acne surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPB0","description":"ICD-OBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBE0","description":"ICD-IBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA31","description":"ICD-2GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77261","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec size w foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1223","description":"Wheelchair spec size w foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEE0","description":"ICD-MEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIB1","description":"ICD-AAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87426","description":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of erythropoietin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82668","description":"Assay of erythropoietin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUB0","description":"ICD-IBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHD1","description":"ICD-MEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUC0","description":"ICD-MDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral aprepitant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8501","description":"Oral aprepitant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGID1","description":"ICD-NGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alginate dressing > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6198","description":"Alginate dressing > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWF1","description":"ICD-HAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary pouch w/o barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5072","description":"Urinary pouch w/o barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Provision splnt intracoronal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4320","description":"Provision splnt intracoronal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAD0","description":"ICD-OFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26356","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCF0","description":"ICD-MLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQE0","description":"ICD-KBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0804T","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA150","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLC1","description":"ICD-NJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLA0","description":"ICD-MCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9341","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","description":"HCPCS-J9341","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLB0","description":"ICD-NBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36904","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDED1","description":"ICD-BDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUA1","description":"ICD-KEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIND0","description":"ICD-NIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occlusal guard adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9943","description":"Occlusal guard adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86051","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC11","description":"ICD-3BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOC0","description":"ICD-LCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVF1","description":"ICD-OKVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRB1","description":"ICD-HGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSC1","description":"ICD-PBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCC1","description":"ICD-JDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAE1","description":"ICD-KAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of midfoot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28260","description":"Release of midfoot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alveoloplasty not w/extracts","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7321","description":"Alveoloplasty not w/extracts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Omegaven_ 10 Grams Lipids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4187","description":"Omegaven_ 10 Grams Lipids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAF0","description":"ICD-IGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTA1","description":"ICD-NGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ neuro non-recharg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1767","description":"Generator_ neuro non-recharg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68110","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Highly Complex Clinical Problem_ With Comprehensive Review Of Patient_S History And Medical Records And High Level Of Medical Decision M","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80505","description":"Pathology Clinical Consultation; For A Highly Complex Clinical Problem_ With Comprehensive Review Of Patient_S History And Medical Records And High Level Of Medical Decision M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6031","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","description":"HCPCS-L6031","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSE1","description":"ICD-GGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA20","description":"Medium Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92632","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","description":"CPT-92632","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUE0","description":"ICD-OEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBA0","description":"ICD-JCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23D","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iron stain peripheral blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85536","description":"Iron stain peripheral blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36568","description":"Insert picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2B","description":"Medium Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDD1","description":"ICD-JHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incis spine 3 column adl seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22208","description":"Incis spine 3 column adl seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Root canal therapy 3 canals","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3330","description":"Root canal therapy 3 canals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93248","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHB0","description":"ICD-KBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay growth hormone (hgh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83003","description":"Assay growth hormone (hgh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx laryngoscopy w/oper scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31526","description":"Dx laryngoscopy w/oper scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE154","description":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Finasteride_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0138","description":"Finasteride_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVE0","description":"ICD-FCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMA1","description":"ICD-OGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No satisfy with care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0918","description":"No satisfy with care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap revise/remv eltrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43648","description":"Lap revise/remv eltrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSD1","description":"ICD-LBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXB0","description":"ICD-BAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDB1","description":"ICD-NHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc thigh/knee tum deep <5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27328","description":"Exc thigh/knee tum deep <5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJD1","description":"ICD-NGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJB0","description":"ICD-OIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDND1","description":"ICD-FDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deferoxamine mesylate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0895","description":"Deferoxamine mesylate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBF1","description":"ICD-CHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1702","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1702","description":"CDT-D1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHC0","description":"ICD-MKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-93145","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","description":"CPT-93145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXD0","description":"ICD-FAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSA1","description":"ICD-DDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-99445","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","description":"CPT-99445","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJC0","description":"ICD-FDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFED0","description":"ICD-JFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIA0","description":"ICD-CEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0A","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"VitoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4317","description":"VitoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEB0","description":"ICD-OKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAA1","description":"ICD-NFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB130","description":"Special Care High _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELF1","description":"ICD-KELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA32","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNC0","description":"ICD-GFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMF0","description":"ICD-MHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGA0","description":"ICD-GCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unspecified preventive proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1999","description":"Unspecified preventive proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRF1","description":"ICD-PJRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCE0","description":"ICD-AGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYF1","description":"ICD-GFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGA1","description":"ICD-FCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANB0","description":"ICD-GANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFE0","description":"ICD-NFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21C","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal hemoglobin chemical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83030","description":"Fetal hemoglobin chemical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc scr uter mal or us/samp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9618","description":"Doc scr uter mal or us/samp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 22 Or Functional Status M","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2142","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 22 Or Functional Status M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth bleeding control","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91651","description":"Anesth bleeding control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVF1","description":"ICD-JBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIND0","description":"ICD-JIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFC1","description":"ICD-OFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITD1","description":"ICD-EITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9981","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Max MRI capture & interprete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0369","description":"Max MRI capture & interprete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTD0","description":"ICD-CGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1192","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1 probe&reverse trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87535","description":"Hiv-1 probe&reverse trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstr lwr jaw segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21198","description":"Reconstr lwr jaw segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFB0","description":"ICD-BHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOF1","description":"ICD-OKOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHF0","description":"ICD-FAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Middle cerebral artery echo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76821","description":"Middle cerebral artery echo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee jnt ratchet lock ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2430","description":"Knee jnt ratchet lock ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fam-trastuzumab deruxtecan-nxki_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9358","description":"Injection_ fam-trastuzumab deruxtecan-nxki_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJA1","description":"ICD-JAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hd trapeze bar free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0912","description":"Hd trapeze bar free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXE1","description":"ICD-FIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tension based scoliosis orth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1005","description":"Tension based scoliosis orth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27560","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOE0","description":"ICD-LGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ladies shoes hightop depth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3217","description":"Ladies shoes hightop depth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXE1","description":"ICD-BHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4424","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","description":"HCPCS-Q4424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISE0","description":"ICD-OISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLB0","description":"ICD-OLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reproductive Medicine (Preimplantation Genetic Assessment)_ Analysis Of 24 Chromosomes Using Embryonic Dna Genomic Sequence Analysis For Aneuploidy_ And A Mitochondrial Dna Sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0254U","description":"Reproductive Medicine (Preimplantation Genetic Assessment)_ Analysis Of 24 Chromosomes Using Embryonic Dna Genomic Sequence Analysis For Aneuploidy_ And A Mitochondrial Dna Sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal Tract Imaging_ Intraluminal (Eg_ Capsule Endoscopy)_ Colon_ With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91113","description":"Gastrointestinal Tract Imaging_ Intraluminal (Eg_ Capsule Endoscopy)_ Colon_ With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXB0","description":"ICD-NKXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJC0","description":"ICD-GIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTE0","description":"ICD-ODTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove tear gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68540","description":"Remove tear gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIF0","description":"ICD-MCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring_ radiofrequency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58674","description":"Laparoscopy_ surgical_ ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring_ radiofrequency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device_ vascular hemostatic seal_ mechano-electr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0455T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device_ vascular hemostatic seal_ mechano-electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trilaciclib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1448","description":"Injection_ trilaciclib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB02","description":"Low Rehab_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hx bld transf b/f 1992","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9449","description":"Hx bld transf b/f 1992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01932","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","description":"CPT-01932","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 6 central carbon metabolites (ie_ a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ and succ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0139U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 6 central carbon metabolites (ie_ a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ and succ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29720","description":"Repair of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of spermatic ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54901","description":"Fusion of spermatic ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAA0","description":"ICD-GIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOE0","description":"ICD-LDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77290","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKID0","description":"ICD-NKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWF1","description":"ICD-PKWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise windpipe scar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31830","description":"Revise windpipe scar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35022","description":"Repair artery rupture chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat midfoot fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28456","description":"Treat midfoot fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA245","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIA1","description":"ICD-BGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADA0","description":"ICD-EADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWE1","description":"ICD-CEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYB0","description":"ICD-KIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-60661","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","description":"CPT-60661","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21079","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of eye prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2626","description":"Reduction of eye prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFD1","description":"ICD-FDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHB1","description":"ICD-MIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICD1","description":"ICD-MICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBA1","description":"ICD-FBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32400","description":"Needle biopsy chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted to a SPU or an ASC for monitoring and observation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0597","description":"Patient admitted to a SPU or an ASC for monitoring and observation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urea nitrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84520","description":"Assay of urea nitrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0677","description":"Non-pneumatic sequential compression garment_ trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psych svcs provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4060F","description":"Psych svcs provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIB1","description":"ICD-MFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sympathectomy cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64802","description":"Sympathectomy cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRF1","description":"ICD-LGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELF1","description":"ICD-GELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cysto/uretero stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52344","description":"Cysto/uretero stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJB1","description":"ICD-CDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Consult slides prep elsewher","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0484","description":"Consult slides prep elsewher","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDB1","description":"ICD-OGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVD1","description":"ICD-KCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"corticotomy - four or more teeth or tooth spaces_ per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7297","description":"corticotomy - four or more teeth or tooth spaces_ per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of esophagus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43101","description":"Excision of esophagus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject skin lesions >7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11901","description":"Inject skin lesions >7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5A","description":"Default_ /PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6072","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92629","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","description":"CPT-92629","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: high complexity_ requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the pla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97163","description":"Physical therapy evaluation: high complexity_ requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the pla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen non tlc devices","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80300","description":"Drug screen non tlc devices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL11","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom sleep apnea appliance fabrication and placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9947","description":"Custom sleep apnea appliance fabrication and placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35190","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gene test beta-thalassemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3846","description":"Gene test beta-thalassemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAC0","description":"ICD-MHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA01","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC134","description":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10A","description":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYC0","description":"ICD-ODYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUB1","description":"ICD-JFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMC1","description":"ICD-MAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHF1","description":"ICD-KDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penile vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93980","description":"Penile vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUF1","description":"ICD-EIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1004T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","description":"CPT-1004T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSB1","description":"ICD-CFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antibody_ severe acute respiratory system coronavirus 2 (SARS CoV-2) (Coronavirus disease [COVID-19])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86769","description":"Antibody_ severe acute respiratory system coronavirus 2 (SARS CoV-2) (Coronavirus disease [COVID-19])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAB1","description":"ICD-NLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Utility services waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2035","description":"Utility services waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSE1","description":"ICD-DDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ omadacycline_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9051","description":"Injection_ omadacycline_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2214","description":"Pneumatic caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1A","description":"Default_ /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAE0","description":"ICD-NIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Instillation of antineoplastic pharmacologic/biologic agent into renal pelvis_ any method_ including all imaging guidance_including volumetric measurement if performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9789","description":"Instillation of antineoplastic pharmacologic/biologic agent into renal pelvis_ any method_ including all imaging guidance_including volumetric measurement if performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient was a permanent nursing home resident at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1058","description":"Patient was a permanent nursing home resident at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHF0","description":"ICD-IBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOD1","description":"ICD-PCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophoretic test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82664","description":"Electrophoretic test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFD0","description":"ICD-FFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (mild cognitive impairment)_ analysis of B-amyloid 1-42 and 1-40_ chemiluminescence enzyme immunoassay_ cerebral spinal fluid_ reported as positive_ likely positive_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0358U","description":"Neurology (mild cognitive impairment)_ analysis of B-amyloid 1-42 and 1-40_ chemiluminescence enzyme immunoassay_ cerebral spinal fluid_ reported as positive_ likely positive_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAF0","description":"ICD-IEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBID1","description":"ICD-NBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATA1","description":"ICD-GATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9481","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine; scoliosis study_ including supine and erect studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72090","description":"Radiologic examination_ spine; scoliosis study_ including supine and erect studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic mens shoes oxford","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3219","description":"Orthopedic mens shoes oxford","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB31","description":"ICD-3DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJB1","description":"ICD-KEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXF0","description":"ICD-FEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0977T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","description":"CPT-0977T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE221","description":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune diseases (eg_ systemic lupus erythematosus [SLE])_ analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorben","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0312U","description":"Autoimmune diseases (eg_ systemic lupus erythematosus [SLE])_ analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorben","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA14","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNC0","description":"ICD-NFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65272","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant/replace hearing aid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69710","description":"Implant/replace hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDB0","description":"ICD-CHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clin tx mdd not comm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8960","description":"Clin tx mdd not comm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMC1","description":"ICD-JDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDB1","description":"ICD-MIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Fixed Bilateral Space Maintainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1558","description":"Removal Of Fixed Bilateral Space Maintainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18X","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTC1","description":"ICD-FGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20A","description":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13101","description":"Cmplx rpr trunk 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKE1","description":"ICD-OCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clin symp vol ovrld assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1004F","description":"Clin symp vol ovrld assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seven Standard Field Stereoscopic Photos With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2103","description":"Seven Standard Field Stereoscopic Photos With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo new ureter/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50948","description":"Laparo new ureter/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject for sacroiliac joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0259","description":"Inject for sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMD1","description":"ICD-NDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extra ambulance attendant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0424","description":"Extra ambulance attendant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIF0","description":"ICD-GBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUF1","description":"ICD-CBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe dennis browne splint bo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3640","description":"Shoe dennis browne splint bo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBA0","description":"ICD-OCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITB0","description":"ICD-NITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ehrlichia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86666","description":"Ehrlichia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21A","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVB0","description":"ICD-BGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgimend_ fetal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9358","description":"Surgimend_ fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAF0","description":"ICD-EDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARA0","description":"ICD-LARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESF1","description":"ICD-HESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLA0","description":"ICD-OLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag r an/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0631","description":"Lso sag r an/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTF1","description":"ICD-CCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPB1","description":"ICD-OGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKF0","description":"ICD-JFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Varicella-zoster ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90396","description":"Varicella-zoster ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0541U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","description":"CPT-0541U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSE0","description":"ICD-KDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAB1","description":"ICD-JBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of total testosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84403","description":"Assay of total testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYD1","description":"ICD-GIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUC1","description":"ICD-EEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVF1","description":"ICD-NKVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27217","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harness figure of 8 sing con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6675","description":"Harness figure of 8 sing con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKA1","description":"ICD-KEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30468","description":"Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No pt category on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9293","description":"No pt category on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXE0","description":"ICD-FFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAA0","description":"ICD-CCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diethylstilbestrol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9165","description":"Diethylstilbestrol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUB1","description":"ICD-OIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1427","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","description":"HCPCS-M1427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA11","description":"ICD-4IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flt3 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81245","description":"Flt3 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0204","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0204","description":"CDT-D0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX30","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2135","description":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obstetric panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80081","description":"Obstetric panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot single axis ankle/foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5974","description":"Foot single axis ankle/foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted ambulance service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0999","description":"Unlisted ambulance service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGF0","description":"ICD-CDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRD0","description":"ICD-DFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0626T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (oropharyngeal)_ detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets_ cell-free HPV 16 and 18 DNA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0470U","description":"Oncology (oropharyngeal)_ detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets_ cell-free HPV 16 and 18 DNA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWF0","description":"ICD-OCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HIV-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87390","description":"IAAD IA HIV-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUB1","description":"ICD-NKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRC0","description":"ICD-LBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEE1","description":"ICD-EHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal stent placement(s)_ includes angioplasty within the same v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7535","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal stent placement(s)_ includes angioplasty within the same v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLC1","description":"ICD-BGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGA1","description":"ICD-OGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderna Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 50mcg/0.25mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1711","description":"Moderna Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 50mcg/0.25mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compact travel hemodialyzer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1635","description":"Compact travel hemodialyzer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone cutting ramus closed","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7941","description":"Bone cutting ramus closed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFB1","description":"ICD-CHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQB1","description":"ICD-KBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHF0","description":"ICD-NAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1612","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","description":"HCPCS-J1612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0984T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","description":"CPT-0984T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGF1","description":"ICD-OAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUD1","description":"ICD-NEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway pressure cpap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94660","description":"Pos airway pressure cpap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIC1","description":"ICD-BFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1503","description":"HCPCS-A1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVA1","description":"ICD-BEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECE1","description":"ICD-NECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFE1","description":"ICD-BBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXF1","description":"ICD-CHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEA0","description":"ICD-GGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILE0","description":"ICD-EILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLB0","description":"ICD-NKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18C","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of insulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83525","description":"Assay of insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCF1","description":"ICD-CCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nutri counsel-control caries","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1310","description":"Nutri counsel-control caries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUF0","description":"ICD-MBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKE1","description":"ICD-GIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63003","description":"Remove spine lamina 1/2 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBB1","description":"ICD-FFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit new age 5-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99383","description":"Prev visit new age 5-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow stump activated lock h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6130","description":"Elbow stump activated lock h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43610","description":"Excision of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam l-s spine 2/3 vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72100","description":"X-ray exam l-s spine 2/3 vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOE1","description":"ICD-HDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAB1","description":"ICD-MJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHF1","description":"ICD-KGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDC1","description":"ICD-OHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25426","description":"Repair/graft radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24A","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXF1","description":"ICD-CEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA45","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKF1","description":"ICD-KCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59857","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infliximab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80230","description":"Infliximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12B","description":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1070T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1070T","description":"CPT-1070T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD104","description":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01999","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","description":"CPT-01999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB12","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYB1","description":"ICD-PHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSB0","description":"ICD-PJSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vasopressin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84588","description":"Assay of vasopressin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental bitewings four films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0274","description":"Dental bitewings four films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10D","description":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNB1","description":"ICD-GDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hfo w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3921","description":"Hfo w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Powered pressure reducing underlay/pad_ alternating_ with pump_ inc heavy duty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0183","description":"Powered pressure reducing underlay/pad_ alternating_ with pump_ inc heavy duty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYC0","description":"ICD-LGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNB0","description":"ICD-FGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVC1","description":"ICD-NKVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attendant Care Services_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1793","description":"Attendant Care Services_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27428","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53250","description":"Removal of urethra gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNE1","description":"ICD-GGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychosocial rehabilitation services_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2017","description":"Psychosocial rehabilitation services_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBA0","description":"ICD-AIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLA1","description":"ICD-JHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroestradiol f18_ diagnostic_ 1 mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9060","description":"Fluoroestradiol f18_ diagnostic_ 1 mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair mouth laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40830","description":"Repair mouth laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJC0","description":"ICD-NJJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulance response/treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0998","description":"Ambulance response/treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATF0","description":"ICD-KATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc ob care/deliver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59898","description":"Laparo proc ob care/deliver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis scale","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1639","description":"Dialysis scale","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNA0","description":"ICD-OGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sysrsn no dicom srch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9344","description":"Sysrsn no dicom srch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Legionella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86713","description":"Legionella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pantoprazole sodium_ 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2470","description":"Injection_ pantoprazole sodium_ 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore treat shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23107","description":"Explore treat shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc rsn no scr uter malig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9619","description":"Doc rsn no scr uter malig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVF0","description":"ICD-JEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQA1","description":"ICD-PJQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB40","description":"Medium Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIB1","description":"ICD-NDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRD0","description":"ICD-PGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHA1","description":"ICD-MCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECA1","description":"ICD-AECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla ii typing ag equiv lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81375","description":"Hla ii typing ag equiv lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","description":"HCPCS-Q4376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1003T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","description":"CPT-1003T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQA0","description":"ICD-DAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOE1","description":"ICD-PCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOB0","description":"ICD-PJOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLA0","description":"ICD-NBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC110","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep c genotype prior to med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9207","description":"Hep c genotype prior to med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation Supply; Sleeve_ Disposable_ Per Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4437","description":"Irrigation Supply; Sleeve_ Disposable_ Per Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18D","description":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27658","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hook/hand_ hvy dty_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6721","description":"Hook/hand_ hvy dty_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQC0","description":"ICD-CEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydroxyprogesterone caproate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1725","description":"Hydroxyprogesterone caproate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMC0","description":"ICD-CCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54316","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0652U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0652U","description":"CPT-0652U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPA0","description":"ICD-NIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMB1","description":"ICD-KFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD224","description":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/family 45 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90834","description":"Psytx pt&/family 45 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTC0","description":"ICD-BGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA21","description":"ICD-4AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBB0","description":"ICD-NIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAF0","description":"ICD-OAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device_ requiring flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7299","description":"Removal of temporary anchorage device_ requiring flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKA1","description":"ICD-JFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Head control interface mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2327","description":"Head control interface mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSF1","description":"ICD-ODSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo spiral prefabricated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1951","description":"Afo spiral prefabricated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUD1","description":"ICD-ADUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNA1","description":"ICD-KDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval on foot not performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8415","description":"Eval on foot not performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis blood pressure cuff","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4663","description":"Dialysis blood pressure cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBB1","description":"ICD-CDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64864","description":"Repair of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLB0","description":"ICD-EBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefotetan disodiu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0074","description":"Injection_ cefotetan disodiu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKD0","description":"ICD-NFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITA0","description":"ICD-NITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA12","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIC1","description":"ICD-KEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOC1","description":"ICD-OFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGF1","description":"ICD-NFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOA0","description":"ICD-LEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1006T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","description":"CPT-1006T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abscess imaging ltd area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78805","description":"Abscess imaging ltd area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj suprascapular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64418","description":"N block inj suprascapular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPB1","description":"ICD-BIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen gel/paste wound fil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6011","description":"Collagen gel/paste wound fil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Root surgery bicuspid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3421","description":"Root surgery bicuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQE1","description":"ICD-GDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10C","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plt_ pher_ l/r cmv-neg_ irr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9053","description":"Plt_ pher_ l/r cmv-neg_ irr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESB1","description":"ICD-HESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWC0","description":"ICD-OCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ high complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes review of medical and/or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97167","description":"Occupational therapy evaluation_ high complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes review of medical and/or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMF0","description":"ICD-AEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILC1","description":"ICD-NILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q2057","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","description":"HCPCS-Q2057","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD141","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHA1","description":"ICD-OLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD211","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXA0","description":"ICD-KAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25491","description":"Reinforce ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBE0","description":"ICD-EGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYB0","description":"ICD-PHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCA0","description":"ICD-GDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41520","description":"Reconstruction tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2B","description":"Very High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc viral load <200","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9243","description":"Doc viral load <200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEF1","description":"ICD-MAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0658U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0658U","description":"CPT-0658U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAD0","description":"ICD-AEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDF1","description":"ICD-CHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJC1","description":"ICD-GAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEB1","description":"ICD-ABEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKB1","description":"ICD-GBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMD0","description":"ICD-MBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADF0","description":"ICD-MADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 60-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0517","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 60-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACB0","description":"ICD-JACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of lower eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15821","description":"Revision of lower eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ureteral reflux study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78740","description":"Ureteral reflux study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCB0","description":"ICD-EFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63272","description":"Excise intrspinl lesion lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sex offend tx svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2029","description":"Sex offend tx svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI jnt of lwr extre w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73721","description":"MRI jnt of lwr extre w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSB1","description":"ICD-OHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAF1","description":"ICD-ICAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHD0","description":"ICD-KBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_  casirivimab and imdevimab_ 2400 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0243","description":"Injection_  casirivimab and imdevimab_ 2400 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHC0","description":"ICD-OCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Braf gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81210","description":"Braf gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBA0","description":"ICD-OJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABA0","description":"ICD-AABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ phenylephrine ketorolac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9447","description":"Inj_ phenylephrine ketorolac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wet mounts/ w preparations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0111","description":"Wet mounts/ w preparations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28F","description":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIB0","description":"ICD-CAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHB0","description":"ICD-EHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic belt/harness/boot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0944","description":"Pelvic belt/harness/boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE215","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28G","description":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tendon for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20924","description":"Removal of tendon for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYD0","description":"ICD-CIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEC1","description":"ICD-OBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLD0","description":"ICD-JFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBB0","description":"ICD-ODBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLB1","description":"ICD-CCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJB1","description":"ICD-CEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHA0","description":"ICD-MKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFD0","description":"ICD-KEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9884","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brca2 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81217","description":"Brca2 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMD1","description":"ICD-GHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lab pathology consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80500","description":"Lab pathology consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4358","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","description":"HCPCS-Q4358","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debridement of premalignant hyperkeratotic lesion(s) (ie_ targeted curettage_ abrasion) followed with photodynamic therapy by external application of light to destroy premalig","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96574","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie_ targeted curettage_ abrasion) followed with photodynamic therapy by external application of light to destroy premalig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYF1","description":"ICD-CEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methadone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6053","description":"Methadone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXF0","description":"ICD-JFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTD0","description":"ICD-NFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnio tri-core amniotic_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4295","description":"Amnio tri-core amniotic_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Benzodiazepines","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6031","description":"Benzodiazepines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/submuc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45335","description":"Sigmoidoscopy w/submuc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Medcurrent_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1002","description":"Clinical Decision Support Mechanism Medcurrent_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJC0","description":"ICD-CEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert emergency airway","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31500","description":"Insert emergency airway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOA0","description":"ICD-KGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVA1","description":"ICD-OJVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBE1","description":"ICD-CEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBC0","description":"ICD-GEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ microarray gene expression profiling of 70 content genes and 465 housekeeping genes_ utilizing fresh frozen or formalin-fixed paraffin-embedded tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81521","description":"Oncology (breast)_ mRNA_ microarray gene expression profiling of 70 content genes and 465 housekeeping genes_ utilizing fresh frozen or formalin-fixed paraffin-embedded tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhv-6 dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87533","description":"Hhv-6 dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEF0","description":"ICD-JAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHB0","description":"ICD-ADHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYA1","description":"ICD-OJYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENF1","description":"ICD-FENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60545","description":"Explore adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43300","description":"Repair of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSC0","description":"ICD-OFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric motility studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91020","description":"Gastric motility studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABC1","description":"ICD-NABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFA0","description":"ICD-GIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3_ *4_ *5_ *6_ *7)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81231","description":"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3_ *4_ *5_ *6_ *7)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemophilus influenza b vaccine (hib)_ hboc conjugate (4 dose schedule)_for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90645","description":"Hemophilus influenza b vaccine (hib)_ hboc conjugate (4 dose schedule)_for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole_ (Abilify Asimtufii)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9152","description":"Injection_ aripiprazole_ (Abilify Asimtufii)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPD0","description":"ICD-FCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB256","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTD0","description":"ICD-EGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJA0","description":"ICD-NKJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abdom aneurysm endovas rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75953","description":"Abdom aneurysm endovas rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth pelvis surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84451","description":"Anesth pelvis surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJB1","description":"ICD-GBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTA1","description":"ICD-BDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHED1","description":"ICD-BHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWC0","description":"ICD-LFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alarm symp assessed-1+ prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1071F","description":"Alarm symp assessed-1+ prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45020","description":"Drainage of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intrnl bleaching per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9974","description":"Intrnl bleaching per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risperidone_ (perseris)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2798","description":"Injection_ risperidone_ (perseris)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJB1","description":"ICD-KIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBB1","description":"ICD-GCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of hand bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26230","description":"Partial removal of hand bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther/proph/diag iv inf init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96365","description":"Ther/proph/diag iv inf init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21248","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVE1","description":"ICD-BHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46604","description":"Anoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYE0","description":"ICD-DFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0610U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","description":"CPT-0610U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-75577","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","description":"CPT-75577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUA0","description":"ICD-FGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA56","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVE1","description":"ICD-KFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Silicone gel insert or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6692","description":"Silicone gel insert or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27681","description":"Release of lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37160","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9362","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9362","description":"HCPCS-J9362","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (Suicidal Ideation)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 54 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0293U","description":"Psychiatry (Suicidal Ideation)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 54 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWF1","description":"ICD-LHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cyp2c19 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81225","description":"Cyp2c19 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDD0","description":"ICD-ODDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval risk vte card 30d prior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9298","description":"Eval risk vte card 30d prior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl trifocal 4.00/>6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2306","description":"Lens sphcyl trifocal 4.00/>6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCD0","description":"ICD-OJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing no","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0384T","description":"External heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0406","description":"HCPCS-A0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVF1","description":"ICD-OAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3291","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","description":"HCPCS-J3291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIA0","description":"ICD-AHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUF0","description":"ICD-EGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27685","description":"Revision of lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep bk ptb open end socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5535","description":"Prep bk ptb open end socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRA0","description":"ICD-HBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ velmanase alfa-tycv_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0217","description":"Injection_ velmanase alfa-tycv_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCE1","description":"ICD-OBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQE1","description":"ICD-PGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14B","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); binding antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86041","description":"Acetylcholine receptor (AChR); binding antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDA1","description":"ICD-GCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metacarpophalangeal implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8630","description":"Metacarpophalangeal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0501U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","description":"CPT-0501U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUD0","description":"ICD-FCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trluml perip athrc iliac art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0238T","description":"Trluml perip athrc iliac art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8G","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1012","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFE1","description":"ICD-GAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC250","description":"Special Care High _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45332","description":"Sigmoidoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24006","description":"Release elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVE0","description":"ICD-OCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNB1","description":"ICD-JFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL05","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEC1","description":"ICD-JCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOD0","description":"ICD-OGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA211","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKA0","description":"ICD-KIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBA1","description":"ICD-KDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLB0","description":"ICD-IGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSD1","description":"ICD-LDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doppler echo exam heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93320","description":"Doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25126","description":"Remove/graft forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHB1","description":"ICD-OBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ 5-50 genes (eg_ ALK_ BRAF_ CDKN2A_ EGFR_ ERBB2_ KIT_ KRAS_ MET_ NRAS_ PDGFRA_ PDGFRB_ PGR_ PIK3CA_ PTEN_ RET)_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81449","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ 5-50 genes (eg_ ALK_ BRAF_ CDKN2A_ EGFR_ ERBB2_ KIT_ KRAS_ MET_ NRAS_ PDGFRA_ PDGFRB_ PGR_ PIK3CA_ PTEN_ RET)_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDE1","description":"ICD-MFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0A","description":"Default_ /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJA0","description":"ICD-OAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINE0","description":"ICD-OINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRD0","description":"ICD-GCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILC0","description":"ICD-MILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHD0","description":"ICD-OLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAE1","description":"ICD-KHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX25","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of skull tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61564","description":"Excision of skull tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXD0","description":"ICD-OBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEB0","description":"ICD-NIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dna analysis ret-oncogene","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3840","description":"Dna analysis ret-oncogene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrodiag polyneuro 6 mn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3751F","description":"Electrodiag polyneuro 6 mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44800","description":"Excision of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc sickle cell test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85660","description":"Rbc sickle cell test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8F","description":"Very High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWA1","description":"ICD-OBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete occlusal adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9952","description":"Complete occlusal adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOE0","description":"ICD-OBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD125","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQD0","description":"ICD-OAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX23","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHA1","description":"ICD-OIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESC1","description":"ICD-GESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCD0","description":"ICD-NBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diaphragm surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39599","description":"Diaphragm surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0891","description":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9160","description":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSA0","description":"ICD-OBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWA1","description":"ICD-DAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEB1","description":"ICD-NGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWD1","description":"ICD-GBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEA0","description":"ICD-ADEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAB1","description":"ICD-ODAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDB0","description":"ICD-NBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand/chin ctrl std joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2374","description":"Hand/chin ctrl std joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMC1","description":"ICD-AAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0665","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","description":"HCPCS-G0665","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1445","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","description":"HCPCS-M1445","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAE1","description":"ICD-IBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMB1","description":"ICD-CCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment x10sv retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67228","description":"Treatment x10sv retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBE1","description":"ICD-ACBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXF1","description":"ICD-OFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDE0","description":"ICD-EFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary proce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0839T","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7523","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd balloon dil esoph30 mm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43233","description":"Egd balloon dil esoph30 mm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72194","description":"Ct pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE201","description":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Primary closure sinus perf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7261","description":"Primary closure sinus perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonfamily homecare train/15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5115","description":"Nonfamily homecare train/15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEF0","description":"ICD-IIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBE1","description":"ICD-MFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEA0","description":"ICD-JHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFA1","description":"ICD-CCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMC0","description":"ICD-IEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGA0","description":"ICD-FBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis volume measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81050","description":"Urinalysis volume measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL53","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2115","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA51","description":"Default_ /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIC0","description":"ICD-FFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hh respiratory thrpy in eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5180","description":"Hh respiratory thrpy in eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMC0","description":"ICD-CGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEE0","description":"ICD-JHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intend rpt dia retin msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9671","description":"Intend rpt dia retin msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE120","description":"Special Care High _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABC0","description":"ICD-BABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABA0","description":"ICD-KABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUD0","description":"ICD-GDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correct skin color 6.0 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11920","description":"Correct skin color 6.0 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQE1","description":"ICD-CEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","description":"CPT-00190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKB1","description":"ICD-NFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87594","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","description":"CPT-87594","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meas lung vol thru 2 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94013","description":"Meas lung vol thru 2 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJB1","description":"ICD-KBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESC1","description":"ICD-DESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Provider who referred the patient to another provider received a report from the provider to whom the patient was referred","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9969","description":"Provider who referred the patient to another provider received a report from the provider to whom the patient was referred","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kras gene addl variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81276","description":"Kras gene addl variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95149","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEF0","description":"ICD-EGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQE1","description":"ICD-OFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGF0","description":"ICD-CGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPA1","description":"ICD-BEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Already Receiving Physical/Occupational/Speech/Recreational Therapy During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0040","description":"Patient Already Receiving Physical/Occupational/Speech/Recreational Therapy During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tap block unil by injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64486","description":"Tap block unil by injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0139","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","description":"HCPCS-J0139","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB31","description":"ICD-2HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28G","description":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQF1","description":"ICD-CCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJD0","description":"ICD-JGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise excessive skin thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15832","description":"Excise excessive skin thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 3 (HIPPS rate code)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 3 (HIPPS rate code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIB1","description":"ICD-NGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEE0","description":"ICD-NEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunohisto antibody slide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88344","description":"Immunohisto antibody slide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Athletic train eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97005","description":"Athletic train eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVF0","description":"ICD-NAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB40","description":"Ultra High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 xhd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0864","description":"Pwc gp3 xhd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB204","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc spermatic cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55559","description":"Laparo proc spermatic cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEB0","description":"ICD-BEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0962T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","description":"CPT-0962T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSE0","description":"ICD-KBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJB0","description":"ICD-OGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhcp-svs of aide_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0156","description":"Hhcp-svs of aide_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBF0","description":"ICD-OKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHE1","description":"ICD-KGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00731","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","description":"CPT-00731","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHE1","description":"ICD-NHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93246","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0C","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pontic titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6214","description":"Pontic titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWA1","description":"ICD-GGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVF0","description":"ICD-KFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEB0","description":"ICD-NCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient is currently on a statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9796","description":"Patient is currently on a statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMD1","description":"ICD-AHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCD1","description":"ICD-NKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vagotomy & pylorus repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43640","description":"Vagotomy & pylorus repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lamaze class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9436","description":"Lamaze class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB01","description":"Low Rehab_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIE1","description":"ICD-CBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of chin nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64736","description":"Incision of chin nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLC0","description":"ICD-EHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9632","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tympanometry & reflex thresh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92550","description":"Tympanometry & reflex thresh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRA0","description":"ICD-LDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0665U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0665U","description":"CPT-0665U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sugars multiple qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84377","description":"Sugars multiple qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQF0","description":"ICD-OIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE146","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJE0","description":"ICD-GAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJA1","description":"ICD-CDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDD1","description":"ICD-ODDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXB0","description":"ICD-BGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHC1","description":"ICD-EIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27215","description":"Treat pelvic fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB244","description":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No elig ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8857","description":"No elig ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28F","description":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUE0","description":"ICD-CAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFC1","description":"ICD-GAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay caffeine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80155","description":"Drug assay caffeine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOF1","description":"ICD-CDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETB0","description":"ICD-IETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2388","description":"Foam drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0483U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","description":"CPT-0483U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXC1","description":"ICD-CFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRE0","description":"ICD-KCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1C","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWF1","description":"ICD-DCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Afstyla)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7210","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Afstyla)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMA1","description":"ICD-CEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX01","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intl custm cong/latyp insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5681","description":"Intl custm cong/latyp insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFE1","description":"ICD-NLFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQD1","description":"ICD-GHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAA0","description":"ICD-MGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABB0","description":"ICD-MABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABB1","description":"ICD-NABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVF1","description":"ICD-BGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ gemcitabine hydrochloride (accord)_ not therapeutically equivalent to j9201_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9196","description":"Injection_ gemcitabine hydrochloride (accord)_ not therapeutically equivalent to j9201_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA106","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc prosth taa add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33884","description":"Endovasc prosth taa add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pten gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81321","description":"Pten gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEF1","description":"ICD-KIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOD0","description":"ICD-GHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJD1","description":"ICD-CHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9616","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","description":"HCPCS-A9616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic Radiology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4001","description":"Diagnostic Radiology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBA1","description":"ICD-GEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC31","description":"ICD-1JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20B","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPD1","description":"ICD-ODPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESD0","description":"ICD-HESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18C","description":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCC1","description":"ICD-FFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35452","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert uro/ves nck sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53445","description":"Insert uro/ves nck sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-invasive vagus nerve stimulator (GammaCore-S)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1020","description":"Non-invasive vagus nerve stimulator (GammaCore-S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBB1","description":"ICD-MLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUC0","description":"ICD-BEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUA1","description":"ICD-IFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSE1","description":"ICD-OJSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCED1","description":"ICD-BCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBF1","description":"ICD-KHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conformity evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5020","description":"Conformity evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15261","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB21","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBD0","description":"ICD-JFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreservation embryo(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89258","description":"Cryopreservation embryo(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSC0","description":"ICD-CBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCF0","description":"ICD-NBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/hemodynam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75889","description":"Vein x-ray liver w/hemodynam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97551","description":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA30","description":"High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLE1","description":"ICD-MKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6062","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5D","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug/substance nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80375","description":"Drug/substance nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCC0","description":"ICD-NFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFC0","description":"ICD-KHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ ablation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1886","description":"Catheter_ ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJA0","description":"ICD-CFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; with biopsy_ single or multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0653T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; with biopsy_ single or multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAB0","description":"ICD-GGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBE0","description":"ICD-GHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18I","description":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWD1","description":"ICD-HAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWC0","description":"ICD-HIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ alfentanil hydrochloride_ 500 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0216","description":"Injection_ alfentanil hydrochloride_ 500 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQF0","description":"ICD-GGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD117","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28545","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEE0","description":"ICD-EFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQD1","description":"ICD-GAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES125","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2180","description":"Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limb muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95831","description":"Limb muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDF0","description":"ICD-NHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMC0","description":"ICD-EDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove palate/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42120","description":"Remove palate/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2071","description":"Medication Assisted Treatment_ Buprenorphine (Implant Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of etiocholanolone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82696","description":"Assay of etiocholanolone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection Hpc Nos 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9985","description":"Injection Hpc Nos 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Av fusion/forearm vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36820","description":"Av fusion/forearm vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Root surgery molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3425","description":"Root surgery molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20703","description":"Removal Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB226","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient safety and support of positive experiences with anesthesia mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0059","description":"Patient safety and support of positive experiences with anesthesia mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Personal care ser per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1020","description":"Personal care ser per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trcath replace aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33366","description":"Trcath replace aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce clavicle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23490","description":"Reinforce clavicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41016","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thiopurine S-methyltransferase (TPMT)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84433","description":"Thiopurine S-methyltransferase (TPMT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28I","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESA0","description":"ICD-PESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contour back for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2293","description":"Contour back for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEID0","description":"ICD-AEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCA0","description":"ICD-NBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQB1","description":"ICD-OGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inirs each vessel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0205T","description":"Inirs each vessel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abd imag w/us_ ct or MRI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9455","description":"Abd imag w/us_ ct or MRI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No rh-immunoglobulin order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8811","description":"No rh-immunoglobulin order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKF1","description":"ICD-GBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCC1","description":"ICD-IHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXB0","description":"ICD-KAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frenuloplasty","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7963","description":"Frenuloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma plan of care not documented_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1222","description":"Glaucoma plan of care not documented_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67909","description":"Revise eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aerosol mask used w nebulize","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7015","description":"Aerosol mask used w nebulize","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64575","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANB1","description":"ICD-OANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ketamine and norketamine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80357","description":"Ketamine and norketamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67904","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zinc paste band w >=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6456","description":"Zinc paste band w >=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enclosed walker w rear seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0144","description":"Enclosed walker w rear seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXB0","description":"ICD-KFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fem urinary collect pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4328","description":"Fem urinary collect pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSA1","description":"ICD-CFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debride abdom wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11005","description":"Debride abdom wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for myelogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62284","description":"Injection for myelogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCND1","description":"ICD-BCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQD0","description":"ICD-LFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43420","description":"Repair esophagus opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Composite drsg > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6205","description":"Composite drsg > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUA1","description":"ICD-KCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBB1","description":"ICD-GFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/svc oxygen equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0740","description":"Repair/svc oxygen equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML45","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGE1","description":"ICD-CDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEF1","description":"ICD-BCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUC0","description":"ICD-MLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7637","description":"Dexamethasone comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical opening esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43351","description":"Surgical opening esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1368","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20C","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove lung artery emboli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33910","description":"Remove lung artery emboli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15D","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0677U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677U","description":"CPT-0677U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJD1","description":"ICD-NAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPD0","description":"ICD-GBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC21","description":"ICD-1GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29851","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLA0","description":"ICD-OBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Matristem wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4119","description":"Matristem wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICC1","description":"ICD-JICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diag laparo separate proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49320","description":"Diag laparo separate proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQB0","description":"ICD-HDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB226","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat trigeminal tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61791","description":"Treat trigeminal tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telescopic intraocular lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1840","description":"Telescopic intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous exchange of biliary drainage catheter (eg_ external_ internal-external_ or conversion of internal-external to external only)_ with removal of calculi/debris from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7545","description":"Percutaneous exchange of biliary drainage catheter (eg_ external_ internal-external_ or conversion of internal-external to external only)_ with removal of calculi/debris from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCD1","description":"ICD-OHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp 5/>yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99149","description":"Mod sed diff phys/qhp 5/>yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEE1","description":"ICD-OAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLA1","description":"ICD-BGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1903","description":"HCPCS-C1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAD0","description":"ICD-JHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFC1","description":"ICD-KFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDE0","description":"ICD-OGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC32","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUD1","description":"ICD-FGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec lock on manual pw elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6638","description":"Elec lock on manual pw elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0990T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","description":"CPT-0990T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33917","description":"Repair pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCE0","description":"ICD-EGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Regional block anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9211","description":"Regional block anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEF1","description":"ICD-ODEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrodes_ pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4556","description":"Electrodes_ pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHC0","description":"ICD-BBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQB0","description":"ICD-KFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electric heat pad standard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0210","description":"Electric heat pad standard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37261","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","description":"CPT-37261","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUC0","description":"ICD-OKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCE1","description":"ICD-NGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA15","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETB1","description":"ICD-OETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLD1","description":"ICD-CBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67830","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIA1","description":"ICD-FDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excisional biopsy of minor salivary glands","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7284","description":"Excisional biopsy of minor salivary glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTA1","description":"ICD-JBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITD0","description":"ICD-AITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHF0","description":"ICD-JCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5931","description":"Surgical obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXA1","description":"ICD-FHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15A","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGC0","description":"ICD-JCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDC1","description":"ICD-ECDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1202","description":"HCPCS-B1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYC0","description":"ICD-LAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKC0","description":"ICD-OKKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11100","description":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens_ intraocular (new tech)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1780","description":"Lens_ intraocular (new tech)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAED1","description":"ICD-FAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQE0","description":"ICD-PFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES156","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01220","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","description":"CPT-01220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQC0","description":"ICD-GDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51595","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress disc rf lumbar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2348","description":"Decompress disc rf lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCB0","description":"ICD-MDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/cont_ com","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8921","description":"Tte w or w/o fol w/cont_ com","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEC1","description":"ICD-MKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA126","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMF0","description":"ICD-EBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald for cochlear implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5273","description":"Ald for cochlear implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMA1","description":"ICD-CIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCB0","description":"ICD-MJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16025","description":"Dress/debrid p-thick burn m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCME0","description":"ICD-JCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13152","description":"Cmplx rpr e/n/e/l 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86971","description":"Rbc pretx incubatj w/enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec stim unattend for press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0281","description":"Elec stim unattend for press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKE0","description":"ICD-CBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0C","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDC0","description":"ICD-EGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBE0","description":"ICD-MJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7557","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPB1","description":"ICD-KDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmi is documented above normal parameters and a follow-up plan is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1293","description":"Bmi is documented above normal parameters and a follow-up plan is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","description":"CPT-00882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBC1","description":"ICD-OGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99226","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC124","description":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Presbyopia-correct function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2788","description":"Presbyopia-correct function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prenatal care atrisk assessm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1000","description":"Prenatal care atrisk assessm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMA0","description":"ICD-EDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKA0","description":"ICD-KFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scintimammography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8080","description":"Scintimammography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTD0","description":"ICD-JGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPD0","description":"ICD-BEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Buccal/labial frenectomy (frenulectomy)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7961","description":"Buccal/labial frenectomy (frenulectomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBA0","description":"ICD-ABBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromatogram assay sugars","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84375","description":"Chromatogram assay sugars","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBD0","description":"ICD-FDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bumetanide_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1939","description":"Injection_ bumetanide_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ustekinumab_ for intravenous injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9487","description":"Ustekinumab_ for intravenous injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIA0","description":"ICD-GDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEND1","description":"ICD-KEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL52","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37283","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","description":"CPT-37283","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chronic Care Management Services_ Each Additional 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional_ Per Calendar Month (Li","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2058","description":"Chronic Care Management Services_ Each Additional 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional_ Per Calendar Month (Li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped term dev_ hook_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6712","description":"Ped term dev_ hook_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEA1","description":"ICD-OBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0015","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTD0","description":"ICD-EBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLE1","description":"ICD-JFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio abdominal arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75635","description":"Ct angio abdominal arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTB0","description":"ICD-EDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALF1","description":"ICD-JALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arm tendon lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24305","description":"Arm tendon lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACE0","description":"ICD-IACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Brolucizumab-Dbll_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0179","description":"Injection_ Brolucizumab-Dbll_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insrt drug device for iop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0356T","description":"Insrt drug device for iop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1493","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","description":"HCPCS-M1493","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Protect body sock ea pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0984","description":"Protect body sock ea pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric restrictive procedure_ endoscopic sleeve gastroplasty_ with esophagogastroduodenoscopy and intraluminal tube insertion_ if performed_ including all system and tissue a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9784","description":"Gastric restrictive procedure_ endoscopic sleeve gastroplasty_ with esophagogastroduodenoscopy and intraluminal tube insertion_ if performed_ including all system and tissue a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUB1","description":"ICD-KBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAF0","description":"ICD-OFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXB1","description":"ICD-BDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24D","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFA1","description":"ICD-NAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRE1","description":"ICD-CDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJF1","description":"ICD-KBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELA0","description":"ICD-BELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHND0","description":"ICD-JHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixation of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27570","description":"Fixation of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair lower leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27734","description":"Repair lower leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA40","description":"High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy c/th facet jnt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64634","description":"Destroy c/th facet jnt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chlorhexidine antisept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4248","description":"Chlorhexidine antisept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKC0","description":"ICD-JFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHD0","description":"ICD-FBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPC0","description":"ICD-JEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery electrocorticogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95829","description":"Surgery electrocorticogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54100","description":"Biopsy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJE1","description":"ICD-BDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOF0","description":"ICD-OLOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24B","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA33","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA31","description":"ICD-3CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1B","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHF1","description":"ICD-JGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUC0","description":"ICD-JHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVA1","description":"ICD-CIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIB1","description":"ICD-OBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTF0","description":"ICD-EBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elastase_ Pancreatic (El-1)_ Fecal; Quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82653","description":"Elastase_ Pancreatic (El-1)_ Fecal; Quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAB0","description":"ICD-KCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOA1","description":"ICD-LIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA23","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIED0","description":"ICD-KIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36215","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-apgf_ biosimilar_ (nyvepria)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5122","description":"Injection_ pegfilgrastim-apgf_ biosimilar_ (nyvepria)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ emicizumab-kxwh_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9995","description":"Injection_ emicizumab-kxwh_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acesso AC_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4312","description":"Acesso AC_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1289","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1289","description":"HCPCS-J1289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCB0","description":"ICD-NHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHME1","description":"ICD-KHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYE1","description":"ICD-DBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXF1","description":"ICD-GCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACA0","description":"ICD-KACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIA1","description":"ICD-OGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXF1","description":"ICD-NFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTA0","description":"ICD-MDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 20-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88264","description":"Chromosome analysis 20-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wcd device interrogate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93292","description":"Wcd device interrogate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth fat layer removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80251","description":"Anesth fat layer removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD217","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-op asst not doc_ rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9617","description":"Pre-op asst not doc_ rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDME1","description":"ICD-JDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVA0","description":"ICD-BGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3C","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0768T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMB0","description":"ICD-JGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occult blood test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4773","description":"Occult blood test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOB1","description":"ICD-GCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0517","description":"Removal of non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLB1","description":"ICD-JGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ adalimumab-afzb (abrilada)_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5132","description":"Injection_ adalimumab-afzb (abrilada)_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB11","description":"ICD-1FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWD0","description":"ICD-PEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto tissue graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4283","description":"Auto tissue graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation at shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23920","description":"Amputation at shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10C","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBA0","description":"ICD-BGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPE0","description":"ICD-OJPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERB0","description":"ICD-PERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove inner ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69910","description":"Remove inner ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24D","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0669T","description":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96130","description":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDB0","description":"ICD-JFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITA1","description":"ICD-GITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPC1","description":"ICD-NHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEE1","description":"ICD-OIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording_ and disconnection per patient encounter_ wireless cardiac stimula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0521T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording_ and disconnection per patient encounter_ wireless cardiac stimula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIB0","description":"ICD-GEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temporary external pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92953","description":"Temporary external pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB230","description":"Special Care Low _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKB0","description":"ICD-GGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXF1","description":"ICD-KGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRD0","description":"ICD-PBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prefab porc/ceram crown pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2929","description":"Prefab porc/ceram crown pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFE1","description":"ICD-BIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microbe susceptible diffuse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87181","description":"Microbe susceptible diffuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAF1","description":"ICD-NIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKD1","description":"ICD-GGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7190","description":"Factor viii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote 30 day ecg rev/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93270","description":"Remote 30 day ecg rev/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAA1","description":"ICD-OEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJD1","description":"ICD-OFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAB0","description":"ICD-EAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trtmnt simulation 3d image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0393","description":"Trtmnt simulation 3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01782","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","description":"CPT-01782","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILF0","description":"ICD-KILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; mechano-electrical skin interface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0457T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; mechano-electrical skin interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYC0","description":"ICD-HAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27450","description":"Incision of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIA0","description":"ICD-BEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCED1","description":"ICD-JCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKA1","description":"ICD-NAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1051","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-27713","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","description":"CPT-27713","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Piflufolastat F-18_ Diagnostic_ 1 Millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9595","description":"Piflufolastat F-18_ Diagnostic_ 1 Millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGB1","description":"ICD-KGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVA1","description":"ICD-FBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINC1","description":"ICD-OINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of osteocalcin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83937","description":"Assay of osteocalcin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aortic circulation assist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33971","description":"Aortic circulation assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBE0","description":"ICD-JBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAC1","description":"ICD-KGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASA1","description":"ICD-LASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antithromb thx presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8696","description":"Antithromb thx presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVB0","description":"ICD-JGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFND1","description":"ICD-OFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC230","description":"Special Care High _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB31","description":"ICD-3AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAA1","description":"ICD-KFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath indw foley 2 way silicn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4344","description":"Cath indw foley 2 way silicn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNE1","description":"ICD-OBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0604","description":"HCPCS-A0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFC0","description":"ICD-JGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFE0","description":"ICD-FIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISE1","description":"ICD-KISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8B","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMA1","description":"ICD-BHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office emergency care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99058","description":"Office emergency care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI pelvis w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72195","description":"MRI pelvis w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","description":"HCPCS-M1382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8C","description":"Low Rehab_ ADL Index 0-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL03","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Design custom breast implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19396","description":"Design custom breast implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMA0","description":"ICD-OBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22B","description":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2301","description":"Pwr standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXA0","description":"ICD-FFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQC1","description":"ICD-DIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAF0","description":"ICD-EHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMB0","description":"ICD-MDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFB1","description":"ICD-NJFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBB0","description":"ICD-OFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQF0","description":"ICD-CCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXE1","description":"ICD-JDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infus insulin pump non needl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4230","description":"Infus insulin pump non needl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEE1","description":"ICD-CIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQC1","description":"ICD-LCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth hernia repair preemie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83651","description":"Anesth hernia repair preemie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQD0","description":"ICD-PAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBED0","description":"ICD-EBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXF1","description":"ICD-NGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-123 sod iodide mil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9509","description":"Iodine i-123 sod iodide mil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLID1","description":"ICD-NLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Counseling_ group_ by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9003","description":"Counseling_ group_ by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTE1","description":"ICD-CBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUF0","description":"ICD-BFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC114","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIF0","description":"ICD-NBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEC1","description":"ICD-BIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21C","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1329","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung and colon cancer)_ DNA_ qualitative_ next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes_ formalin-fixed par","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0448U","description":"Oncology (lung and colon cancer)_ DNA_ qualitative_ next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes_ formalin-fixed par","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9308","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9308","description":"HCPCS-C9308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVB0","description":"ICD-JHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRF0","description":"ICD-CHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pentobarbital sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2515","description":"Pentobarbital sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18G","description":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWE1","description":"ICD-LDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOE0","description":"ICD-DCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amniowrap2_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4221","description":"Amniowrap2_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGF1","description":"ICD-GAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWA0","description":"ICD-HHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Internal Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4011","description":"Internal Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML11","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERB1","description":"ICD-GERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alemtuzumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9010","description":"Alemtuzumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMA0","description":"ICD-IDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPB1","description":"ICD-KCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Beta not given no reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9188","description":"Beta not given no reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFA1","description":"ICD-OEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDC1","description":"ICD-JIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cesarean birth class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9438","description":"Cesarean birth class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCA1","description":"ICD-AFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthodontic rem appliance tx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8210","description":"Orthodontic rem appliance tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDC0","description":"ICD-FIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGC0","description":"ICD-ODGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVE0","description":"ICD-BCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKC0","description":"ICD-BEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEB1","description":"ICD-FAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYF0","description":"ICD-PKYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impltj Nonbiol/Synth Implt Fasc Rnfcmt Abdl Wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0437T","description":"Impltj Nonbiol/Synth Implt Fasc Rnfcmt Abdl Wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interspinous implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1821","description":"Interspinous implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLD0","description":"ICD-FBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLF1","description":"ICD-FBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEED1","description":"ICD-AEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m fanolesomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9566","description":"Tc99m fanolesomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy/needle bx each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31629","description":"Bronchoscopy/needle bx each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65880","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRE0","description":"ICD-OFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBC0","description":"ICD-MDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17266","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBE0","description":"ICD-AFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81219","description":"Calr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16374","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16374","description":"CPT-16374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXF0","description":"ICD-OIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc visit unspecified nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9055","description":"Onc visit unspecified nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43620","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bio-connekt per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4161","description":"Bio-connekt per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonfamily hc train/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5116","description":"Nonfamily hc train/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); open_ from living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0665T","description":"Donor hysterectomy (including cold preservation); open_ from living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQC0","description":"ICD-KIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Has Any Emergency Department Encounter During The Performance Period With Place Of Service Indicator 23","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0035","description":"Patient Has Any Emergency Department Encounter During The Performance Period With Place Of Service Indicator 23","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2A","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AI IBD MRNA XPRSN PRFL 17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0203U","description":"AI IBD MRNA XPRSN PRFL 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx pancreatc p r1/r2 no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9106","description":"Onc dx pancreatc p r1/r2 no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std mult pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0842","description":"Pwc gp2 std mult pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA21","description":"ICD-3CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1385","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","description":"HCPCS-M1385","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEF1","description":"ICD-IEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESE1","description":"ICD-OESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDE1","description":"ICD-GFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 4 vsts p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90954","description":"Esrd serv 4 vsts p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Typhoid vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90691","description":"Typhoid vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epifix_ inj_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4145","description":"Epifix_ inj_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29870","description":"Knee arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIC1","description":"ICD-OCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no disc tx opt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9400","description":"Doc reas no disc tx opt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLF1","description":"ICD-EBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMF0","description":"ICD-CIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBE1","description":"ICD-MGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKA0","description":"ICD-JDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBF0","description":"ICD-GIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transurethral rf treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53860","description":"Transurethral rf treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTD0","description":"ICD-EFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA234","description":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1194","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cromolyn sodium noncomp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7631","description":"Cromolyn sodium noncomp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELF0","description":"ICD-AELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKE1","description":"ICD-KDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX43","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLD0","description":"ICD-OJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNE1","description":"ICD-OGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMF1","description":"ICD-OEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPD1","description":"ICD-JFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sc ther infusion addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96370","description":"Sc ther infusion addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dynamic cavernosometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54231","description":"Dynamic cavernosometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWF0","description":"ICD-DHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCC1","description":"ICD-BDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med trng & support per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0034","description":"Med trng & support per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNE0","description":"ICD-BDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryoprecipitated fibrinogen complex_ pathogen reduced_ eachunit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9026","description":"Cryoprecipitated fibrinogen complex_ pathogen reduced_ eachunit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCA0","description":"ICD-MHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epicord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4187","description":"Epicord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJD1","description":"ICD-JBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRC1","description":"ICD-DDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36578","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thrombolytic venous therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37212","description":"Thrombolytic venous therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETE1","description":"ICD-IETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coroners autopsy (necropsy)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88045","description":"Coroners autopsy (necropsy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lo rig pos pnl l1-l5 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0641","description":"Lo rig pos pnl l1-l5 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIC1","description":"ICD-BDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt instr no bd rest 4 days/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4248F","description":"Pt instr no bd rest 4 days/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zaire ebolavirus vaccine_ live_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90758","description":"Zaire ebolavirus vaccine_ live_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso corset front","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0970","description":"Tlso corset front","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALF0","description":"ICD-FALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPB1","description":"ICD-OHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18F","description":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flunisolide comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7641","description":"Flunisolide comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lwr xtr vasc stdy bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93924","description":"Lwr xtr vasc stdy bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVB1","description":"ICD-NJVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUA1","description":"ICD-MFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation nasal sinus artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30915","description":"Ligation nasal sinus artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJB1","description":"ICD-CCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza dna amp prob addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87503","description":"Influenza dna amp prob addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Number of patients not screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1208","description":"Number of patients not screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTC0","description":"ICD-BHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Robotic surgical system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2900","description":"Robotic surgical system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXE0","description":"ICD-NCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28630","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8566","description":"Pt inelig ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq card stent/ath/angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92933","description":"Prq card stent/ath/angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQF1","description":"ICD-GEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKF0","description":"ICD-KAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIF0","description":"ICD-ABIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC113","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Internal nerve revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64727","description":"Internal nerve revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28505","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28B","description":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Motion test w/ft press meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96001","description":"Motion test w/ft press meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0683U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683U","description":"CPT-0683U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHA0","description":"ICD-NAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB101","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBA0","description":"ICD-OBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ bal dil_ non-vascular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1726","description":"Cath_ bal dil_ non-vascular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHD0","description":"ICD-OBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50575","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKE1","description":"ICD-KGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Create eardrum opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69436","description":"Create eardrum opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trach-esoph voice pros md in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8509","description":"Trach-esoph voice pros md in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXB1","description":"ICD-OGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of ureter & kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50740","description":"Fusion of ureter & kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAE0","description":"ICD-ABAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone srgry cmptr fluor image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054T","description":"Bone srgry cmptr fluor image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWB1","description":"ICD-PJWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMA1","description":"ICD-IAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENF1","description":"ICD-BENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sheath upper limb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8415","description":"Sheath upper limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC154","description":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJA1","description":"ICD-OEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of protein any source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84160","description":"Assay of protein any source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIF0","description":"ICD-FAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1401","description":"HCPCS-C1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1468","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","description":"HCPCS-M1468","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBA0","description":"ICD-KGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9460","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWC0","description":"ICD-DAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIB0","description":"ICD-KGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noonan spectrum disorders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81442","description":"Noonan spectrum disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB40","description":"Low Rehab_ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEE1","description":"ICD-GAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPA1","description":"ICD-NAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYC1","description":"ICD-CHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58943","description":"Removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Windowing of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29730","description":"Windowing of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTC1","description":"ICD-GGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPB0","description":"ICD-NKPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGF1","description":"ICD-OEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGB0","description":"ICD-FEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc rsn no preop assmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9616","description":"Doc rsn no preop assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0589U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","description":"CPT-0589U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETA0","description":"ICD-GETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ moderate complexity_ requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical acti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97170","description":"Athletic training evaluation_ moderate complexity_ requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical acti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27825","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETE1","description":"ICD-NETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee joint cam lock each joi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2415","description":"Knee joint cam lock each joi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01931","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","description":"CPT-01931","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYF0","description":"ICD-HBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYE1","description":"ICD-KEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBB0","description":"ICD-MHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain ovary abscess percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58822","description":"Drain ovary abscess percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary pouch w ex wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4391","description":"Urinary pouch w ex wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVE1","description":"ICD-KHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALF0","description":"ICD-CALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJB0","description":"ICD-KAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBA1","description":"ICD-BCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1342","description":"Patients who died during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVC1","description":"ICD-NEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2699","description":"Brachytx_ non-stranded_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental case management - motivational interviewing","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9993","description":"Dental case management - motivational interviewing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAE0","description":"ICD-JAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFC0","description":"ICD-GFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33984","description":"Ecmo/ecls rmvl prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXF0","description":"ICD-JAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00322","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","description":"CPT-00322","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHF0","description":"ICD-CHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophageal sphincter augmentation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43285","description":"Removal of esophageal sphincter augmentation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQD0","description":"ICD-DEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTD0","description":"ICD-GCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSF0","description":"ICD-LDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAF0","description":"ICD-OGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPF0","description":"ICD-BEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHA1","description":"ICD-KDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIF0","description":"ICD-CBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd remove lesion snare","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43251","description":"Egd remove lesion snare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87341","description":"IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4B","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHF0","description":"ICD-KCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVF1","description":"ICD-KGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFF1","description":"ICD-NHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPB0","description":"ICD-NLPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHD0","description":"ICD-KDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUC0","description":"ICD-NHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIID0","description":"ICD-GIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEE0","description":"ICD-OFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay urine catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82382","description":"Assay urine catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC21","description":"ICD-1BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"P-mastectomy w/ln removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19302","description":"P-mastectomy w/ln removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcath stent cca w/eps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37215","description":"Transcath stent cca w/eps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMD0","description":"ICD-JDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVF1","description":"ICD-FFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYB1","description":"ICD-OFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMA0","description":"ICD-EIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAB1","description":"ICD-OCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below knee cuff suspension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5666","description":"Below knee cuff suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCF1","description":"ICD-MLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26605","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKA1","description":"ICD-GEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSA0","description":"ICD-PBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O2 contents liquid lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8121","description":"O2 contents liquid lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOD0","description":"ICD-LIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDE1","description":"ICD-CEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auric/peri pain assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1116F","description":"Auric/peri pain assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBC1","description":"ICD-OHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPF0","description":"ICD-GBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18E","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subs episode for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1128F","description":"Subs episode for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insrt/redo neurostim 1 array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61885","description":"Insrt/redo neurostim 1 array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11C","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTF0","description":"ICD-JCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0104","description":"HCPCS-C0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVB1","description":"ICD-JDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neg microalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3061F","description":"Neg microalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDB0","description":"ICD-OLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAD0","description":"ICD-GBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); percutaneous femoral vein approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0805T","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); percutaneous femoral vein approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23520","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part hand no fingers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6020","description":"Part hand no fingers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pet image ltd area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78811","description":"Pet image ltd area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYD1","description":"ICD-CBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXC1","description":"ICD-OBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWB1","description":"ICD-HGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assessment by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9001","description":"Assessment by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRA1","description":"ICD-OIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOF1","description":"ICD-KIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test sock wrist disart/bel e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6680","description":"Test sock wrist disart/bel e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACE0","description":"ICD-MACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (hospira) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9294","description":"Injection_ pemetrexed (hospira) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIE1","description":"ICD-GFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJF1","description":"ICD-OFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ loncastuximab tesirine-lpyl_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9084","description":"Injection_ loncastuximab tesirine-lpyl_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUF0","description":"ICD-CCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavior identification-supporting assessment_ administered by one technician under the direction of a physician or other qualified health care professional_ face-to-face with","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97152","description":"Behavior identification-supporting assessment_ administered by one technician under the direction of a physician or other qualified health care professional_ face-to-face with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2174","description":"Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOE0","description":"ICD-GFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHB0","description":"ICD-OLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKB0","description":"ICD-KGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCB0","description":"ICD-BDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1000T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","description":"CPT-1000T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBD1","description":"ICD-FHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXA0","description":"ICD-JCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYC1","description":"ICD-OLYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41017","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXB1","description":"ICD-CHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYA0","description":"ICD-PEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ copanlisib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9030","description":"Injection_ copanlisib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD115","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Growth stimulation gene 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83006","description":"Growth stimulation gene 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73090","description":"X-ray exam of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2753","description":"Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHA1","description":"ICD-ODHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGD0","description":"ICD-FAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUA1","description":"ICD-EHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nsclc stgi no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9063","description":"Onc dx nsclc stgi no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1073","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","description":"HCPCS-J1073","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clin sign vol ovrld assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2002F","description":"Clin sign vol ovrld assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYC1","description":"ICD-DIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIE0","description":"ICD-AIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein six or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33516","description":"Cabg vein six or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj filgrastim excl biosimil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1442","description":"Inj filgrastim excl biosimil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCB1","description":"ICD-ODCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No srch for ct in 12mo norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9342","description":"No srch for ct in 12mo norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (hospira)_ not therapeutically equivalent to j0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0877","description":"Injection_ daptomycin (hospira)_ not therapeutically equivalent to j0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJB1","description":"ICD-KCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aquatic therapy/exercises","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97113","description":"Aquatic therapy/exercises","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALB1","description":"ICD-JALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQB1","description":"ICD-OIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPD1","description":"ICD-OFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42330","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57455","description":"Biopsy of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUC0","description":"ICD-MKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIA1","description":"ICD-FHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILD0","description":"ICD-KILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEB1","description":"ICD-IIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel)_ radiological supervision and interpretation; each additional non-coronary vessel (list separately in addition to c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75946","description":"Intravascular ultrasound (non-coronary vessel)_ radiological supervision and interpretation; each additional non-coronary vessel (list separately in addition to c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDE1","description":"ICD-MGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHD1","description":"ICD-OJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOC1","description":"ICD-GCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHB0","description":"ICD-MGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERB1","description":"ICD-DERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDF0","description":"ICD-NKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received chemotherapy in the last 14 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9847","description":"Patient received chemotherapy in the last 14 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPF1","description":"ICD-BAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise max/zygoma b9 tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21030","description":"Excise max/zygoma b9 tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC10","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQA1","description":"ICD-KFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (with or without the patient present)_ face-to-face with gua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97156","description":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (with or without the patient present)_ face-to-face with gua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUE0","description":"ICD-EAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKF0","description":"ICD-CDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIB1","description":"ICD-GEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33851","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MLH1 (mutL homolog 1) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0158U","description":"MLH1 (mutL homolog 1) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 1999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4722","description":"Dialys sol fld vol > 1999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUC1","description":"ICD-GEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWC0","description":"ICD-GGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLA1","description":"ICD-OFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00800","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","description":"CPT-00800","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Audit/dast 15-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99408","description":"Audit/dast 15-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMD1","description":"ICD-NGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA54","description":"Medium Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMF1","description":"ICD-MCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Topotecan oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8705","description":"Topotecan oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTF1","description":"ICD-GGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSA1","description":"ICD-DGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv)_ includes: hiv risk assessment (initial or continued","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0013","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv)_ includes: hiv risk assessment (initial or continued","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX01","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Integra drt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4105","description":"Integra drt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1>=risk or>= mod risk for te","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8972","description":"1>=risk or>= mod risk for te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Install spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63741","description":"Install spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61705","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAA0","description":"ICD-CHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIME1","description":"ICD-IIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFC1","description":"ICD-NDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12A","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rare constitutional and other heritable disorders_ whole genome and mitochondrial DNA sequence analysis_ blood_ frozen & formalin-fixed paraffin-embedded (FFPE) tissue_ saliva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0265U","description":"Rare constitutional and other heritable disorders_ whole genome and mitochondrial DNA sequence analysis_ blood_ frozen & formalin-fixed paraffin-embedded (FFPE) tissue_ saliva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVA0","description":"ICD-FAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/2.25-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2112","description":"Spherocylindr 7.25d/2.25-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0621U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","description":"CPT-0621U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX07","description":"High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient Respite Care - A flat per diem rate before area wage adjustment paid for each day on which the patient is in an inpatient facility and is receiving respite care.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0604","description":"Inpatient Respite Care - A flat per diem rate before area wage adjustment paid for each day on which the patient is in an inpatient facility and is receiving respite care.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACF0","description":"ICD-CACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHD0","description":"ICD-AAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam l-s spine bending","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72114","description":"X-ray exam l-s spine bending","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE101","description":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDB1","description":"ICD-MHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0504U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","description":"CPT-0504U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA_ gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0047U","description":"Oncology (prostate)_ mRNA_ gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC21","description":"ICD-4HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fees w/laryngeal sense test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92616","description":"Fees w/laryngeal sense test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6558","description":"Gradient compression stocking_ thigh length_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj arthroscopy discectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7876","description":"Tmj arthroscopy discectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEB0","description":"ICD-GEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJE1","description":"ICD-CCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fqhc visit_ mh new pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0469","description":"Fqhc visit_ mh new pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMC1","description":"ICD-CHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPC0","description":"ICD-NAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAF0","description":"ICD-CFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUD0","description":"ICD-GEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73610","description":"X-ray exam of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDA1","description":"ICD-IIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSE1","description":"ICD-GFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thiotepa injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9340","description":"Thiotepa injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alglucosidase alfa injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0220","description":"Alglucosidase alfa injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVA0","description":"ICD-BDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIE1","description":"ICD-OBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relocate pocket for defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33223","description":"Relocate pocket for defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJC1","description":"ICD-FFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIA1","description":"ICD-OCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASD0","description":"ICD-GASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63076","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAF1","description":"ICD-ODAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEF1","description":"ICD-JDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVA0","description":"ICD-OJVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12D","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLA1","description":"ICD-NCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGE0","description":"ICD-BGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBF1","description":"ICD-NLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand tendon/muscle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26494","description":"Hand tendon/muscle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAA1","description":"ICD-KIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGF1","description":"ICD-JIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral - periapical radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0707","description":"Intraoral - periapical radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vanomycin dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87500","description":"Vanomycin dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSC1","description":"ICD-LBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOE0","description":"ICD-HGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXE0","description":"ICD-BIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPE1","description":"ICD-BAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB260","description":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFB1","description":"ICD-GDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Did Not Receive At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2162","description":"Patient Did Not Receive At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply intrcav radiat compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77763","description":"Apply intrcav radiat compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0685U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685U","description":"CPT-0685U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKC0","description":"ICD-JHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1001","description":"HCPCS-A1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXC0","description":"ICD-BBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQB1","description":"ICD-PCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBC0","description":"ICD-JHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBA1","description":"ICD-OEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUD1","description":"ICD-OEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cetuximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9055","description":"Cetuximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21085","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diet counsel at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9474","description":"Diet counsel at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Not pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8712","description":"Not pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAD0","description":"ICD-NCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA10","description":"High Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zenith Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4253","description":"Zenith Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of midfoot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28304","description":"Incision of midfoot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dexmedetomidine_ oral_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1105","description":"Dexmedetomidine_ oral_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMD1","description":"ICD-NAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMF1","description":"ICD-CIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC240","description":"Special Care High _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alkaloids nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80323","description":"Alkaloids nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMB1","description":"ICD-GAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mast subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19304","description":"Mast subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0103","description":"HCPCS-A0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tenofovir_ by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ urine_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0025U","description":"Tenofovir_ by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ urine_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep a vac injxn admin/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4148F","description":"Hep a vac injxn admin/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22A","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hdr rdncl skn surf brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77767","description":"Hdr rdncl skn surf brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph egd dilation <30 mm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43249","description":"Esoph egd dilation <30 mm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFME1","description":"ICD-CFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADA1","description":"ICD-IADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attempted vbac after care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59622","description":"Attempted vbac after care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQD1","description":"ICD-PCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRC0","description":"ICD-PGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHC0","description":"ICD-IAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Referral To Physical_ Occupational_ Speech_ Or Recreational Therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0042","description":"Referral To Physical_ Occupational_ Speech_ Or Recreational Therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98000","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","description":"CPT-98000","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOC1","description":"ICD-DFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMB1","description":"ICD-KHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUF0","description":"ICD-JIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHF0","description":"ICD-KBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUD1","description":"ICD-OBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pmkr_ dual_ rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1785","description":"Pmkr_ dual_ rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJA0","description":"ICD-KIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVE1","description":"ICD-GGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLA0","description":"ICD-ECLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXA0","description":"ICD-OEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ voriconazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3465","description":"Injection_ voriconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical path gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88300","description":"Surgical path gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEF1","description":"ICD-KAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conditioning play audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92582","description":"Conditioning play audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ATXN2 (ataxin 2) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81179","description":"ATXN2 (ataxin 2) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOE0","description":"ICD-CAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seg pneumatic appl full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0667","description":"Seg pneumatic appl full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHC0","description":"ICD-ODHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver allotransplantation; heterotopic_ partial or whole_ from cadaver or living donor_ any age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47136","description":"Liver allotransplantation; heterotopic_ partial or whole_ from cadaver or living donor_ any age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9986","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNE1","description":"ICD-NCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXA0","description":"ICD-OLXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPA1","description":"ICD-OLPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECC0","description":"ICD-OECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKF0","description":"ICD-BFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16071","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16071","description":"CPT-16071","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB155","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYF0","description":"ICD-GFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23515","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus)_ derived from anatomical image da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0745T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus)_ derived from anatomical image da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21263","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAC1","description":"ICD-BFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAD1","description":"ICD-OLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEC1","description":"ICD-CEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMF1","description":"ICD-NAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEB0","description":"ICD-MLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0648U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0648U","description":"CPT-0648U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICE1","description":"ICD-MICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Garamycin gentamicin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1580","description":"Garamycin gentamicin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQB0","description":"ICD-LGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deb musc/fascia 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11043","description":"Deb musc/fascia 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPE0","description":"ICD-CHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBE1","description":"ICD-OLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUA0","description":"ICD-KFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHE1","description":"ICD-BCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQE1","description":"ICD-CAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETF1","description":"ICD-AETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76080","description":"X-ray exam of fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLB0","description":"ICD-KCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0851","description":"Pwc gp 3 hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flowcytometry/read 16 & >","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88189","description":"Flowcytometry/read 16 & >","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB21","description":"ICD-2DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQB1","description":"ICD-HAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETD0","description":"ICD-KETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9026","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","description":"HCPCS-J9026","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAB1","description":"ICD-ADAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXE0","description":"ICD-KGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy islet cell trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0342","description":"Laparoscopy islet cell trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIA1","description":"ICD-AEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKA0","description":"ICD-BDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVE0","description":"ICD-BDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc antibody identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86870","description":"Rbc antibody identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAC1","description":"ICD-CIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4335","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","description":"HCPCS-Q4335","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr rem hernia init reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49550","description":"Rpr rem hernia init reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig osteo screen measu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8401","description":"Pt inelig osteo screen measu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGD1","description":"ICD-CHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20A","description":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEE0","description":"ICD-NHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUC1","description":"ICD-FFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHC0","description":"ICD-BIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27509","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFC0","description":"ICD-GEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMA1","description":"ICD-NCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAE1","description":"ICD-GEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOA1","description":"ICD-CEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLF1","description":"ICD-MGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attendant care service /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5126","description":"Attendant care service /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photo patch test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95052","description":"Photo patch test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lsh w/t/o ut 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58542","description":"Lsh w/t/o ut 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUA0","description":"ICD-EDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close mult vsd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33675","description":"Close mult vsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQF1","description":"ICD-HCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCE1","description":"ICD-CHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJB1","description":"ICD-OIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFE1","description":"ICD-OCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUC1","description":"ICD-BHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFF1","description":"ICD-NCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thigh/wght bear lacer molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2540","description":"Thigh/wght bear lacer molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of abdominal wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49900","description":"Repair of abdominal wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADC0","description":"ICD-GADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABE1","description":"ICD-EABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPD1","description":"ICD-KCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEE0","description":"ICD-FHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hm postpar hyper per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9212","description":"Hm postpar hyper per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATB1","description":"ICD-BATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo multilig ank sup pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1906","description":"Afo multilig ank sup pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare donor lung single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32855","description":"Prepare donor lung single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99233","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc order anti-plat or p2y12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9609","description":"Doc order anti-plat or p2y12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRD1","description":"ICD-HFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOD0","description":"ICD-HCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE251","description":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frame typ socket bel elbow/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6687","description":"Frame typ socket bel elbow/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amniotext patch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4247","description":"Amniotext patch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKC0","description":"ICD-JBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFF1","description":"ICD-JEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRD1","description":"ICD-PJRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHED0","description":"ICD-KHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDE1","description":"ICD-FFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDF1","description":"ICD-GBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQF1","description":"ICD-KIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB215","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63015","description":"Remove spine lamina >2 crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ betibeglogene autotemcel_ per treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3393","description":"Injection_ betibeglogene autotemcel_ per treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSA0","description":"ICD-PLSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWE1","description":"ICD-LAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUC0","description":"ICD-AAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cannula declotting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36861","description":"Cannula declotting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom glove for term device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6895","description":"Custom glove for term device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHB1","description":"ICD-AFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJD0","description":"ICD-JDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ho flex pavlik harns pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1620","description":"Ho flex pavlik harns pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDC0","description":"ICD-OGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Admin influenza virus vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0008","description":"Admin influenza virus vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calculated 10-year ascvd risk score of  = 20 percent during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1364","description":"Calculated 10-year ascvd risk score of  = 20 percent during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCE1","description":"ICD-MLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mcoln1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81290","description":"Mcoln1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rcmnd flw-up 10 yrs docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0528F","description":"Rcmnd flw-up 10 yrs docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation medicine (allograft rejection_ renal)_ measurement of donor and third-party-induced CD154+T-cytotoxic memory cells_ utilizing whole peripheral blood_ algorithm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0018M","description":"Transplantation medicine (allograft rejection_ renal)_ measurement of donor and third-party-induced CD154+T-cytotoxic memory cells_ utilizing whole peripheral blood_ algorithm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB26","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ldl-c 100-129 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3049F","description":"Ldl-c 100-129 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARB1","description":"ICD-DARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYD0","description":"ICD-HGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUF1","description":"ICD-CFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJB0","description":"ICD-BEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Valvotomy pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33471","description":"Valvotomy pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"APC (APC regulator of WNT signaling pathway)(EG_familial adenomatosis polyposis [FAP] MRNA sequence analysis (list seperately in addition to code for primary procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0157U","description":"APC (APC regulator of WNT signaling pathway)(EG_familial adenomatosis polyposis [FAP] MRNA sequence analysis (list seperately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ ocriplasmin_ 0.125 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7316","description":"Inj_ ocriplasmin_ 0.125 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQA0","description":"ICD-DFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (Cutaquig)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1551","description":"Injection_ immune globulin (Cutaquig)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESE1","description":"ICD-CESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue culture lymphocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88230","description":"Tissue culture lymphocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEB0","description":"ICD-KIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect metatarsal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28173","description":"Resect metatarsal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWF0","description":"ICD-KBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore wound chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20101","description":"Explore wound chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27256","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0170","description":"Commode chair electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6028","description":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit cont anticoag diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9336","description":"Hit cont anticoag diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50955","description":"Ureter endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by groin incision_ unilateral (Li","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34714","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by groin incision_ unilateral (Li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPF0","description":"ICD-BDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOA1","description":"ICD-DIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vent mgmt nf per day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94004","description":"Vent mgmt nf per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFC0","description":"ICD-NCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGC0","description":"ICD-OIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWA0","description":"ICD-KHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAB1","description":"ICD-GHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01215","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","description":"CPT-01215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAE1","description":"ICD-MAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove digit nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64776","description":"Remove digit nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRA1","description":"ICD-KFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28I","description":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93283","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow disarticulation switch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6940","description":"Elbow disarticulation switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93313","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74220","description":"Contrast x-ray esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBF1","description":"ICD-ECBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA11","description":"ICD-1AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMF0","description":"ICD-MKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTF0","description":"ICD-GCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIC1","description":"ICD-FBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deionizer h2o puri system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1615","description":"Deionizer h2o puri system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCD1","description":"ICD-NGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8F","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTF0","description":"ICD-JDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQA1","description":"ICD-KGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8D","description":"Medium Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext ureth clmp or compr dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4356","description":"Ext ureth clmp or compr dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB11","description":"ICD-3BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSA0","description":"ICD-OHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTC0","description":"ICD-BDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sinus caus bac inx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9364","description":"Sinus caus bac inx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHB1","description":"ICD-CCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTE0","description":"ICD-JCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBE1","description":"ICD-NJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vaccine 3 dose adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90746","description":"Hepb vaccine 3 dose adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWA1","description":"ICD-PFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCB1","description":"ICD-EBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0425","description":"Inpt/ed teleconsult30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC225","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dt vaccine under 7 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90702","description":"Dt vaccine under 7 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGA0","description":"ICD-BBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuromuscular junction test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95937","description":"Neuromuscular junction test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain bladder by trocar/cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51101","description":"Drain bladder by trocar/cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extension per extension per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2760","description":"Extension per extension per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urokinase 250_000 iu inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3365","description":"Urokinase 250_000 iu inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBF0","description":"ICD-NKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rubeola antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86765","description":"Rubeola antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXE1","description":"ICD-FGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"40-75y w/type 1/2 w/ldl-c rs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9676","description":"40-75y w/type 1/2 w/ldl-c rs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplant femur ridge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27140","description":"Transplant femur ridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCD0","description":"ICD-FBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA135","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAE0","description":"ICD-IAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB115","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA221","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0562T","description":"Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aac non-electronic board","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1902","description":"Aac non-electronic board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1213","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sleep study unatt&resp efft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95806","description":"Sleep study unatt&resp efft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNA0","description":"ICD-NFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4D","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24366","description":"Reconstruct head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meg spontaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95965","description":"Meg spontaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive chest wall surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19272","description":"Extensive chest wall surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDE1","description":"ICD-GIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I131 tositumomab_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9544","description":"I131 tositumomab_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBD0","description":"ICD-EIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPB0","description":"ICD-OGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical conference by physic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0220","description":"Medical conference by physic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFD1","description":"ICD-JCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4388","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","description":"HCPCS-Q4388","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Circumcision neonate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54160","description":"Circumcision neonate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGC0","description":"ICD-CEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implt cran bone flap to abdo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61316","description":"Implt cran bone flap to abdo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOC1","description":"ICD-HEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Card output measure subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93562","description":"Card output measure subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKD0","description":"ICD-JBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albuterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7609","description":"Albuterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXD1","description":"ICD-BEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA246","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFB1","description":"ICD-BGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93585","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; first 30 minutes of technician time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0364T","description":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; first 30 minutes of technician time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDD0","description":"ICD-BDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUA0","description":"ICD-GDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC21","description":"ICD-1KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"C motor evoked upr&lwr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95939","description":"C motor evoked upr&lwr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary proce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0837T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYF0","description":"ICD-PIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8A","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYC1","description":"ICD-LBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67916","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFB0","description":"ICD-JEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIA0","description":"ICD-NLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-linked intellectual dblt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81470","description":"X-linked intellectual dblt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJB1","description":"ICD-FBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dtap vaccine < 7 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90700","description":"Dtap vaccine < 7 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKF0","description":"ICD-NAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrics (preeclampsia)_ kinase insert domain receptor (KDR)_ Endoglin (ENG)_ and retinol-binding protein 4 (RBP4)_ by immunoassay_ serum_ algorithm reported as a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0390U","description":"Obstetrics (preeclampsia)_ kinase insert domain receptor (KDR)_ Endoglin (ENG)_ and retinol-binding protein 4 (RBP4)_ by immunoassay_ serum_ algorithm reported as a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKF0","description":"ICD-NBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA104","description":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB240","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aminocaproic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0017","description":"Injection_ aminocaproic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD141","description":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ATXN7 (ataxin 7) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81181","description":"ATXN7 (ataxin 7) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10A","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place needle in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36000","description":"Place needle in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSA1","description":"ICD-OBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo torsion cable hip pelv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2050","description":"Hkafo torsion cable hip pelv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUB0","description":"ICD-OCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-op service lvrs 1-9 dos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0304","description":"Pre-op service lvrs 1-9 dos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIC0","description":"ICD-OGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUF1","description":"ICD-CHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRE0","description":"ICD-HFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOC1","description":"ICD-GEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70190","description":"X-ray exam of eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYD0","description":"ICD-HEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24650","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPE0","description":"ICD-FBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q9996","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","description":"HCPCS-Q9996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00880","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","description":"CPT-00880","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKD0","description":"ICD-KCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFND0","description":"ICD-OFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOC0","description":"ICD-OGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVF1","description":"ICD-JEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLE0","description":"ICD-BHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0574U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","description":"CPT-0574U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51575","description":"Removal of bladder & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv musc migraine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64615","description":"Chemodenerv musc migraine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive management and care coordination for advanced illness_ per calendar month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0311","description":"Comprehensive management and care coordination for advanced illness_ per calendar month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFD0","description":"ICD-CDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXC1","description":"ICD-BAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open nasoethmoid fx w/ fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21339","description":"Open nasoethmoid fx w/ fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of palm tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26170","description":"Removal of palm tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAE1","description":"ICD-BGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB31","description":"ICD-3KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE230","description":"Reduced Physical Function _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22D","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29824","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9141","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXE1","description":"ICD-BAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2A","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUA1","description":"ICD-GBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYC1","description":"ICD-HEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1127","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVC1","description":"ICD-OFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microbiology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87999","description":"Microbiology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIB1","description":"ICD-ODIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRE0","description":"ICD-OIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD213","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00454","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","description":"CPT-00454","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPF1","description":"ICD-FIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFF0","description":"ICD-FCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no pos air press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8849","description":"Doc reas no pos air press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAC0","description":"ICD-OIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGC1","description":"ICD-NFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Satisfy survey not complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0917","description":"Satisfy survey not complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC105","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit noc per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9379","description":"Hit noc per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50972","description":"Ureter endoscopy & catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1430","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","description":"HCPCS-M1430","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLA0","description":"ICD-NJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESE1","description":"ICD-KESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSD1","description":"ICD-KFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA31","description":"ICD-4EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay porcelin 3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2643","description":"Dental onlay porcelin 3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBB1","description":"ICD-OEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBE1","description":"ICD-NDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg_ anchor_ screw_ tack) and all associated radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34712","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg_ anchor_ screw_ tack) and all associated radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDC1","description":"ICD-EBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATD0","description":"ICD-GATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFE1","description":"ICD-JEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXB0","description":"ICD-JHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVD1","description":"ICD-OKVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIA1","description":"ICD-MJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCA0","description":"ICD-KBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYB0","description":"ICD-DFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEB1","description":"ICD-OFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBC0","description":"ICD-MLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTF1","description":"ICD-OCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval aud status rehab add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92627","description":"Eval aud status rehab add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUE1","description":"ICD-ADUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFC1","description":"ICD-JAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M.pneumon dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87581","description":"M.pneumon dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of collarbone joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23106","description":"Incision of collarbone joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vaginal hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94451","description":"Anesth vaginal hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAB1","description":"ICD-BIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUC0","description":"ICD-CCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34201","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKF0","description":"ICD-KFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ldl-c <100 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3048F","description":"Ldl-c <100 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65782","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLB1","description":"ICD-OCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24B","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBE1","description":"ICD-KDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLA1","description":"ICD-MLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUF1","description":"ICD-ECUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUF0","description":"ICD-EBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0504","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0504","description":"CDT-D0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEB1","description":"ICD-FFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELE1","description":"ICD-GELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq transcath septal reduxn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93583","description":"Perq transcath septal reduxn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28C","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0759","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","description":"HCPCS-J0759","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUD0","description":"ICD-NJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEE1","description":"ICD-NAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAF1","description":"ICD-FAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefepime hydrochloride (b braun)_ not therapeutically equivalent to maxipime_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0703","description":"Injection_ cefepime hydrochloride (b braun)_ not therapeutically equivalent to maxipime_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUD0","description":"ICD-BCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCA1","description":"ICD-FBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWE1","description":"ICD-OKWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHD0","description":"ICD-EBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPD0","description":"ICD-KEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAF0","description":"ICD-GGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB07","description":"Very High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray kidneys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75833","description":"Vein x-ray kidneys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMC0","description":"ICD-KEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of palm bursas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26030","description":"Drainage of palm bursas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIF0","description":"ICD-IIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cancer stage docd metast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3301F","description":"Cancer stage docd metast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0B","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-t9 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0455","description":"Tlso flex trnk sj-t9 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWB1","description":"ICD-OCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHC1","description":"ICD-KDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHC0","description":"ICD-NJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ob us nuchal meas 1 gest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76813","description":"Ob us nuchal meas 1 gest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAF1","description":"ICD-AIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRD1","description":"ICD-LBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJD1","description":"ICD-NJJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNB1","description":"ICD-NHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42215","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of creatinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82565","description":"Assay of creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28F","description":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25C","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATC1","description":"ICD-KATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMD0","description":"ICD-NIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tirofiban hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3246","description":"Tirofiban hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computer-aided detection_ including computer algorithm analysis of MRI image data for lesion detection/characterization_ pharmacokinetic analysis_ with further physician revie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0159T","description":"Computer-aided detection_ including computer algorithm analysis of MRI image data for lesion detection/characterization_ pharmacokinetic analysis_ with further physician revie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx cml blast phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9125","description":"Onc dx cml blast phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myomectomy vag method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58145","description":"Myomectomy vag method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTD0","description":"ICD-FHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75966","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX35","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYF0","description":"ICD-PFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUC0","description":"ICD-MJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOC0","description":"ICD-DBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups_ utilizing whole blood_ common RBC alleles reported","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001U","description":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups_ utilizing whole blood_ common RBC alleles reported","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDD0","description":"ICD-OGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1107","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCA1","description":"ICD-FDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRE0","description":"ICD-OBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct lip with flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40527","description":"Reconstruct lip with flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEB0","description":"ICD-KAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing complete hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81379","description":"Hla i typing complete hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAC0","description":"ICD-FFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"guided tissue regeneration - resorbable barrier_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6106","description":"guided tissue regeneration - resorbable barrier_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous carboxyhb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88740","description":"Transcutaneous carboxyhb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRC1","description":"ICD-KFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mastoidectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69502","description":"Mastoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEID1","description":"ICD-FEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11624","description":"Exc s/n/h/f/g mal+mrg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFA0","description":"ICD-JBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGID1","description":"ICD-OGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQB0","description":"ICD-LFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC56","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOB0","description":"ICD-HIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX54","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOE1","description":"ICD-CGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0063","description":"Cardiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDF0","description":"ICD-EEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg & 1 cast chg ak/d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5420","description":"Postop dsg & 1 cast chg ak/d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVA1","description":"ICD-BDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth trach-bronch reconst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53951","description":"Anesth trach-bronch reconst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant tcat pulm vlv perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33477","description":"Implant tcat pulm vlv perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQF1","description":"ICD-GFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESE0","description":"ICD-GESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Appl desensitizing resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9911","description":"Appl desensitizing resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGC0","description":"ICD-JIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat each add spine fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22328","description":"Treat each add spine fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMB0","description":"ICD-AFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJD0","description":"ICD-NGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDC0","description":"ICD-NHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJA1","description":"ICD-JGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOB1","description":"ICD-KBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59350","description":"Repair of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27499","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVF1","description":"ICD-FAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain aneurysm repr complx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61697","description":"Brain aneurysm repr complx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA225","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88025","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBF1","description":"ICD-JDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBB0","description":"ICD-JCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1170","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWF0","description":"ICD-GDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam caster tire any size ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2219","description":"Foam caster tire any size ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBD1","description":"ICD-BBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE224","description":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5144","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","description":"HCPCS-Q5144","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95865","description":"Muscle test larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Azathioprine oral 50mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7500","description":"Azathioprine oral 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted px small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44799","description":"Unlisted px small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50722","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLB1","description":"ICD-ODLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDA0","description":"ICD-OKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder & vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57289","description":"Repair bladder & vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospitalists Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4009","description":"Hospitalists Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine4/>vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72074","description":"X-ray exam thorac spine4/>vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (wg critical care)_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0613","description":"Injection_ calcium gluconate (wg critical care)_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOD1","description":"ICD-GHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQD1","description":"ICD-DIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJD0","description":"ICD-CDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBID0","description":"ICD-CBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIC0","description":"ICD-KEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHF0","description":"ICD-KFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Moving Expenses)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7333","description":"Community Transition Svcs (Moving Expenses)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg > 48 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6239","description":"Hydrocolld drg > 48 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLA1","description":"ICD-EGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLB1","description":"ICD-ICLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJF0","description":"ICD-NGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPF1","description":"ICD-JIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWF1","description":"ICD-OJWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJC1","description":"ICD-OEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-op service lvrs 10-15dos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0303","description":"Pre-op service lvrs 10-15dos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser surgery of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52647","description":"Laser surgery of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYE1","description":"ICD-OFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKB1","description":"ICD-JGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIB1","description":"ICD-EIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv4 vacc no prsv 6-35 m im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90685","description":"Iiv4 vacc no prsv 6-35 m im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27535","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITC1","description":"ICD-FITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIA0","description":"ICD-FBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Naltrexone_ depot form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2315","description":"Naltrexone_ depot form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low- dose computed tomography for lung cancer screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8032","description":"Low- dose computed tomography for lung cancer screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude organ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37243","description":"Vasc embolize/occlude organ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PalinGen or ProMatrX_ 0.36 mg per 0.25 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4174","description":"PalinGen or ProMatrX_ 0.36 mg per 0.25 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHA1","description":"ICD-KGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKA1","description":"ICD-JIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatases","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84080","description":"Assay alkaline phosphatases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc hand les sc 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26111","description":"Exc hand les sc 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3A","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE115","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01756","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","description":"CPT-01756","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Massage therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97124","description":"Massage therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optimizing Chronic Disease Management Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0056","description":"Optimizing Chronic Disease Management Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERE0","description":"ICD-DERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spinal disk surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63035","description":"Spinal disk surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGE0","description":"ICD-JHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVA0","description":"ICD-OEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQB0","description":"ICD-HFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBF1","description":"ICD-EGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWB1","description":"ICD-GHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQB0","description":"ICD-LIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVF1","description":"ICD-OHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprssion thxpy prescribed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4267F","description":"Comprssion thxpy prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFF1","description":"ICD-OLFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLB1","description":"ICD-BBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLD1","description":"ICD-NGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lung lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32540","description":"Removal of lung lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWA1","description":"ICD-KCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRE0","description":"ICD-HCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMD0","description":"ICD-JAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct interp both jaw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0367","description":"Cone beam ct interp both jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCB1","description":"ICD-AFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQB1","description":"ICD-LEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ziprasidone mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3486","description":"Ziprasidone mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral nutrition additiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4216","description":"Parenteral nutrition additiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRD0","description":"ICD-HFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKF1","description":"ICD-JDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODND1","description":"ICD-ODND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMF0","description":"ICD-MEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHC0","description":"ICD-CCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Radrite_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1024","description":"Clinical Decision Support Mechanism Radrite_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zanamivir_ inh pwdr_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9034","description":"Zanamivir_ inh pwdr_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLA1","description":"ICD-JFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ppps_ subseq visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0439","description":"Ppps_ subseq visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1384","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","description":"HCPCS-M1384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initiated Episode Of Rehabilitation Therapy_ Medical_ Or Chiropractic Care For Neck Impairment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1143","description":"Initiated Episode Of Rehabilitation Therapy_ Medical_ Or Chiropractic Care For Neck Impairment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUF1","description":"ICD-CDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYC0","description":"ICD-PHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC124","description":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interprof phone/online 31/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99449","description":"Interprof phone/online 31/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2045","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","description":"HCPCS-A2045","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81165","description":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ue fx orth shoul cap forearm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3981","description":"Ue fx orth shoul cap forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXE0","description":"ICD-CDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVB1","description":"ICD-GAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61892","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMA1","description":"ICD-MAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFME0","description":"ICD-FFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25B","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOF0","description":"ICD-DDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJC1","description":"ICD-KDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGD1","description":"ICD-BDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA225","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMA1","description":"ICD-JAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNB1","description":"ICD-OCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC21","description":"Medium Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo tib fx semi-rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2114","description":"Afo tib fx semi-rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVB1","description":"ICD-KHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGD0","description":"ICD-CBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAC1","description":"ICD-AAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76519","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Driver pneumatic vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0480","description":"Driver pneumatic vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or n","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2210","description":"Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAA1","description":"ICD-GCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCE0","description":"ICD-KGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHE1","description":"ICD-NEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBE0","description":"ICD-FIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCD0","description":"ICD-EFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis treatment performed exactly three times per week for > 90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8714","description":"Hemodialysis treatment performed exactly three times per week for > 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conformal radn thxpy rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4181F","description":"Conformal radn thxpy rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTA1","description":"ICD-IBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEC0","description":"ICD-JIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspirate pleura w/o imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32554","description":"Aspirate pleura w/o imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fresnell prism press-on lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2718","description":"Fresnell prism press-on lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCF0","description":"ICD-CBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo sing solid stirrup calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1980","description":"Afo sing solid stirrup calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBA0","description":"ICD-NEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFF0","description":"ICD-KDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd w/thrml txmnt gerd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43257","description":"Egd w/thrml txmnt gerd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGF1","description":"ICD-KCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEA1","description":"ICD-IEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE212","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGA0","description":"ICD-BCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightwt foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1260","description":"Wheelchair lightwt foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABC0","description":"ICD-MABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLA1","description":"ICD-NDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Benesch boot pair junior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3214","description":"Benesch boot pair junior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hocm 300-349mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9962","description":"Hocm 300-349mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUF1","description":"ICD-IGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1A","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exercise class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9451","description":"Exercise class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPD1","description":"ICD-BFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11C","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath eval fna report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88173","description":"Cytopath eval fna report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95938","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hallus-valgus nt dyn pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3100","description":"Hallus-valgus nt dyn pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUA1","description":"ICD-JEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHB0","description":"ICD-CAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ethinyl estradiol and etonogestrel 0.015 mg_ 0.12 mg per 24hours; monthly vaginal ring_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7295","description":"Ethinyl estradiol and etonogestrel 0.015 mg_ 0.12 mg per 24hours; monthly vaginal ring_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMA1","description":"ICD-JHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8X","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0922T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","description":"CPT-0922T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA02","description":"Very High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIF0","description":"ICD-EGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0885T","description":"Colonoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0489U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","description":"CPT-0489U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25365","description":"Revise radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRF0","description":"ICD-CBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine 3vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72072","description":"X-ray exam thorac spine 3vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABD0","description":"ICD-MABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74010","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVD1","description":"ICD-GFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ue triple control harness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6677","description":"Ue triple control harness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Additional supplies_ materials_ and clinical staff time over and above those usually included in an office visit or other non-facility service(s)_ when performed during a PHE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99072","description":"Additional supplies_ materials_ and clinical staff time over and above those usually included in an office visit or other non-facility service(s)_ when performed during a PHE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHE0","description":"ICD-MHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA231","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYE0","description":"ICD-OKYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIE1","description":"ICD-KCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMD0","description":"ICD-JCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDND0","description":"ICD-NDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA22","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24800","description":"Fusion of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOD0","description":"ICD-GCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQF1","description":"ICD-OHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKE0","description":"ICD-NGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHF1","description":"ICD-GIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Co/membane diffuse capacity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94729","description":"Co/membane diffuse capacity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMC1","description":"ICD-GDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38222","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA05","description":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst w/urinary repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58267","description":"Vag hyst w/urinary repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngography_ contrast_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70373","description":"Laryngography_ contrast_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza Virus Vaccine_ Quadrivalent (Aiiv4)_ Inactivated_ Adjuvanted_ Preservative Free_ 0.5 Ml Dosage_ For Intramuscular Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90694","description":"Influenza Virus Vaccine_ Quadrivalent (Aiiv4)_ Inactivated_ Adjuvanted_ Preservative Free_ 0.5 Ml Dosage_ For Intramuscular Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDB1","description":"ICD-EBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUE1","description":"ICD-ODUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLA0","description":"ICD-ODLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56631","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXF0","description":"ICD-GIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/ndl aspir/bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44407","description":"Colonoscopy w/ndl aspir/bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYB0","description":"ICD-OIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRD0","description":"ICD-HIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vasc graft into carpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25430","description":"Vasc graft into carpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACB1","description":"ICD-AACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Derma-fat-fascia graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15770","description":"Derma-fat-fascia graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6012","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFF1","description":"ICD-NGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder blade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73010","description":"X-ray exam of shoulder blade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBC1","description":"ICD-ODBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTD1","description":"ICD-GDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cltx medial ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27760","description":"Cltx medial ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95833","description":"Body muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEE1","description":"ICD-BCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25A","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ra tracer id of sentinl node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38792","description":"Ra tracer id of sentinl node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGND1","description":"ICD-JGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOB0","description":"ICD-OHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXE1","description":"ICD-OEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22A","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transport portable x-ray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0070","description":"Transport portable x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTE1","description":"ICD-AGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB16","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy l/s facet jnt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64636","description":"Destroy l/s facet jnt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25C","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Internal eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92287","description":"Internal eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of hematoma/fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10140","description":"Drainage of hematoma/fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBE0","description":"ICD-MFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28G","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYB0","description":"ICD-GFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXE1","description":"ICD-FBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJF1","description":"ICD-GFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEB1","description":"ICD-BFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGF0","description":"ICD-OHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJD0","description":"ICD-NDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ischm stroke symp ge3 hrsb/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1066F","description":"Ischm stroke symp ge3 hrsb/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavral qualit analys voice","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92524","description":"Behavral qualit analys voice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34703","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert lens prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66985","description":"Insert lens prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIB1","description":"ICD-MAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0236","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","description":"HCPCS-M0236","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVB0","description":"ICD-KGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFF0","description":"ICD-NLFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHA0","description":"ICD-IGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5150","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","description":"HCPCS-Q5150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEF0","description":"ICD-BEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ciliary endoscopic ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66711","description":"Ciliary endoscopic ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLD1","description":"ICD-CCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRC0","description":"ICD-ODRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAC0","description":"ICD-BCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITE1","description":"ICD-IITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote 30 day ecg tech supp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93229","description":"Remote 30 day ecg tech supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oligoclonal bands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83916","description":"Oligoclonal bands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTB1","description":"ICD-GHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCB1","description":"ICD-MLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGD1","description":"ICD-JAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Capsaicin 8% patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7336","description":"Capsaicin 8% patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPC1","description":"ICD-KEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coordinating Stroke Care To Promote Prevention And Cultivate Positive Outcomes Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0054","description":"Coordinating Stroke Care To Promote Prevention And Cultivate Positive Outcomes Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress spinal cord thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63055","description":"Decompress spinal cord thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEC0","description":"ICD-AHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABB1","description":"ICD-FABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPB1","description":"ICD-OEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPC1","description":"ICD-FCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology gynecologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81536","description":"Oncology gynecologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA136","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvef less than/equal to 35%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3055F","description":"Lvef less than/equal to 35%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEME0","description":"ICD-JEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBB1","description":"ICD-MIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens aniseikonic bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2218","description":"Lens aniseikonic bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML34","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2027","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","description":"HCPCS-A2027","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTC1","description":"ICD-CHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAA0","description":"ICD-MFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures rebase cmplt mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5711","description":"Dentures rebase cmplt mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPF0","description":"ICD-FIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGE0","description":"ICD-NKGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Finger splint_ static","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4049","description":"Finger splint_ static","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELB1","description":"ICD-NELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQB1","description":"ICD-CDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCF1","description":"ICD-EGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJA1","description":"ICD-OAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNA0","description":"ICD-NBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABC0","description":"ICD-NABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovas iliac a device addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34808","description":"Endovas iliac a device addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted reprod med lab proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89398","description":"Unlisted reprod med lab proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAB0","description":"ICD-FCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCA0","description":"ICD-IBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHA0","description":"ICD-AAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWE0","description":"ICD-OHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43810","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITE0","description":"ICD-KITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27280","description":"Fusion of sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPD1","description":"ICD-JDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDA0","description":"ICD-NKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht hemodialysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9335","description":"Ht hemodialysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHA0","description":"ICD-MBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSB0","description":"ICD-OKSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECC1","description":"ICD-OECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUE0","description":"ICD-GHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYA1","description":"ICD-LIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVF1","description":"ICD-OFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAE1","description":"ICD-IIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIB0","description":"ICD-OJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma scrn hgh risk direc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0118","description":"Glaucoma scrn hgh risk direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXD1","description":"ICD-OLXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rsa lower extr exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0350T","description":"Rsa lower extr exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMA1","description":"ICD-IGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMA1","description":"ICD-IIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA60","description":"Default_ /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak sleeve susp neoprene/equa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5695","description":"Ak sleeve susp neoprene/equa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBA0","description":"ICD-NDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUA1","description":"ICD-KIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Sequencing Of Paired Malignant And Normal Dna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marrow_ Comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0297U","description":"Oncology (Pan Tumor)_ Whole Genome Sequencing Of Paired Malignant And Normal Dna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marrow_ Comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYA0","description":"ICD-OBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0858","description":"Pwc gp3 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLC1","description":"ICD-NCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFF1","description":"ICD-FDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos back post/lat wdth>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2616","description":"Pos back post/lat wdth>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of nasal vestibular lateral wall stenosis with implant(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9749","description":"Repair of nasal vestibular lateral wall stenosis with implant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66991","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJA0","description":"ICD-FGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLB1","description":"ICD-NDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Octagam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1568","description":"Octagam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1453","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","description":"HCPCS-M1453","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETF0","description":"ICD-OETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPF0","description":"ICD-JAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUB0","description":"ICD-BGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No oder pjp for med reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9219","description":"No oder pjp for med reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bile tract surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47999","description":"Bile tract surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADID1","description":"ICD-ADID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exchange drainage catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49423","description":"Exchange drainage catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPA0","description":"ICD-GHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8X","description":"High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIC0","description":"ICD-OFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPF0","description":"ICD-NCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAC1","description":"ICD-NCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAE1","description":"ICD-ICAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23D","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65865","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANB1","description":"ICD-GANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWF0","description":"ICD-GFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01937","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","description":"CPT-01937","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attach bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51840","description":"Attach bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_ autosys_ rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0148","description":"Scr c/v cyto_ autosys_ rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTA0","description":"ICD-ABTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAB1","description":"ICD-FBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99307","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21B","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1801","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1801","description":"CDT-D1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMA0","description":"ICD-GFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20606","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFE0","description":"ICD-JAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko elastic w/joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1812","description":"Ko elastic w/joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mohs surg addl block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17315","description":"Mohs surg addl block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEE0","description":"ICD-NGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKD0","description":"ICD-JAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCB0","description":"ICD-EGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trach suction cath close sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4605","description":"Trach suction cath close sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKB1","description":"ICD-NAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACE0","description":"ICD-NACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62180","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYB1","description":"ICD-PBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPD1","description":"ICD-OLPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINC0","description":"ICD-GINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCA1","description":"ICD-ADCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cryoglobulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82595","description":"Assay of cryoglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44369","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9900","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ imm glob bivigam_ 500mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1556","description":"Inj_ imm glob bivigam_ 500mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ transpl pkg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2152","description":"Solid organ transpl pkg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCF0","description":"ICD-MGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCD1","description":"ICD-KBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXF0","description":"ICD-BFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUC0","description":"ICD-FCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body pos current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8981","description":"Body pos current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq cervicothoracic inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22510","description":"Perq cervicothoracic inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLF0","description":"ICD-NLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Appliance removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7997","description":"Appliance removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFB1","description":"ICD-FFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYC1","description":"ICD-OBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supported employ_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2023","description":"Supported employ_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELF0","description":"ICD-KELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lacosamide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9254","description":"Injection_ lacosamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCD1","description":"ICD-CBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36901","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFC1","description":"ICD-BCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo-myomectomy complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58546","description":"Laparo-myomectomy complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assist oocyte fertilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89281","description":"Assist oocyte fertilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microscopic exam of urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81015","description":"Microscopic exam of urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETB0","description":"ICD-NETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct pelvis w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72192","description":"Ct pelvis w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHE1","description":"ICD-KHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continuous Home Care - A flat per hourly rate before area wage adjustment for intensive home nursing care delivered by personnel when the need for such care exceeds 8 hours","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0603","description":"Continuous Home Care - A flat per hourly rate before area wage adjustment for intensive home nursing care delivered by personnel when the need for such care exceeds 8 hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBE0","description":"ICD-MBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIC0","description":"ICD-OEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILC1","description":"ICD-MILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPF1","description":"ICD-CHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost s/d acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7405","description":"Add ue prost s/d acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETD0","description":"ICD-IETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJD1","description":"ICD-NEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQD0","description":"ICD-HGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise cornea with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65770","description":"Revise cornea with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHD0","description":"ICD-IAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57288","description":"Repair bladder defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYE0","description":"ICD-PHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUB0","description":"ICD-EBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocytotoxicity assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86805","description":"Lymphocytotoxicity assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracran angioplsty w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61635","description":"Intracran angioplsty w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRF0","description":"ICD-LDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bls-emergency","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0429","description":"Bls-emergency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVD1","description":"ICD-JCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0636T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSD1","description":"ICD-GBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIE0","description":"ICD-GBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect hip tum w/innom bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27077","description":"Resect hip tum w/innom bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"History of preoperative posterior capsule rupture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9759","description":"History of preoperative posterior capsule rupture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB130","description":"Clinically Complex _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXA1","description":"ICD-CIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAA0","description":"ICD-CFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44389","description":"Colonoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with dementia any time during the patient_s history through the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1164","description":"Patients with dementia any time during the patient_s history through the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOA1","description":"ICD-DBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYB0","description":"ICD-LDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bls defibrillation supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0384","description":"Bls defibrillation supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25441","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOB0","description":"ICD-DCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMC0","description":"ICD-OEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPF1","description":"ICD-NBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood/lymph system procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38999","description":"Blood/lymph system procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAC1","description":"ICD-ECAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENA0","description":"ICD-KENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWA0","description":"ICD-PCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCE1","description":"ICD-OGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMA1","description":"ICD-BAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFA0","description":"ICD-FDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGF0","description":"ICD-JIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic donning sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7600","description":"Prosthetic donning sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB206","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lambswool sheepskin pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0189","description":"Lambswool sheepskin pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWC1","description":"ICD-GEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGE1","description":"ICD-JFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTD1","description":"ICD-KFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1067T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1067T","description":"CPT-1067T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Humidifier supplemental w/ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0560","description":"Humidifier supplemental w/ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFD0","description":"ICD-BHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Min hd traum gcs=15 w/ct ed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9530","description":"Min hd traum gcs=15 w/ct ed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHF0","description":"ICD-JBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spermicide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4269","description":"Spermicide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methylnaltrexone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2212","description":"Methylnaltrexone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBB0","description":"ICD-EGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63075","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bld glucose monitor w voice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2100","description":"Bld glucose monitor w voice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKA0","description":"ICD-CCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with injection(s) for augmentation (eg_ percutaneous_ transoral)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31574","description":"Laryngoscopy_ flexible; with injection(s) for augmentation (eg_ percutaneous_ transoral)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRF0","description":"ICD-HFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTA1","description":"ICD-GFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC26","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHE0","description":"ICD-NKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0009","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRD0","description":"ICD-OCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lngleg cylndr ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4036","description":"Cast sup lngleg cylndr ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEE0","description":"ICD-KGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mtms by pharm est 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99606","description":"Mtms by pharm est 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOE1","description":"ICD-PLOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Youth size pull-on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4534","description":"Youth size pull-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64836","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49614","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Topical app of fluoride","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1208","description":"Topical app of fluoride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4295","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","description":"HCPCS-A4295","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4B","description":"Default_ /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qual card diag prior 12 mons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1460F","description":"Qual card diag prior 12 mons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVE1","description":"ICD-FGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0716","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0716","description":"HCPCS-E0716","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENB1","description":"ICD-JENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILA0","description":"ICD-FILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"At least two orders for the same high-risk medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9637","description":"At least two orders for the same high-risk medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYA0","description":"ICD-LGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALA0","description":"ICD-BALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVE0","description":"ICD-CBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUD1","description":"ICD-KIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLC0","description":"ICD-OJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDF0","description":"ICD-CDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brucella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86622","description":"Brucella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair head rest extensi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0966","description":"Wheelchair head rest extensi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1355","description":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABD0","description":"ICD-GABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20206","description":"Needle biopsy muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLME0","description":"ICD-OLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66155","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTB0","description":"ICD-OBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBB0","description":"ICD-BGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDF0","description":"ICD-FFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYC1","description":"ICD-OJYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01636","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","description":"CPT-01636","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autonomic nrv parasym inervj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95921","description":"Autonomic nrv parasym inervj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0877","description":"Pwc gp4 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of thigh muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27430","description":"Revision of thigh muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC02","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost s/d ultlite mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7402","description":"Add ue prost s/d ultlite mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIB0","description":"ICD-FGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYD1","description":"ICD-KHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABD1","description":"ICD-AABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERD1","description":"ICD-PERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Risperidone_ long acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2794","description":"Risperidone_ long acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSC1","description":"ICD-DBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES145","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of tsi globulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84445","description":"Assay of tsi globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onlay titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6634","description":"Onlay titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALE0","description":"ICD-GALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRE1","description":"ICD-GHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDC0","description":"ICD-MJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress optic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67570","description":"Decompress optic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBD0","description":"ICD-NFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPE1","description":"ICD-FGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Isoproterenol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7659","description":"Isoproterenol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOC1","description":"ICD-DIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMF0","description":"ICD-CBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryosurg ablate fa each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19105","description":"Cryosurg ablate fa each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23D","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIND0","description":"ICD-KIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFA0","description":"ICD-OKFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGE1","description":"ICD-BHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ex for speech device rx 1hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92607","description":"Ex for speech device rx 1hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKD1","description":"ICD-KAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQE1","description":"ICD-LIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELB1","description":"ICD-AELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICC0","description":"ICD-BICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch drain 2 piece system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4426","description":"Ost pch drain 2 piece system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair rectum & vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57250","description":"Repair rectum & vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin pneum swg frc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5822","description":"Endo knee-shin pneum swg frc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBME0","description":"ICD-JBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57700","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA60","description":"Ultra High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXB1","description":"ICD-JFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGF0","description":"ICD-ODGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0738","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","description":"HCPCS-J0738","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heparin infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1520","description":"Heparin infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAC0","description":"ICD-CAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFA0","description":"ICD-JHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEC0","description":"ICD-OKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEE0","description":"ICD-NKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ortho shoe add leather insol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3500","description":"Ortho shoe add leather insol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRD1","description":"ICD-DFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSD0","description":"ICD-PJSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv no prsv increased ag im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90662","description":"Iiv no prsv increased ag im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTD0","description":"ICD-BCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mopath procedure level 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81407","description":"Mopath procedure level 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0304U","description":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKD1","description":"ICD-JBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAF1","description":"ICD-NCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTF0","description":"ICD-AFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISE1","description":"ICD-CISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCB1","description":"ICD-MJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVE0","description":"ICD-BFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRB0","description":"ICD-OLRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24A","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWA0","description":"ICD-CEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/wedge resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32666","description":"Thoracoscopy w/wedge resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAB1","description":"ICD-BDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1501","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1501","description":"CDT-D1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB101","description":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAF0","description":"ICD-KAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMB0","description":"ICD-JCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj reshaping components","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7865","description":"Tmj reshaping components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAME1","description":"ICD-AAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit pain mgmt per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9325","description":"Hit pain mgmt per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt post facet implt cerv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0219T","description":"Plmt post facet implt cerv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDB1","description":"ICD-CCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOD0","description":"ICD-PDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25405","description":"Repair/graft radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKC1","description":"ICD-CBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC130","description":"Special Care Low _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB234","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTA1","description":"ICD-OCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITD0","description":"ICD-FITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEF0","description":"ICD-KCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVD0","description":"ICD-GFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQD0","description":"ICD-ODQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLD1","description":"ICD-OLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6555","description":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Positron emission tomography radiopharmaceutical_ diagnostic_ for tumor identification_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9597","description":"Positron emission tomography radiopharmaceutical_ diagnostic_ for tumor identification_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTF0","description":"ICD-OGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBF1","description":"ICD-MKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEF1","description":"ICD-MCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96936","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWF0","description":"ICD-KEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin beta esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0887","description":"Epoetin beta esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELC1","description":"ICD-IELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ trans atherec_rotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1724","description":"Cath_ trans atherec_rotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOC0","description":"ICD-PLOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHC0","description":"ICD-MCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUE0","description":"ICD-BIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9245","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9245","description":"CDT-D9245","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWC0","description":"ICD-LHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEF0","description":"ICD-NCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOB1","description":"ICD-OKOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFF1","description":"ICD-GEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dexamethasone 9%_ intraocular_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9034","description":"Injection_ dexamethasone 9%_ intraocular_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYF1","description":"ICD-PEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUA1","description":"ICD-IIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic control pelvic sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2580","description":"Pelvic control pelvic sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKA0","description":"ICD-NGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEB1","description":"ICD-ODEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLB0","description":"ICD-FDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28585","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc rspse chmotx rx motility cntrst tomography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0083U","description":"Onc rspse chmotx rx motility cntrst tomography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 2999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4723","description":"Dialys sol fld vol > 2999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIF0","description":"ICD-FIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28D","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of finger splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29130","description":"Application of finger splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB124","description":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKF0","description":"ICD-GIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial and fungal)_ organism identification_ blood culture_ using rRNA FISH_ 6 or more organism targets_ reported as positive or negative with phenotypi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0086U","description":"Infectious disease (bacterial and fungal)_ organism identification_ blood culture_ using rRNA FISH_ 6 or more organism targets_ reported as positive or negative with phenotypi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81005","description":"Urinalysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVF1","description":"ICD-NAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC53","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bld typing serologic rh phnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86906","description":"Bld typing serologic rh phnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mon anesth care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9654","description":"Mon anesth care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0972T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","description":"CPT-0972T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAD1","description":"ICD-KEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pancreas)_ DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression_ pancreatic cyst fluid_ algorithm reported as a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0313U","description":"Oncology (pancreas)_ DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression_ pancreatic cyst fluid_ algorithm reported as a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIE0","description":"ICD-BFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue homogenization cultr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87176","description":"Tissue homogenization cultr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEC0","description":"ICD-MGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPD1","description":"ICD-FBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCC0","description":"ICD-EFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRD1","description":"ICD-GFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1802","description":"HCPCS-A1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31576","description":"Laryngoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay rbc protoporphyrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84202","description":"Assay rbc protoporphyrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient recorded spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94014","description":"Patient recorded spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEC0","description":"ICD-CEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJC1","description":"ICD-GHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAB1","description":"ICD-MAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37260","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","description":"CPT-37260","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVA0","description":"ICD-FGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIE1","description":"ICD-ACIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGB0","description":"ICD-CAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAA1","description":"ICD-NKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IV injection_ bebtelovimab_ include injection and post administration monitoring in the patient’s home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0223","description":"IV injection_ bebtelovimab_ include injection and post administration monitoring in the patient’s home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENB1","description":"ICD-KENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYC1","description":"ICD-HCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Of Substernal Implantable Defibrillator Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0572T","description":"Insertion Of Substernal Implantable Defibrillator Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUE1","description":"ICD-MLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAC0","description":"ICD-CGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDE0","description":"ICD-MJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBD0","description":"ICD-ADBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exam of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57452","description":"Exam of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQF1","description":"ICD-GDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam breastbone 2/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71120","description":"X-ray exam breastbone 2/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indirect immunofluorescence","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0483","description":"Indirect immunofluorescence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of unstable kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27422","description":"Revision of unstable kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3273F","description":"High risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt immunity to hep b docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3216F","description":"Pt immunity to hep b docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOF0","description":"ICD-CAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCB1","description":"ICD-OKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq card revasc chronic 1vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92943","description":"Prq card revasc chronic 1vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILF1","description":"ICD-IILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX15","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ synojoynt_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7331","description":"Hyaluronan or derivative_ synojoynt_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAE1","description":"ICD-NDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8I","description":"Medium Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKA1","description":"ICD-FCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQF0","description":"ICD-HDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No card tamp e/in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9409","description":"No card tamp e/in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTA0","description":"ICD-OCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXF0","description":"ICD-OHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00812","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","description":"CPT-00812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERF1","description":"ICD-DERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45114","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thiethylperazine maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3280","description":"Thiethylperazine maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBB1","description":"ICD-AEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27265","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enzyme histochemistry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88319","description":"Enzyme histochemistry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAD0","description":"ICD-CBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAA1","description":"ICD-OIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1463","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","description":"HCPCS-M1463","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0953T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","description":"CPT-0953T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHA1","description":"ICD-AIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15B","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAC1","description":"ICD-MGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug scrn quan levetiracetam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80177","description":"Drug scrn quan levetiracetam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRE0","description":"ICD-GFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radical resect abd tumor<5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22904","description":"Radical resect abd tumor<5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below/above elbow lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6698","description":"Below/above elbow lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML46","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pul art balloon repr percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92997","description":"Pul art balloon repr percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFF0","description":"ICD-NAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonemergency transport air","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0140","description":"Nonemergency transport air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKD0","description":"ICD-FAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv tstng asked/docd/revwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3292F","description":"Hiv tstng asked/docd/revwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSD1","description":"ICD-OKSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKA0","description":"ICD-OJKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed fx ht w/o rails w/m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0290","description":"Hosp bed fx ht w/o rails w/m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0645U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0645U","description":"CPT-0645U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBF1","description":"ICD-GEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3B","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGED1","description":"ICD-NGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAA0","description":"ICD-MDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp iliofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35665","description":"Art byp iliofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cvd risk assessment not performed or incomplete (e.g._ cvd risk assessment was not documented)_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1257","description":"Cvd risk assessment not performed or incomplete (e.g._ cvd risk assessment was not documented)_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWE0","description":"ICD-PGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVF1","description":"ICD-GCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99459","description":"Pelvic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIE1","description":"ICD-NCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTD1","description":"ICD-CHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBA0","description":"ICD-BBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove anal fist inter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46275","description":"Remove anal fist inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRF0","description":"ICD-LHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBA1","description":"ICD-MEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB53","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUB0","description":"ICD-JFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITB1","description":"ICD-KITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastrin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82938","description":"Gastrin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPF1","description":"ICD-KHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQF1","description":"ICD-KHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy rem totl cortex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32652","description":"Thoracoscopy rem totl cortex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAND0","description":"ICD-CAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert semi-rigid prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54400","description":"Insert semi-rigid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc depletion of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38212","description":"Rbc depletion of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINE0","description":"ICD-NINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTE0","description":"ICD-OKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ burosumab-twza_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0584","description":"Injection_ burosumab-twza_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urtr inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9631","description":"Urtr inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change of nephrostomy or pyelostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50398","description":"Change of nephrostomy or pyelostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81171","description":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTA0","description":"ICD-JHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMD0","description":"ICD-KEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB11","description":"ICD-4AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIE1","description":"ICD-JFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDC1","description":"ICD-MFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calculus spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82365","description":"Calculus spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXD1","description":"ICD-GAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDD0","description":"ICD-MBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQD0","description":"ICD-OFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOF0","description":"ICD-DHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKB1","description":"ICD-KAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp mal+marg 0.5/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11620","description":"Exc h-f-nk-sp mal+marg 0.5/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92002","description":"Eye exam new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurobehavioral status exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96116","description":"Neurobehavioral status exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB230","description":"Clinically Complex _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKE0","description":"ICD-CGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Batt pack/cart_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1356","description":"Batt pack/cart_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIE1","description":"ICD-AIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKD0","description":"ICD-JGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPD0","description":"ICD-BFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFB0","description":"ICD-FEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISB1","description":"ICD-GISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+ cell count >= 500 cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3496F","description":"Cd4+ cell count >= 500 cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVC1","description":"ICD-FDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFD0","description":"ICD-FBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCE0","description":"ICD-BFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTF0","description":"ICD-FBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam dressing wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6215","description":"Foam dressing wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC11","description":"ICD-1BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGA1","description":"ICD-BCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 60th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1177","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 60th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXD0","description":"ICD-CBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFC1","description":"ICD-CDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/dxa no results doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8400","description":"Pt w/dxa no results doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smpd1 gene common variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81330","description":"Smpd1 gene common variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Set-up cardiovert-defibrill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93745","description":"Set-up cardiovert-defibrill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27232","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ unilateral; complete_ minimum of two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73510","description":"Radiologic examination_ hip_ unilateral; complete_ minimum of two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIF0","description":"ICD-NHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66030","description":"Injection treatment of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBE1","description":"ICD-ADBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFA0","description":"ICD-NHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23665","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0993T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","description":"CPT-0993T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary colon cancer (Lynch syndrome)_ targeted mRNA sequence analysis panel (MLH1_ MSH2_ MSH6_ PMS2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0162U","description":"Hereditary colon cancer (Lynch syndrome)_ targeted mRNA sequence analysis panel (MLH1_ MSH2_ MSH6_ PMS2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screen mammo doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3014F","description":"Screen mammo doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4B","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLA0","description":"ICD-GFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJME1","description":"ICD-OJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gravlee jet washer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4470","description":"Gravlee jet washer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACC0","description":"ICD-NACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALE1","description":"ICD-BALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whelchr fxd full length arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1050","description":"Whelchr fxd full length arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDA0","description":"ICD-FHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLB0","description":"ICD-MDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of semen fructose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82757","description":"Assay of semen fructose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLB0","description":"ICD-EHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTD0","description":"ICD-OHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGE0","description":"ICD-OLGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary colon ca dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81436","description":"Hereditary colon ca dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ arm_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6523","description":"Gradient compression garment_ arm_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk molded distal cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5668","description":"Bk molded distal cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPF1","description":"ICD-GAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHD1","description":"ICD-AGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHF0","description":"ICD-EHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSC1","description":"ICD-OCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c dpth 20-21 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2342","description":"W/c dpth 20-21 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUC1","description":"ICD-JEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKA0","description":"ICD-KHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHD0","description":"ICD-OJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGA0","description":"ICD-GEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLC1","description":"ICD-CFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJC1","description":"ICD-FBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJF0","description":"ICD-FIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardioversion electric int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92961","description":"Cardioversion electric int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRB1","description":"ICD-GGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKA1","description":"ICD-FBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43762","description":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUB1","description":"ICD-MHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0D","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPB1","description":"ICD-JHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPE0","description":"ICD-FHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENC1","description":"ICD-KENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trach-esoph voice pros pt in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8507","description":"Trach-esoph voice pros pt in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bia whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0358T","description":"Bia whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISE0","description":"ICD-HISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7565","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7565","description":"HCPCS-C7565","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBED1","description":"ICD-MBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIE0","description":"ICD-NLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00918","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","description":"CPT-00918","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1191","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAB0","description":"ICD-BDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE144","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJA0","description":"ICD-BFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYE1","description":"ICD-KAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSF1","description":"ICD-HGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLF0","description":"ICD-JBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed total elect w/ matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0296","description":"Hosp bed total elect w/ matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23921","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBF1","description":"ICD-CBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37254","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","description":"CPT-37254","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29901","description":"Mcp joint arthroscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAF1","description":"ICD-KIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Thoracoscopic_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33269","description":"Exclusion Of Left Atrial Appendage_ Thoracoscopic_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELC1","description":"ICD-AELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFF0","description":"ICD-NKFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trluml perip athrc renal art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0234T","description":"Trluml perip athrc renal art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXA0","description":"ICD-JGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYD0","description":"ICD-OBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUF1","description":"ICD-NLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18H","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26727","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj perflexane lip micros_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9955","description":"Inj perflexane lip micros_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD256","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23625","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQB1","description":"ICD-PBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLB1","description":"ICD-KFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFB1","description":"ICD-OJFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB225","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIA0","description":"ICD-NGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28740","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin ext jnts fld swg e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5726","description":"Knee-shin ext jnts fld swg e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPF1","description":"ICD-NLPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABB1","description":"ICD-KABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18D","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemi-wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1085","description":"Hemi-wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXF1","description":"ICD-ODXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPF1","description":"ICD-FGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occupational multifocal lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2786","description":"Occupational multifocal lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin w/ noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2722","description":"Crown resin w/ noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJA0","description":"ICD-OKJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coch implant headset replace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8615","description":"Coch implant headset replace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec alys vagus nrv pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0317T","description":"Elec alys vagus nrv pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLF1","description":"ICD-MBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARB0","description":"ICD-GARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYD1","description":"ICD-OCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASC0","description":"ICD-GASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA53","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJE0","description":"ICD-CDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAE0","description":"ICD-BGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBED0","description":"ICD-FBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCB1","description":"ICD-OLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSB1","description":"ICD-GHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82725","description":"Assay of blood fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLC1","description":"ICD-BCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCF1","description":"ICD-BFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infiltration of sustained release therapeutic drug - single or multiple sites","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9613","description":"Infiltration of sustained release therapeutic drug - single or multiple sites","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9009","description":"Mccd_ risk adj_ level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transport chair pt wt >300lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1039","description":"Transport chair pt wt >300lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contraceptive vaginal ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7303","description":"Contraceptive vaginal ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXE0","description":"ICD-NBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXB0","description":"ICD-OGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKA1","description":"ICD-JBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMB0","description":"ICD-NKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dynamic fine wire emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96003","description":"Dynamic fine wire emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDC1","description":"ICD-AEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARF0","description":"ICD-DARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBF0","description":"ICD-CDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelet survival","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78191","description":"Platelet survival","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Applied Pathways_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1000","description":"Clinical Decision Support Mechanism Applied Pathways_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"C/o for orthotic/prosth use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97762","description":"C/o for orthotic/prosth use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology tissue of origin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81504","description":"Oncology tissue of origin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/congen repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52400","description":"Cystouretero w/congen repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRC0","description":"ICD-PIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPF1","description":"ICD-OHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLID1","description":"ICD-MLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAE1","description":"ICD-FAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUF0","description":"ICD-MDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPB0","description":"ICD-JCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJE0","description":"ICD-GEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lutetium Lu 177_ dotatate_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9031","description":"Lutetium Lu 177_ dotatate_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGA0","description":"ICD-NCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removable retainer adjust","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8681","description":"Removable retainer adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic compression device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0675","description":"Pneumatic compression device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHC1","description":"ICD-GHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0301","description":"HCPCS-C0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBF1","description":"ICD-ICBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21725","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sinus aug w bone/bone sup","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7951","description":"Sinus aug w bone/bone sup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Wisconsin Card Sorting Test)_ administered by a computer_ with qualified health care professional interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96120","description":"Neuropsychological testing (eg_ Wisconsin Card Sorting Test)_ administered by a computer_ with qualified health care professional interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQF1","description":"ICD-OEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJD0","description":"ICD-CAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Follow-up/reassessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0316","description":"Follow-up/reassessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54435","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27788","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10C","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGA0","description":"ICD-GDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplants of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27397","description":"Transplants of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDA0","description":"ICD-OLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES351","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy_ flexible_ transoral_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0884T","description":"Esophagoscopy_ flexible_ transoral_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision graft abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35907","description":"Excision graft abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28406","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53505","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33363","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAD0","description":"ICD-GDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETD0","description":"ICD-NETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cysto impl 4 or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9740","description":"Cysto impl 4 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct maxilla segment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7947","description":"Reconstruct maxilla segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulpal therapy anterior prim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3230","description":"Pulpal therapy anterior prim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXC1","description":"ICD-GIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Silvr oxide batt glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4236","description":"Silvr oxide batt glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHE1","description":"ICD-ABHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDD1","description":"ICD-OHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWA1","description":"ICD-PDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo sng/dbl mechanical act","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2005","description":"Kafo sng/dbl mechanical act","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laminotomy single cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63040","description":"Laminotomy single cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco use assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1000F","description":"Tobacco use assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0365U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFED1","description":"ICD-MFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tee w or w/o fol w/cont_cong","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8926","description":"Tee w or w/o fol w/cont_cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20B","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AJCC stage at breast cancer diagnosis = II or III","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9831","description":"AJCC stage at breast cancer diagnosis = II or III","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1472","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","description":"HCPCS-M1472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC50","description":"High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBB1","description":"ICD-ABBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKD1","description":"ICD-JHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIB1","description":"ICD-OFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Angina present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1011F","description":"Angina present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNF1","description":"ICD-JGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMC1","description":"ICD-OJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQB1","description":"ICD-GCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWA1","description":"ICD-LAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWB1","description":"ICD-OFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLE0","description":"ICD-CHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB32","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8A","description":"Very High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"American amnion ac tri-layer_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4305","description":"American amnion ac tri-layer_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMA1","description":"ICD-ABMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAB0","description":"ICD-GIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50980","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYD1","description":"ICD-GEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLE0","description":"ICD-MDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLB0","description":"ICD-ADLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD236","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0798T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ekg tracing for initial prev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0404","description":"Ekg tracing for initial prev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inhibin a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86336","description":"Inhibin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calc bmi out nrm param nof/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8419","description":"Calc bmi out nrm param nof/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop dress & 1 cast chg bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5400","description":"Postop dress & 1 cast chg bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36800","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOA0","description":"ICD-LBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYC1","description":"ICD-LHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECB1","description":"ICD-BECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genotype dna hepatitis b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87912","description":"Genotype dna hepatitis b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKB1","description":"ICD-OCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"New eye exam & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92018","description":"New eye exam & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTE1","description":"ICD-GBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIND0","description":"ICD-BIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40702","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Situximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9455","description":"Injection_ Situximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLC1","description":"ICD-MKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay metallic 3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2543","description":"Dental onlay metallic 3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"YT GNOTYP ACHE EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0201U","description":"YT GNOTYP ACHE EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQF0","description":"ICD-PGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYF0","description":"ICD-DDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB213","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUB0","description":"ICD-BEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified hea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9037","description":"Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified hea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQD1","description":"ICD-KBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcholinesterase assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82013","description":"Acetylcholinesterase assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIE1","description":"ICD-KDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPA0","description":"ICD-GEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"implant/abutment supported interim fixed denture for edentulous arch - mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6118","description":"implant/abutment supported interim fixed denture for edentulous arch - mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIE0","description":"ICD-OFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTA1","description":"ICD-ABTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHF1","description":"ICD-ADHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc of dsm-iv init eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9212","description":"Doc of dsm-iv init eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair vessel graft defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35870","description":"Repair vessel graft defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove tear gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68550","description":"Remove tear gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin protect wc cus wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2603","description":"Skin protect wc cus wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA31","description":"ICD-3JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Instr xrcz back pain 12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4240F","description":"Instr xrcz back pain 12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dil macular/fundus not perfo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8398","description":"Dil macular/fundus not perfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXC0","description":"ICD-KIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUC0","description":"ICD-AEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collagen dressing <=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6021","description":"Collagen dressing <=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBB0","description":"ICD-AIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD140","description":"Reduced Physical Function _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEF1","description":"ICD-GCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDB0","description":"ICD-OJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITC1","description":"ICD-BITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteopath manj 7-8 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98928","description":"Osteopath manj 7-8 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repos nstim apnea sensing ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0433T","description":"Repos nstim apnea sensing ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1111","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQD0","description":"ICD-GGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCF1","description":"ICD-AGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1502","description":"HCPCS-A1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Splint - intra-coronal; natural teeth or prosthetic crowns","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4322","description":"Splint - intra-coronal; natural teeth or prosthetic crowns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine&cord 2 trx thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63197","description":"Incise spine&cord 2 trx thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWA1","description":"ICD-HIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNE1","description":"ICD-FGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denosumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0897","description":"Denosumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37249","description":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWF0","description":"ICD-PAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crutch forearm each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0111","description":"Crutch forearm each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAE1","description":"ICD-JGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73030","description":"X-ray exam of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAD1","description":"ICD-IIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ arm_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6522","description":"Gradient compression garment_ arm_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0979T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","description":"CPT-0979T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHA1","description":"ICD-NKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAF0","description":"ICD-CAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pierce earlobes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69090","description":"Pierce earlobes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMA1","description":"ICD-MIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTB1","description":"ICD-CGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBF1","description":"ICD-JFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx nodule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32608","description":"Thoracoscopy w/bx nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWE0","description":"ICD-HEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74018","description":"Radiologic examination_ abdomen; 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc first line amox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9315","description":"Doc first line amox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLF0","description":"ICD-IBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricular pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7537","description":"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricular pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECA0","description":"ICD-CECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPC0","description":"ICD-GDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD106","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77615","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay test for blood fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82274","description":"Assay test for blood fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCA0","description":"ICD-JFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24361","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHB0","description":"ICD-KIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHC1","description":"ICD-CAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJF1","description":"ICD-KHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECF1","description":"ICD-AECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXD0","description":"ICD-JCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYA0","description":"ICD-LHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHB1","description":"ICD-JDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFA0","description":"ICD-FFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0522U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","description":"CPT-0522U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37273","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","description":"CPT-37273","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA12","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKB1","description":"ICD-JEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg <=16 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6237","description":"Hydrocolld drg <=16 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1028T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1028T","description":"CPT-1028T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30460","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us guide intraop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76998","description":"Us guide intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Services of skilled nurse in home health setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0154","description":"Services of skilled nurse in home health setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or bo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1195","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or bo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAA1","description":"ICD-EEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance used to reduce upper airway collapsibility_ without fixed mechanical hinge_ custom fabricated_ includes fitting and adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1027","description":"Oral device/appliance used to reduce upper airway collapsibility_ without fixed mechanical hinge_ custom fabricated_ includes fitting and adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99344","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap paraesoph her rpr w/mesh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43282","description":"Lap paraesoph her rpr w/mesh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pediatrics Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4024","description":"Pediatrics Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8D","description":"High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis auto w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81001","description":"Urinalysis auto w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA15","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43124","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBE0","description":"ICD-NJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDB0","description":"ICD-OGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYC1","description":"ICD-KBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self-care ed provided to pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4450F","description":"Self-care ed provided to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Internal eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92286","description":"Internal eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAD0","description":"ICD-OEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRF1","description":"ICD-HDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILB1","description":"ICD-NILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLE0","description":"ICD-BCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFA0","description":"ICD-CEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAD1","description":"ICD-BDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDD1","description":"ICD-KBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTB1","description":"ICD-ABTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMF0","description":"ICD-CHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain ovary abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58820","description":"Drain ovary abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4A","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKA1","description":"ICD-BAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILD0","description":"ICD-AILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Renin stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80417","description":"Renin stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31291","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEC0","description":"ICD-EHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDC0","description":"ICD-MFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo iv push sngl drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96409","description":"Chemo iv push sngl drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide for amniocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76946","description":"Echo guide for amniocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct upper extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73200","description":"Ct upper extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","description":"HCPCS-Q4387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNC1","description":"ICD-OGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEA1","description":"ICD-CGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Norsn no foot exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9225","description":"Norsn no foot exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUE1","description":"ICD-EHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHD0","description":"ICD-IHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67039","description":"Laser treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHB0","description":"ICD-CFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBC0","description":"ICD-OKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMA1","description":"ICD-IFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOC0","description":"ICD-GFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAA0","description":"ICD-OIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44314","description":"Revision of ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFE0","description":"ICD-OCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRD1","description":"ICD-CGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; intercalary_ complete (ie_ cylindrical) (List separately in addition to code for prim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20934","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; intercalary_ complete (ie_ cylindrical) (List separately in addition to code for prim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fabrication of a custom removable clear plastic temporary aesthetic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9938","description":"Fabrication of a custom removable clear plastic temporary aesthetic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB31","description":"ICD-2JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUC1","description":"ICD-IAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXB0","description":"ICD-OLXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cysto w/ureter stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52341","description":"Cysto w/ureter stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSD1","description":"ICD-LFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval for deep sed/gen anesth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9219","description":"Eval for deep sed/gen anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIB1","description":"ICD-JDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIA0","description":"ICD-JGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTC0","description":"ICD-GCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rotary wing air transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0431","description":"Rotary wing air transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHF0","description":"ICD-IHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXB0","description":"ICD-CGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald blu tooth fm/dm receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5286","description":"Ald blu tooth fm/dm receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEC1","description":"ICD-OHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visualization adjunct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9968","description":"Visualization adjunct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBA0","description":"ICD-BDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1462","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","description":"HCPCS-M1462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYF1","description":"ICD-LGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2312","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","description":"HCPCS-J2312","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXD1","description":"ICD-NBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMC1","description":"ICD-IGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy liver add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47001","description":"Needle biopsy liver add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart infarct image (ef)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78468","description":"Heart infarct image (ef)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQD0","description":"ICD-LHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venous mech thrombectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37187","description":"Venous mech thrombectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUB1","description":"ICD-MJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRE0","description":"ICD-PKRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKE0","description":"ICD-JCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERC0","description":"ICD-PERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1200","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23505","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (eg_ pharmacogenomics) genomic sequence analysis panel_ must include testing of at least 6 genes_ including CYP2C19_ CYP2D6_ and CYP2D6 duplication/deletion an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81418","description":"Drug metabolism (eg_ pharmacogenomics) genomic sequence analysis panel_ must include testing of at least 6 genes_ including CYP2C19_ CYP2D6_ and CYP2D6 duplication/deletion an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepagam b intravenous_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1573","description":"Hepagam b intravenous_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDC1","description":"ICD-BGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infratemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61590","description":"Infratemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBND1","description":"ICD-KBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUA1","description":"ICD-BDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUD0","description":"ICD-EEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL16","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNC1","description":"ICD-CHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPF1","description":"ICD-BDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor ii prothrom spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85210","description":"Clot factor ii prothrom spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHD0","description":"ICD-NBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10D","description":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms) gene analysis_ full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81236","description":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms) gene analysis_ full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHD0","description":"ICD-JEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTA0","description":"ICD-KGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phosphatase forensic exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84061","description":"Phosphatase forensic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26750","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ivig demo_ services/supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2052","description":"Ivig demo_ services/supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy remove fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58562","description":"Hysteroscopy remove fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARE0","description":"ICD-PARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC32","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9914","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9914","description":"CDT-D9914","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27392","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQB0","description":"ICD-KAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brush biopsy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7288","description":"Brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vestibular device implantation_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0725T","description":"Vestibular device implantation_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnicore pro+_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4299","description":"Amnicore pro+_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair prosthesis per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7520","description":"Repair prosthesis per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap es sph augment dev place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0392T","description":"Lap es sph augment dev place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acoustic refl threshold tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92568","description":"Acoustic refl threshold tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92313","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETC0","description":"ICD-CETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ initial artery_ open or pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7532","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ initial artery_ open or pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXA1","description":"ICD-NEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITB1","description":"ICD-EITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERF0","description":"ICD-HERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHB1","description":"ICD-CBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAF1","description":"ICD-CFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Childbirth refresher class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9437","description":"Childbirth refresher class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ glove_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6520","description":"Gradient compression garment_ glove_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVB0","description":"ICD-FFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUE0","description":"ICD-BFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Static str shldr dev rom adj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1841","description":"Static str shldr dev rom adj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electron microscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88348","description":"Electron microscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61607","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albuterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7613","description":"Albuterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUB1","description":"ICD-CEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUB0","description":"ICD-AFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANC1","description":"ICD-BANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFC1","description":"ICD-JDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDD1","description":"ICD-IEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ avacincaptad pegol_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2782","description":"Injection_ avacincaptad pegol_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Motor-cognitive_ semi-immersive virtual reality-facilitated gait training_ each 15 minutes (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0791T","description":"Motor-cognitive_ semi-immersive virtual reality-facilitated gait training_ each 15 minutes (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIE1","description":"ICD-JIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWA1","description":"ICD-PBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Swingaway detach footrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0052","description":"Swingaway detach footrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSB0","description":"ICD-KGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98984","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","description":"CPT-98984","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUA1","description":"ICD-NDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC114","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSF1","description":"ICD-PFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHED1","description":"ICD-GHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYF0","description":"ICD-HGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLA0","description":"ICD-EDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35460","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sr89 strontium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9600","description":"Sr89 strontium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00792","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","description":"CPT-00792","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44408","description":"Colonoscopy w/decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cervical laminoplsty 2/> seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63050","description":"Cervical laminoplsty 2/> seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEC0","description":"ICD-GAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBD0","description":"ICD-NIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g._ salvage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9895","description":"Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g._ salvage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJA0","description":"ICD-GGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10A","description":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJF1","description":"ICD-CAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous stimulation or sens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33279","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous stimulation or sens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult size pull-on lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4527","description":"Adult size pull-on lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMF1","description":"ICD-FDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rep perf anoper fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46715","description":"Rep perf anoper fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILF1","description":"ICD-BILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICA1","description":"ICD-MICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIA0","description":"ICD-FAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJC0","description":"ICD-JIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRF0","description":"ICD-HGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath therapeutic irrig agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4321","description":"Cath therapeutic irrig agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA26","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen system liquid station","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0440","description":"Oxygen system liquid station","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abduction bar jointed adjust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2300","description":"Abduction bar jointed adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWD1","description":"ICD-LDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1072","description":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHA1","description":"ICD-GBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSF1","description":"ICD-CGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove aortic assist device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33968","description":"Remove aortic assist device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetics 100-300","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88275","description":"Cytogenetics 100-300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHE1","description":"ICD-OIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIE0","description":"ICD-BGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18C","description":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBD0","description":"ICD-AGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAF1","description":"ICD-ADAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA21","description":"ICD-2CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASE1","description":"ICD-OASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lip surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40799","description":"Lip surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risperidone (rykindo)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2801","description":"Injection_ risperidone (rykindo)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Demonstrate use home inr mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0248","description":"Demonstrate use home inr mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gauze <=16 in no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6222","description":"Gauze <=16 in no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXA0","description":"ICD-BFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSD0","description":"ICD-PDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIID0","description":"ICD-AIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPF0","description":"ICD-NAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93976","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion 17-24 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2260","description":"Induced abortion 17-24 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFE1","description":"ICD-NJFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"S bowel endoscope w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44379","description":"S bowel endoscope w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEE1","description":"ICD-BAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAB0","description":"ICD-BFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCF1","description":"ICD-MJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIE0","description":"ICD-NEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27638","description":"Remove/graft leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB21","description":"ICD-4AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11762","description":"Reconstruction of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93242","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cstm dme other than wheelchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0900","description":"Cstm dme other than wheelchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repos car modulj tranvns elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0415T","description":"Repos car modulj tranvns elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEE0","description":"ICD-FGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ENTAMOEBA HISTOLYTICA GRP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87337","description":"IAAD IA ENTAMOEBA HISTOLYTICA GRP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25415","description":"Repair radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp multiplane ext fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20696","description":"Comp multiplane ext fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLB0","description":"ICD-JDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip bone les deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27066","description":"Remove hip bone les deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enema tube_ with or without adapter_ any type_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4457","description":"Enema tube_ with or without adapter_ any type_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0698U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698U","description":"CPT-0698U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYF0","description":"ICD-PCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84078","description":"Assay alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99328","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for bladder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51600","description":"Injection for bladder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBF0","description":"ICD-MLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain pancreatic pseudocyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48510","description":"Drain pancreatic pseudocyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEA0","description":"ICD-MIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIE1","description":"ICD-CGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHB1","description":"ICD-MLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAND1","description":"ICD-OAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65765","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRA1","description":"ICD-DIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCD1","description":"ICD-MBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","description":"HCPCS-J3402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA17","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intrpulmnry percuss vent sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0481","description":"Intrpulmnry percuss vent sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCA1","description":"ICD-IFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQD0","description":"ICD-CAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIA1","description":"ICD-GEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQE1","description":"ICD-DGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOA0","description":"ICD-DFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGA0","description":"ICD-JHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYC0","description":"ICD-OIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFA0","description":"ICD-BCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCC0","description":"ICD-NBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKB0","description":"ICD-JDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPD1","description":"ICD-BHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0B","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMB1","description":"ICD-OKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHE1","description":"ICD-NIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYF0","description":"ICD-HAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pd catheter anchor belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4653","description":"Pd catheter anchor belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADE1","description":"ICD-NADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt srv p day 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90968","description":"Esrd home pt srv p day 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBC1","description":"ICD-CHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKC0","description":"ICD-BBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; parenchyma (eg_ organ)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76981","description":"Ultrasound_ elastography; parenchyma (eg_ organ)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRC0","description":"ICD-KGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shdr fair lead cable direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6590","description":"Shdr fair lead cable direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received active chemotherapy any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1156","description":"Patient received active chemotherapy any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth anorectal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90251","description":"Anesth anorectal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCV2 10MCG TRS-SUCR 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071A","description":"ADM SARSCV2 10MCG TRS-SUCR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXD0","description":"ICD-NCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with non-invasive interface (e.g. mask)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0464","description":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with non-invasive interface (e.g. mask)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc viral load >=200","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9242","description":"Doc viral load >=200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB31","description":"ICD-3LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis nonauto w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81000","description":"Urinalysis nonauto w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMF0","description":"ICD-OHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTE1","description":"ICD-AHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4D","description":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22226","description":"Revise extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74400","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0946T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","description":"CPT-0946T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXD0","description":"ICD-GGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCED1","description":"ICD-NCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00625","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","description":"CPT-00625","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth face/skull bone surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19051","description":"Anesth face/skull bone surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43825","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ova and parasites smears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87177","description":"Ova and parasites smears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA126","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCF1","description":"ICD-EBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB01","description":"Medium Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHF0","description":"ICD-MFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ferric pyrophosphate citrate powder_ 0.1mg of iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1444","description":"Injection_ ferric pyrophosphate citrate powder_ 0.1mg of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUD1","description":"ICD-FHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aqueous shunt eye w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66180","description":"Aqueous shunt eye w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWF0","description":"ICD-ODWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPF0","description":"ICD-KDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin beta_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9973","description":"Epoetin beta_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOC1","description":"ICD-CFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37605","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGF0","description":"ICD-NFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed var ht w/o rail w/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0293","description":"Hosp bed var ht w/o rail w/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWC0","description":"ICD-PCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBE0","description":"ICD-JCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUE1","description":"ICD-CGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGED0","description":"ICD-MGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIA1","description":"ICD-OBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTB0","description":"ICD-BGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove part thorax vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22112","description":"Remove part thorax vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB56","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient  compression arm sleeve_ custom_ medium weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6576","description":"Gradient  compression arm sleeve_ custom_ medium weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dipropylacetic acid free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80165","description":"Dipropylacetic acid free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01520","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","description":"CPT-01520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2304","description":"Lens sphcy trifocal 4.0/2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged nursing facility evaluation and management service(s) beyond the  total time for the primary service (when the primary service has been selected using time on the da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0317","description":"Prolonged nursing facility evaluation and management service(s) beyond the  total time for the primary service (when the primary service has been selected using time on the da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rectum and colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45121","description":"Removal of rectum and colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0C","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHB0","description":"ICD-GDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAF1","description":"ICD-GDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGA0","description":"ICD-BFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post fusion 7-12 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22802","description":"Post fusion 7-12 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach_ including transseptal puncture_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0483T","description":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach_ including transseptal puncture_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEF1","description":"ICD-IFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In vivo lab service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88749","description":"In vivo lab service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occluder lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2770","description":"Occluder lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sipuleucel-t auto cd54+","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2043","description":"Sipuleucel-t auto cd54+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC21","description":"ICD-2LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICF0","description":"ICD-CICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27194","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4928","description":"Surgical mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUF0","description":"ICD-MAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No hepc rna after med docrsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9210","description":"No hepc rna after med docrsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1112","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUD1","description":"ICD-MFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMD0","description":"ICD-EIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLME1","description":"ICD-OLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIB1","description":"ICD-FFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virus inoculation shell via","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87254","description":"Virus inoculation shell via","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10D","description":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNE1","description":"ICD-OHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dacarbazine 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9130","description":"Dacarbazine 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43020","description":"Incision of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Refitting of obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5933","description":"Refitting of obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0318","description":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection glatiramer acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1595","description":"Injection glatiramer acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA)_ Chlamydia trachomatis and Neisseria gonorrhoeae_ multiplex amplified probe technique_ urine_ vaginal_ pharyngeal_ or rectal_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0353U","description":"Infectious agent detection by nucleic acid (DNA)_ Chlamydia trachomatis and Neisseria gonorrhoeae_ multiplex amplified probe technique_ urine_ vaginal_ pharyngeal_ or rectal_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOE0","description":"ICD-OKOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA CHLAMYDIA TRACHOMATIS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87320","description":"IAAD IA CHLAMYDIA TRACHOMATIS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Follow up care plan mdd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0545F","description":"Follow up care plan mdd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit tpn over 3l diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9368","description":"Hit tpn over 3l diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB140","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Position wc cush wdth <22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2605","description":"Position wc cush wdth <22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99284","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28F","description":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cranial cervical torticollis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0113","description":"Cranial cervical torticollis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCB0","description":"ICD-BBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGA0","description":"ICD-NIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJC0","description":"ICD-NDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1B","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of kidney wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50500","description":"Repair of kidney wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGE1","description":"ICD-JCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVE1","description":"ICD-FFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eo elas w/metal jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3710","description":"Eo elas w/metal jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACA0","description":"ICD-JACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI upper extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73218","description":"MRI upper extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMF1","description":"ICD-MKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUE0","description":"ICD-EBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free circulating DNA analysis of 83 or more genes_ interrogation for sequence variants_ gene copy number a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0326U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free circulating DNA analysis of 83 or more genes_ interrogation for sequence variants_ gene copy number a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQD0","description":"ICD-LDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAD1","description":"ICD-CAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deep muscle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20205","description":"Deep muscle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSD0","description":"ICD-LGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNF0","description":"ICD-KDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAA1","description":"ICD-GDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTC1","description":"ICD-IBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLB0","description":"ICD-OJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDC0","description":"ICD-OEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAB0","description":"ICD-JAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBE1","description":"ICD-CGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQC1","description":"ICD-GIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tafasitamab-cxix_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9070","description":"Injection_ tafasitamab-cxix_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28H","description":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disp home glucose monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9275","description":"Disp home glucose monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription digital behavioral therapy_ FDA-cleared_ per course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9291","description":"Prescription digital behavioral therapy_ FDA-cleared_ per course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALE0","description":"ICD-OALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB51","description":"Medium Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFE1","description":"ICD-FEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETB0","description":"ICD-GETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External urinary catheters; disposable_ with wicking material_ for use with suction pump_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6590","description":"External urinary catheters; disposable_ with wicking material_ for use with suction pump_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI neck spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72142","description":"MRI neck spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ue pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8669","description":"Fun stat score ue pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUE0","description":"ICD-IHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99484","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43831","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLD0","description":"ICD-AFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAC1","description":"ICD-BCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Itraconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80189","description":"Itraconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSB1","description":"ICD-PBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 6 genotyping (HPA-6w)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa_ antigen CD61] [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ po","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81110","description":"Human Platelet Antigen 6 genotyping (HPA-6w)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa_ antigen CD61] [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ po","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRF0","description":"ICD-KDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collect & prep saliva sample","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0417","description":"Collect & prep saliva sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWE1","description":"ICD-CFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQB1","description":"ICD-OJQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHD0","description":"ICD-CGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21268","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBC1","description":"ICD-ECBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKB0","description":"ICD-KAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAC1","description":"ICD-MAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAA0","description":"ICD-CDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIME0","description":"ICD-NIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQB0","description":"ICD-CBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABE1","description":"ICD-IABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA43","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol hepatic fream","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5200","description":"Parenteral sol hepatic fream","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXC1","description":"ICD-FBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tremelimumab-actl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9147","description":"Injection_ tremelimumab-actl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOF0","description":"ICD-HIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stereoscopic x-ray guidance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6002","description":"Stereoscopic x-ray guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Warming card for nwt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0232","description":"Warming card for nwt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-91125","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","description":"CPT-91125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ olaratumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9485","description":"Injection_ olaratumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRB0","description":"ICD-GHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54505","description":"Biopsy of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUC0","description":"ICD-NCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-81195","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","description":"CPT-81195","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCE0","description":"ICD-OKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15B","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","description":"HCPCS-M1392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24900","description":"Amputation of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ls not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8662","description":"Fun stat score ls not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens trifocal add over 3.25d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2320","description":"Lens trifocal add over 3.25d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88305","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Habil prevoc waiver per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2015","description":"Habil prevoc waiver per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWA1","description":"ICD-GCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Choline c-11_ diagnostic_ per study dose up to 20 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9515","description":"Choline c-11_ diagnostic_ per study dose up to 20 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prp i/hern init reduc >5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49505","description":"Prp i/hern init reduc >5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDE1","description":"ICD-JBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37291","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","description":"CPT-37291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76516","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHE0","description":"ICD-GDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGD1","description":"ICD-GBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUA0","description":"ICD-CEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 5.1-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12053","description":"Intmd rpr face/mm 5.1-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Encephaltis west eqne antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86654","description":"Encephaltis west eqne antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLB1","description":"ICD-GDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2044","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","description":"HCPCS-A2044","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36481","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRA1","description":"ICD-HHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxford w/ supinat/pronator c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3202","description":"Oxford w/ supinat/pronator c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAA1","description":"ICD-OKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMF0","description":"ICD-NEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct upper jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21206","description":"Reconstruct upper jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJE0","description":"ICD-KHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55500","description":"Removal of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory surgical boot eac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3260","description":"Ambulatory surgical boot eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Facial moulage sectional","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5911","description":"Facial moulage sectional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO shoulder intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9735","description":"Patient unable to complete the FOTO shoulder intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHF0","description":"ICD-KGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXD1","description":"ICD-GIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHF0","description":"ICD-JAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0772T","description":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home injectable therapy_ immunotherapy_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies and equipment (drugs a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9563","description":"Home injectable therapy_ immunotherapy_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies and equipment (drugs a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUF1","description":"ICD-EAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELA0","description":"ICD-KELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft fem-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35558","description":"Art byp grft fem-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD214","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 17-18 test","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP18","description":"Auto test panel pricing code_ 17-18 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69310","description":"Rebuild outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRB1","description":"ICD-CDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRA0","description":"ICD-HFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29822","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clsd reduct simpl maxilla fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7620","description":"Clsd reduct simpl maxilla fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 22 Or Functional Status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2144","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 22 Or Functional Status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knuckle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26850","description":"Fusion of knuckle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare sperm duct x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55300","description":"Prepare sperm duct x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKD1","description":"ICD-OJKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIE0","description":"ICD-NKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNE1","description":"ICD-JHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMD1","description":"ICD-FDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In Hospice Or Using Hospice Services During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2153","description":"In Hospice Or Using Hospice Services During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETD1","description":"ICD-BETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBC1","description":"ICD-BCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPA0","description":"ICD-GGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ (Nuwiq)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7209","description":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ (Nuwiq)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammo result com to pt 5 day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5062F","description":"Mammo result com to pt 5 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDE0","description":"ICD-CFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUA0","description":"ICD-MKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"non - surgical sialolithotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7979","description":"non - surgical sialolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRB0","description":"ICD-LDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUF0","description":"ICD-AGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNE0","description":"ICD-CGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other pt/ot goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8991","description":"Other pt/ot goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12B","description":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADA0","description":"ICD-CADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pancreatic)_ DNA_ whole genome sequencing with 5-hydroxymethylcytosine enrichment_ whole blood or plasma_ algorithm reported as cancer detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0410U","description":"Oncology (pancreatic)_ DNA_ whole genome sequencing with 5-hydroxymethylcytosine enrichment_ whole blood or plasma_ algorithm reported as cancer detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYF0","description":"ICD-PLYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAA1","description":"ICD-ICAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLB0","description":"ICD-EGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable male external cat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4349","description":"Disposable male external cat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALB0","description":"ICD-GALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEA0","description":"ICD-GIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVE1","description":"ICD-KCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove skull plate/flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62142","description":"Remove skull plate/flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device_ mechano-electrical skin interface and electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0459T","description":"Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device_ mechano-electrical skin interface and electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL02","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64835","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHF1","description":"ICD-JFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-tibial shell molded to p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2340","description":"Pre-tibial shell molded to p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin tissue procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17999","description":"Skin tissue procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES151","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLF1","description":"ICD-NCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDC0","description":"ICD-GFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHB0","description":"ICD-BGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQE0","description":"ICD-OJQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insrt heart pm atrial & vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33208","description":"Insrt heart pm atrial & vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFD0","description":"ICD-JCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGD0","description":"ICD-FFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDA0","description":"ICD-NIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80434","description":"Insulin tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEE1","description":"ICD-GIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB31","description":"ICD-1DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWC0","description":"ICD-KBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cxr doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3006F","description":"Cxr doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIE0","description":"ICD-CDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15C","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group III_ for enzyme constituents (List separately in addition to code for pri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0759T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group III_ for enzyme constituents (List separately in addition to code for pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAA1","description":"ICD-EFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBF0","description":"ICD-GEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYD0","description":"ICD-CDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1828","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","description":"HCPCS-E1828","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nontherm electromgntc device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0761","description":"Nontherm electromgntc device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC114","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRD1","description":"ICD-KGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEA1","description":"ICD-NDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2290","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2290","description":"HCPCS-J2290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brst prsth bra & bilat form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8002","description":"Brst prsth bra & bilat form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig geno no antvir tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8458","description":"Pt inelig geno no antvir tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01442","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","description":"CPT-01442","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILC0","description":"ICD-NILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dtap-ipv-hib-hepb vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90697","description":"Dtap-ipv-hib-hepb vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Oral); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2068","description":"Medication Assisted Treatment_ Buprenorphine (Oral); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUE0","description":"ICD-FEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMD1","description":"ICD-JEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIC1","description":"ICD-IAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQC1","description":"ICD-GGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","description":"HCPCS-Q4392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGF1","description":"ICD-NHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cetirizine hydrochloride_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1201","description":"Injection_ cetirizine hydrochloride_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22C","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMF1","description":"ICD-MJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33767","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genome re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81427","description":"Genome re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXC1","description":"ICD-KGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRE1","description":"ICD-DDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNF1","description":"ICD-NFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15B","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBB1","description":"ICD-MDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDD0","description":"ICD-IDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplant/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26483","description":"Transplant/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4362","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","description":"HCPCS-Q4362","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLE1","description":"ICD-NFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPD1","description":"ICD-CEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pressure pneum appl full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0672","description":"Pressure pneum appl full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ reslizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2786","description":"Injection_ reslizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine HCl (Immphentiv)_ 20 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2373","description":"Injection_ phenylephrine HCl (Immphentiv)_ 20 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Graft_ vascular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1768","description":"Graft_ vascular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLF1","description":"ICD-JBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUA1","description":"ICD-NKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No pcp proph low cd4 norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9217","description":"No pcp proph low cd4 norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKA1","description":"ICD-OCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIE1","description":"ICD-FEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trach/laryn tube stainless","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7522","description":"Trach/laryn tube stainless","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 2-3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73502","description":"X-ray exam hip uni 2-3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSF0","description":"ICD-OJSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFD0","description":"ICD-NFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCF1","description":"ICD-MHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQE1","description":"ICD-DEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACF0","description":"ICD-JACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis via av graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4053F","description":"Hemodialysis via av graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52276","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB43","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of knee prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27488","description":"Removal of knee prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQB0","description":"ICD-DGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXA1","description":"ICD-CGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of upper nose/throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42804","description":"Biopsy of upper nose/throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDED1","description":"ICD-JDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOB1","description":"ICD-HFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Outrigger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1080","description":"Outrigger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIB1","description":"ICD-IBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Idet single level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22526","description":"Idet single level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRF0","description":"ICD-LCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tetracyclin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0120","description":"Tetracyclin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLF1","description":"ICD-GCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66625","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermatological procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96999","description":"Dermatological procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBF1","description":"ICD-KFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHB0","description":"ICD-BBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Growth hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80430","description":"Growth hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJD0","description":"ICD-JAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBB1","description":"ICD-MCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1041T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1041T","description":"CPT-1041T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doppler flow testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93990","description":"Doppler flow testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injectable poly-l-lactic acid_ restorative implant_ 1 ml_ face (deep dermis_ subcutaneous layers)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0196","description":"Injectable poly-l-lactic acid_ restorative implant_ 1 ml_ face (deep dermis_ subcutaneous layers)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSA0","description":"ICD-KHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUA0","description":"ICD-MGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln cmplt maxil ch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5730","description":"Denture reln cmplt maxil ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC20","description":"Medium Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC11","description":"ICD-2CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDF0","description":"ICD-AIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0405","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0405","description":"CDT-D0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture typing added method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87158","description":"Culture typing added method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18C","description":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDB0","description":"ICD-AEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLA0","description":"ICD-ABLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cms medical evidence form 2728 for dialysis patients: initial form completed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1265","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reticyte/hgb concentrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85046","description":"Reticyte/hgb concentrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVB1","description":"ICD-JFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9947","description":"Leg pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDB1","description":"ICD-KEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLE0","description":"ICD-OGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonvascular shunt x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75809","description":"Nonvascular shunt x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In-home respite care_ 4-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0529","description":"In-home respite care_ 4-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBA0","description":"ICD-FIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUB1","description":"ICD-IHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJE0","description":"ICD-CFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHE0","description":"ICD-FFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB42","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBC0","description":"ICD-CDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMC0","description":"ICD-GCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQE0","description":"ICD-OIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIC0","description":"ICD-IIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQD0","description":"ICD-GCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement interface spsd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1821","description":"Replacement interface spsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQC0","description":"ICD-CHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99427","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTD1","description":"ICD-OFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE144","description":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of esophagus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43100","description":"Excision of esophagus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tail bone ulcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15922","description":"Removal of tail bone ulcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"repair cast partial framework_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5621","description":"repair cast partial framework_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEE0","description":"ICD-CGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/snare","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44394","description":"Colonoscopy w/snare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1108T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1108T","description":"CPT-1108T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL45","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAF1","description":"ICD-NBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBC1","description":"ICD-IDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2206","description":"Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDE0","description":"ICD-NHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68801","description":"Dilate tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQF1","description":"ICD-HBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOF1","description":"ICD-PEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRC0","description":"ICD-GFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eltrd/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33243","description":"Remove eltrd/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA11","description":"ICD-1GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAF0","description":"ICD-NLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUB0","description":"ICD-BDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAME1","description":"ICD-IAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proposed Adopting Best Practices And Promoting Patient Safety Within Emergency Medicine Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0057","description":"Proposed Adopting Best Practices And Promoting Patient Safety Within Emergency Medicine Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGB1","description":"ICD-JHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo total proctocolectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44210","description":"Laparo total proctocolectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Employment Career Assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1732","description":"Employment Career Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27496","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incontinent rectal insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4337","description":"Incontinent rectal insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB154","description":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB21","description":"ICD-2FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJE0","description":"ICD-FGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAE1","description":"ICD-FEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQD1","description":"ICD-GBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair standard w/ leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1150","description":"Wheelchair standard w/ leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQB1","description":"ICD-HBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCF0","description":"ICD-MJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSC0","description":"ICD-DCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 85 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0147U","description":"Drug assay_ definitive_ 85 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6553","description":"Gradient compression stocking_ below knee_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1417","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","description":"HCPCS-M1417","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2920","description":"Methylprednisolone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLC1","description":"ICD-OFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMC1","description":"ICD-EHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22D","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVA0","description":"ICD-NEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Jaw arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29800","description":"Jaw arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWA0","description":"ICD-LDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUA0","description":"ICD-MAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CT studies not reported to a radiation dose index registry due to medical reasons (eg_ ct studies performed for radiation treatment planning or image-guided radiation trtmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9325","description":"CT studies not reported to a radiation dose index registry due to medical reasons (eg_ ct studies performed for radiation treatment planning or image-guided radiation trtmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy shoulder tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23066","description":"Biopsy shoulder tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKF1","description":"ICD-BIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CaregraFT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4322","description":"CaregraFT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB31","description":"ICD-1IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cognitive skills development","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97532","description":"Cognitive skills development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6029","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","description":"HCPCS-L6029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unclassified drug or biological used for ESRD on dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3591","description":"Unclassified drug or biological used for ESRD on dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAA1","description":"ICD-KCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTD1","description":"ICD-NKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smoking cessation gum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4995","description":"Smoking cessation gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change of ureter tube/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50688","description":"Change of ureter tube/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75746","description":"Artery x-rays lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHE0","description":"ICD-OKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49659","description":"Laparo proc hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUA0","description":"ICD-BFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFD1","description":"ICD-GFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSC0","description":"ICD-OBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYD0","description":"ICD-GHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chct for mal hyperthermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89049","description":"Chct for mal hyperthermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27175","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25A","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKD1","description":"ICD-NJKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1301","description":"HCPCS-A1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLE0","description":"ICD-MBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVB0","description":"ICD-FAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preparation of report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90889","description":"Preparation of report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45307","description":"Proctosigmoidoscopy fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWF0","description":"ICD-LGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHA0","description":"ICD-JDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSE1","description":"ICD-DGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSF0","description":"ICD-DDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUB0","description":"ICD-NGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES245","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWD0","description":"ICD-LEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEC1","description":"ICD-BCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIC1","description":"ICD-MKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto interm peritoneal dialy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1592","description":"Auto interm peritoneal dialy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apicoect/perirad surg anter","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3410","description":"Apicoect/perirad surg anter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLB0","description":"ICD-CCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Free assay (ft-3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84481","description":"Free assay (ft-3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXF0","description":"ICD-FFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUF0","description":"ICD-MCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA234","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0570U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","description":"CPT-0570U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermapure 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4152","description":"Dermapure 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUF0","description":"ICD-BGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level VI_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0755T","description":"Digitization of glass microscope slides for level VI_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","description":"HCPCS-A2034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Helicoll_ per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4164","description":"Helicoll_ per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC113","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGB0","description":"ICD-GCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1477","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","description":"HCPCS-M1477","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inactivated je vacc im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90738","description":"Inactivated je vacc im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMC1","description":"ICD-FEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSC1","description":"ICD-OBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHE0","description":"ICD-OFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lubricant per ounce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4402","description":"Lubricant per ounce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00752","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","description":"CPT-00752","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKF1","description":"ICD-OAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFND0","description":"ICD-BFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diab shoe for density insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5500","description":"Diab shoe for density insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUA0","description":"ICD-NKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0101","description":"CDT-D0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTF0","description":"ICD-JFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1371","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","description":"HCPCS-M1371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26645","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj ganirelix acetat 250 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0132","description":"Inj ganirelix acetat 250 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBB0","description":"ICD-KGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNE0","description":"ICD-JFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laminotomy single lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63042","description":"Laminotomy single lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMF1","description":"ICD-OCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVC1","description":"ICD-KAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDA1","description":"ICD-AIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXC0","description":"ICD-GIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQB0","description":"ICD-PIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligate leg veins open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37761","description":"Ligate leg veins open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBC0","description":"ICD-ADBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient encounter during the performance period with hospice and palliative care specialty code 17","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1365","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWF1","description":"ICD-OCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD256","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Y90 ibritumomab_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9543","description":"Y90 ibritumomab_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12B","description":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAC0","description":"ICD-CBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow socket ins use w/lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6694","description":"Elbow socket ins use w/lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSB1","description":"ICD-LBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLE1","description":"ICD-CHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1043T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1043T","description":"CPT-1043T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43310","description":"Repair of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymph system imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78195","description":"Lymph system imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGF1","description":"ICD-CHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture type immunofluoresc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87140","description":"Culture type immunofluoresc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYC1","description":"ICD-PCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXC1","description":"ICD-JAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWD0","description":"ICD-DIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBB0","description":"ICD-NEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0234","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","description":"HCPCS-M0234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX53","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQF1","description":"ICD-HFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHC1","description":"ICD-NGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ nuclear magnetic resonance spectroscopy measurement of myo-inositol_ valine_ and creatinine_ algorithmically combined with cystatin C (by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0259U","description":"Nephrology (chronic kidney disease)_ nuclear magnetic resonance spectroscopy measurement of myo-inositol_ valine_ and creatinine_ algorithmically combined with cystatin C (by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCD1","description":"ICD-GBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUA1","description":"ICD-GDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEB0","description":"ICD-IIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUA0","description":"ICD-MDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBND0","description":"ICD-KBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Singl prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0504","description":"Singl prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXC1","description":"ICD-BBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE154","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB31","description":"ICD-4LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy w/exc of tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31540","description":"Laryngoscopy w/exc of tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMB1","description":"ICD-OAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHA0","description":"ICD-EHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMF1","description":"ICD-FCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDC1","description":"ICD-FHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDD1","description":"ICD-GHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAB0","description":"ICD-AHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50045","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQF0","description":"ICD-OEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelets leukocytes reduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9031","description":"Platelets leukocytes reduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHB1","description":"ICD-EHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDF1","description":"ICD-EIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","description":"HCPCS-J3379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTD1","description":"ICD-OHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOA0","description":"ICD-GCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB235","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAE1","description":"ICD-GAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Emergency Pack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1762","description":"Home Delivered Meals-Emergency Pack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6614","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6614","description":"HCPCS-A6614","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHE1","description":"ICD-FCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29874","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML42","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27307","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cysto w/renal stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52343","description":"Cysto w/renal stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIF1","description":"ICD-JEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFE1","description":"ICD-CEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEB0","description":"ICD-EFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58180","description":"Partial hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHF0","description":"ICD-NGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFF0","description":"ICD-KAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNC0","description":"ICD-NLNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQC0","description":"ICD-CFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient died including all deaths occurring during the hospitalization in which the operation was performed_ even if after 30 days_ and those deaths occurring after discharge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9812","description":"Patient died including all deaths occurring during the hospitalization in which the operation was performed_ even if after 30 days_ and those deaths occurring after discharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCD0","description":"ICD-NJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTC0","description":"ICD-KGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc leg/ankle les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27632","description":"Exc leg/ankle les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEA1","description":"ICD-CIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSC0","description":"ICD-DHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v auto fluid redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88175","description":"Cytopath c/v auto fluid redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80331","description":"Analgesics non-opioid 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAA0","description":"ICD-AGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRE1","description":"ICD-PKRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDB0","description":"ICD-IBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOA1","description":"ICD-PBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOB0","description":"ICD-PFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amalgam three surfaces perma","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2160","description":"Amalgam three surfaces perma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTF0","description":"ICD-IGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhc occup therapy ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0160","description":"Hhc occup therapy ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms_ including identification of 20 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0416U","description":"Infectious agent detection by nucleic acid (DNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms_ including identification of 20 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBE0","description":"ICD-BGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4438","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","description":"HCPCS-Q4438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCC1","description":"ICD-JBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXB1","description":"ICD-CIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sgd accessory_ mounting sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2512","description":"Sgd accessory_ mounting sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFC1","description":"ICD-ODFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNA0","description":"ICD-CFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCF0","description":"ICD-EHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCC0","description":"ICD-JHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMD0","description":"ICD-CFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reagent strip/blood glucose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82948","description":"Reagent strip/blood glucose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYA1","description":"ICD-OAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX05","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCC1","description":"ICD-MJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOB0","description":"ICD-GFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHE0","description":"ICD-BDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system_ including decannulation_ separation from the perfusion sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0494T","description":"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system_ including decannulation_ separation from the perfusion sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHF0","description":"ICD-NEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pentamidine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2545","description":"Pentamidine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic us exam esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43237","description":"Endoscopic us exam esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBA1","description":"ICD-MBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYA0","description":"ICD-DGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2020","description":"Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAA1","description":"ICD-IIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx gastro intub w/asp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43753","description":"Tx gastro intub w/asp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHE1","description":"ICD-EIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Term dev_ sport/rec/work att","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6704","description":"Term dev_ sport/rec/work att","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-81354","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","description":"CPT-81354","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57522","description":"Conization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIB0","description":"ICD-OGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBC0","description":"ICD-IHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPD1","description":"ICD-FFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prefabricated abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6056","description":"Prefabricated abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home infusion/visit 2 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99601","description":"Home infusion/visit 2 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIA1","description":"ICD-CFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXE1","description":"ICD-CAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Csit on pt any reas 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8962","description":"Csit on pt any reas 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML52","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGB1","description":"ICD-BDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58952","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMC0","description":"ICD-JGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine 2vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72070","description":"X-ray exam thorac spine 2vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC43","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHB0","description":"ICD-FIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVC1","description":"ICD-BCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXB0","description":"ICD-FHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trismus appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5937","description":"Trismus appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUA0","description":"ICD-BGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJD1","description":"ICD-CEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXD0","description":"ICD-GDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1323","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPF0","description":"ICD-KHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA145","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software_ data collection_ transmission_ and storage_ each 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0741T","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software_ data collection_ transmission_ and storage_ each 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBA1","description":"ICD-JFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNE0","description":"ICD-KHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA31","description":"ICD-1JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND E","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX14","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND E","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBED1","description":"ICD-BBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig rna no antvir tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8460","description":"Pt inelig rna no antvir tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1014","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPD1","description":"ICD-OAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; REMOVAL_ EACH BALLOON","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53453","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; REMOVAL_ EACH BALLOON","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIB0","description":"ICD-GDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47785","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCB1","description":"ICD-AHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOB1","description":"ICD-LDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECD0","description":"ICD-MECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21422","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28666","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLD0","description":"ICD-CBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33321","description":"Repair major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit enteral per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9340","description":"Hit enteral per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6560","description":"Gradient compression stocking_ full length/chap style_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOE0","description":"ICD-HFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRD0","description":"ICD-CDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOF1","description":"ICD-PGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBE1","description":"ICD-EHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open drainage liver lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47010","description":"Open drainage liver lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC42","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBB0","description":"ICD-NKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins/rep subq defibrillator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33270","description":"Ins/rep subq defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFC0","description":"ICD-GBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging without contrast_ breast; bilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8907","description":"Magnetic resonance imaging without contrast_ breast; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30320","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0767","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0767","description":"HCPCS-E0767","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNB0","description":"ICD-BHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opps/php;activity therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0176","description":"Opps/php;activity therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEE0","description":"ICD-KAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICF1","description":"ICD-AICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt asst re end life issues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4553F","description":"Pt asst re end life issues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Consultation with family","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90887","description":"Consultation with family","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antepartum care only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59425","description":"Antepartum care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous sti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33288","description":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous sti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Jaw motion rehab system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1700","description":"Jaw motion rehab system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prior thyroid dise dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9553","description":"Prior thyroid dise dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICA1","description":"ICD-KICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIB1","description":"ICD-MIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPE1","description":"ICD-JEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHC0","description":"ICD-EAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEC1","description":"ICD-FGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITE0","description":"ICD-MITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKB1","description":"ICD-NCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFED0","description":"ICD-KFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMA0","description":"ICD-CCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFC1","description":"ICD-KDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1085T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1085T","description":"CPT-1085T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0526U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","description":"CPT-0526U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019]_ rs1333048 [CDKN2B-AS1]_ rs12129789 [KCND3]_ rs942","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0440U","description":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019]_ rs1333048 [CDKN2B-AS1]_ rs12129789 [KCND3]_ rs942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGC1","description":"ICD-OAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect leg/ankle tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27615","description":"Resect leg/ankle tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETB0","description":"ICD-FETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCED0","description":"ICD-MCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dna antibody single strand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86226","description":"Dna antibody single strand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crisis intervention per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9484","description":"Crisis intervention per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83718","description":"Assay of lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0215T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retreat root canal molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3348","description":"Retreat root canal molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunotherapy injections","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95117","description":"Immunotherapy injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPC0","description":"ICD-CGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attempted vbac delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59620","description":"Attempted vbac delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADF1","description":"ICD-BADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQF1","description":"ICD-CBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemotx Adm Iv Inf Tech; Ini Inf Office/Clin Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0498","description":"Chemotx Adm Iv Inf Tech; Ini Inf Office/Clin Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA34","description":"High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHB1","description":"ICD-JCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOF0","description":"ICD-KCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCC1","description":"ICD-MDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMF1","description":"ICD-MIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18D","description":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMF0","description":"ICD-FDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/ coronary artery stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4561F","description":"Pt w/ coronary artery stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYF1","description":"ICD-GAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSC1","description":"ICD-GGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE260","description":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIC1","description":"ICD-NBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTC1","description":"ICD-NJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVB0","description":"ICD-NHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ gastrointestinal pathogens_ 31 bacterial_ viral_ and parasitic organisms and identification of 21 associated antibiot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0369U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ gastrointestinal pathogens_ 31 bacterial_ viral_ and parasitic organisms and identification of 21 associated antibiot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB205","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene major bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81206","description":"Bcr/abl1 gene major bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","description":"HCPCS-E0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (Alzheimer Disease)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 24 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0289U","description":"Neurology (Alzheimer Disease)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 24 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL16","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBC0","description":"ICD-JGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWA1","description":"ICD-GAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgicord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4218","description":"Surgicord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVA1","description":"ICD-KFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc endocrine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60659","description":"Laparo proc endocrine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBC0","description":"ICD-GGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOB1","description":"ICD-OBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso flex trunk/thor pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0450","description":"Tlso flex trunk/thor pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBD0","description":"ICD-OHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBF0","description":"ICD-JGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHF1","description":"ICD-CAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluvirin vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2037","description":"Fluvirin vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUA0","description":"ICD-NBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"64 lead ecg w/i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0178T","description":"64 lead ecg w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRF1","description":"ICD-OFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOE0","description":"ICD-CCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKD1","description":"ICD-FGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove in/ex hem grps w/fist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46262","description":"Remove in/ex hem grps w/fist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOB1","description":"ICD-KIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQD0","description":"ICD-KDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBC1","description":"ICD-AFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tpa initi w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8600","description":"Tpa initi w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMB0","description":"ICD-BCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIA1","description":"ICD-NEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWC1","description":"ICD-CAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking garter belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6544","description":"Gc stocking garter belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31240","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHA0","description":"ICD-NGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSE0","description":"ICD-CGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCF1","description":"ICD-IDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65810","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJB1","description":"ICD-NKJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo plas doub free knee mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2036","description":"Kafo plas doub free knee mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAE1","description":"ICD-OIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD221","description":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWF0","description":"ICD-PJWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCC1","description":"ICD-OBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBC1","description":"ICD-FCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRA1","description":"ICD-OGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGC1","description":"ICD-FDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUD0","description":"ICD-MEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4346","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","description":"HCPCS-Q4346","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRA0","description":"ICD-DFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conductive garment for tens/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0731","description":"Conductive garment for tens/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl cardiac modulj pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0412T","description":"Rmvl cardiac modulj pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEC1","description":"ICD-EBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metyrapone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80436","description":"Metyrapone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise two eye muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67316","description":"Revise two eye muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJA0","description":"ICD-KGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ eravacycline_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0122","description":"Injection_ eravacycline_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Approp anticonvuls tstng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4191F","description":"Approp anticonvuls tstng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIA0","description":"ICD-JFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx chron care addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99489","description":"Cmplx chron care addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHA1","description":"ICD-NIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC03","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOA0","description":"ICD-HFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Offset/lat rocker arm w/ela","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2632","description":"Offset/lat rocker arm w/ela","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUC0","description":"ICD-CIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCC0","description":"ICD-JCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWB1","description":"ICD-PAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLA0","description":"ICD-JFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEB1","description":"ICD-FCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKA1","description":"ICD-JGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSE1","description":"ICD-KCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRC1","description":"ICD-LDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYA0","description":"ICD-HDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX10","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup body cast plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4001","description":"Cast sup body cast plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTD1","description":"ICD-EDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLE1","description":"ICD-NCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44372","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41826","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ CROS_ behind the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5180","description":"Hearing aid_ CROS_ behind the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMA1","description":"ICD-IEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3A","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVD0","description":"ICD-BIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth intrcrn nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22051","description":"Anesth intrcrn nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSA1","description":"ICD-GGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compres burngarment facehood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6503","description":"Compres burngarment facehood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9760","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVA0","description":"ICD-KAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVD1","description":"ICD-OBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGED1","description":"ICD-AGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMB0","description":"ICD-OCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35371","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Daily cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0512","description":"Daily cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSB1","description":"ICD-LGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sperm procure subs visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4031","description":"Sperm procure subs visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-123 iobenguane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9582","description":"Iodine i-123 iobenguane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMD1","description":"ICD-JHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visual field assmnt rev/rprt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0378T","description":"Visual field assmnt rev/rprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0836","description":"Pwc gp2 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of anal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46050","description":"Incision of anal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening pap smear by phys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P3001","description":"Screening pap smear by phys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove radius head implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24164","description":"Remove radius head implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1503","description":"HCPCS-C1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQD0","description":"ICD-HAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp axill-fem-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35654","description":"Art byp axill-fem-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGA1","description":"ICD-NBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subtalar arthro w/fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29907","description":"Subtalar arthro w/fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVB1","description":"ICD-BGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ing hernia init reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49500","description":"Rpr ing hernia init reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABD1","description":"ICD-OABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIE1","description":"ICD-MEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWA0","description":"ICD-CHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKF1","description":"ICD-NIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ phenobarbital sodium (sezaby)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2561","description":"Injection_ phenobarbital sodium (sezaby)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ga67 gallium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9556","description":"Ga67 gallium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMC1","description":"ICD-OAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mandible graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7950","description":"Mandible graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med serv eve/wkend/holiday","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99051","description":"Med serv eve/wkend/holiday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUB0","description":"ICD-NLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRB1","description":"ICD-OLRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp comm supp svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2016","description":"Comp comm supp svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69643","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMF0","description":"ICD-EEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect shoulder tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23078","description":"Resect shoulder tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRE0","description":"ICD-DIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj dupuytren cord w/enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20527","description":"Inj dupuytren cord w/enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AmnioCoreTM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4227","description":"AmnioCoreTM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGB0","description":"ICD-NJGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCD0","description":"ICD-KGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc cardiac modulj sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0408T","description":"Insj/rplc cardiac modulj sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJE1","description":"ICD-CHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debridement_ bone including epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed_ first 20 sq cm or less with manual preparation and insertion of deep (e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7500","description":"Debridement_ bone including epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed_ first 20 sq cm or less with manual preparation and insertion of deep (e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydroxyzine pamoate 25mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0177","description":"Hydroxyzine pamoate 25mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulance waiting 1/2 hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0420","description":"Ambulance waiting 1/2 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLD0","description":"ICD-GDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBF0","description":"ICD-MKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITD0","description":"ICD-NITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam filled caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2217","description":"Foam filled caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin pro/pos wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2608","description":"Skin pro/pos wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ three protein biomarkers_ immunoassay using magnetic nanosensor technology_ plasma_ algorithm reported as risk score for likelihood of malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0092U","description":"Oncology (lung)_ three protein biomarkers_ immunoassay using magnetic nanosensor technology_ plasma_ algorithm reported as risk score for likelihood of malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA01","description":"Default_ /Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHE1","description":"ICD-EAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVF1","description":"ICD-CEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBB0","description":"ICD-AFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVE0","description":"ICD-BBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caloric vstblr test w/rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92538","description":"Caloric vstblr test w/rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXE0","description":"ICD-NIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITC1","description":"ICD-CITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLA0","description":"ICD-BCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01404","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","description":"CPT-01404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIA1","description":"ICD-ABIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL15","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIE0","description":"ICD-MCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCE1","description":"ICD-KBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQC1","description":"ICD-ODQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75891","description":"Vein x-ray liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBA1","description":"ICD-MGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICB0","description":"ICD-IICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVC0","description":"ICD-BHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA31","description":"ICD-3GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ob us >/= 14 wks addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76810","description":"Ob us >/= 14 wks addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE236","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBE0","description":"ICD-CHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corplex P_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4231","description":"Corplex P_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYD1","description":"ICD-HDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWA0","description":"ICD-LEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALC0","description":"ICD-AALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 5.1-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12014","description":"Rpr f/e/e/n/l/m 5.1-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pjp proph ordered low cd4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9222","description":"Pjp proph ordered low cd4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA43","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFF1","description":"ICD-JHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXE0","description":"ICD-NAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB16","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBD0","description":"ICD-AEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHA0","description":"ICD-OEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Water distilled w/nebulizer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7018","description":"Water distilled w/nebulizer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYE1","description":"ICD-LIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interscap-thor myoelectronic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6975","description":"Interscap-thor myoelectronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gene expression profiling panel for use in the management of breast cancer treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3854","description":"Gene expression profiling panel for use in the management of breast cancer treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMA1","description":"ICD-FBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50693","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sperm isolation simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89260","description":"Sperm isolation simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB32","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB230","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cur funct asses; no care pln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8543","description":"Cur funct asses; no care pln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90961","description":"Esrd srv 2-3 vsts p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDA0","description":"ICD-KIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKB0","description":"ICD-GFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cyclophosphamide oral 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8530","description":"Cyclophosphamide oral 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGA1","description":"ICD-CAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFF0","description":"ICD-NGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEF0","description":"ICD-MDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGF1","description":"ICD-OBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIF0","description":"ICD-JFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75831","description":"Vein x-ray kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJC1","description":"ICD-BHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGC1","description":"ICD-GGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRD0","description":"ICD-HHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37600","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRD1","description":"ICD-HIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICF1","description":"ICD-KICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCF0","description":"ICD-NGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUB0","description":"ICD-OFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63286","description":"Bx/exc idrl imed lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFB1","description":"ICD-JAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBF1","description":"ICD-AIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDC0","description":"ICD-MHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSA1","description":"ICD-HHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACF1","description":"ICD-BACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not screening for TB or interpreting results (i.e._ patient positive for TB and documentati","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1004","description":"Documentation of medical reason for not screening for TB or interpreting results (i.e._ patient positive for TB and documentati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penile injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54235","description":"Penile injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRD1","description":"ICD-DGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGA0","description":"ICD-CCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUA1","description":"ICD-KDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct rpt to reg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9327","description":"Ct rpt to reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFB0","description":"ICD-OKFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWC1","description":"ICD-OGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAF0","description":"ICD-AGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOA0","description":"ICD-CHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERC1","description":"ICD-DERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFB1","description":"ICD-CDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18F","description":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHND0","description":"ICD-OHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE141","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBB0","description":"ICD-IEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIF1","description":"ICD-EHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTC1","description":"ICD-MLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4223","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4223","description":"HCPCS-Q4223","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAC0","description":"ICD-OCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUE0","description":"ICD-AIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAE1","description":"ICD-NFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34704","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25630","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 23+ tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP23","description":"Auto test panel pricing code_ 23+ tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSA0","description":"ICD-HGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacemnt lithium ionbatter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7367","description":"Replacemnt lithium ionbatter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped size brief/diaper sm/med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4529","description":"Ped size brief/diaper sm/med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81404","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPC1","description":"ICD-NBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transdermal gfr monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0603T","description":"Transdermal gfr monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUB1","description":"ICD-BHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEC0","description":"ICD-BFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTF1","description":"ICD-FGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo intralesional over 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96406","description":"Chemo intralesional over 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32998","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVB1","description":"ICD-GGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort iii w/fhd w/ lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21160","description":"Lefort iii w/fhd w/ lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGF1","description":"ICD-FCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (non-small cell lung cancer)_ next-generation sequencing with identification of single nucleotide variants_ copy number variants_ insertions and deletions_ and struct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0388U","description":"Oncology (non-small cell lung cancer)_ next-generation sequencing with identification of single nucleotide variants_ copy number variants_ insertions and deletions_ and struct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB25","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVE0","description":"ICD-CAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10D","description":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dstry eye lesn_fdr vssl tech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0186","description":"Dstry eye lesn_fdr vssl tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBD1","description":"ICD-CFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITE1","description":"ICD-MITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compressor air power source","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0565","description":"Compressor air power source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo cholangiopancreatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43261","description":"Endo cholangiopancreatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECA1","description":"ICD-BECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAB0","description":"ICD-NLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; Each Add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0628T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; Each Add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVF1","description":"ICD-BIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0540","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","description":"HCPCS-G0540","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD234","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52277","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMC1","description":"ICD-JFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVB1","description":"ICD-JIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHF1","description":"ICD-OAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFE1","description":"ICD-NIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXE1","description":"ICD-JHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Malaria antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86750","description":"Malaria antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0523U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","description":"CPT-0523U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of nasal septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30520","description":"Repair of nasal septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whirlpool therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97022","description":"Whirlpool therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteogen ultrasound stimltor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0760","description":"Osteogen ultrasound stimltor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIE1","description":"ICD-NAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOD1","description":"ICD-CDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWC0","description":"ICD-HGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMC0","description":"ICD-EFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXC1","description":"ICD-OFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJC1","description":"ICD-OBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of gastrostomy tube_ percutaneous_ with magnetic gastropexy_ under ultrasound guidance_ image documentation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0647T","description":"Insertion of gastrostomy tube_ percutaneous_ with magnetic gastropexy_ under ultrasound guidance_ image documentation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric mucosa imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78261","description":"Gastric mucosa imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEA0","description":"ICD-FDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYB1","description":"ICD-DIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2025F","description":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Expired gas collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94250","description":"Expired gas collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJB0","description":"ICD-NHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINC1","description":"ICD-NINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23150","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC12","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with destruction by cryoablation_ posterior nasal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31243","description":"Nasal/sinus endoscopy_ surgical; with destruction by cryoablation_ posterior nasal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAA0","description":"ICD-OBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1272","description":"Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1485","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","description":"HCPCS-M1485","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flex/ext wrist w/wo friction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6621","description":"Flex/ext wrist w/wo friction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVD1","description":"ICD-BBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSB0","description":"ICD-CFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMA0","description":"ICD-MBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUF0","description":"ICD-IFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCF0","description":"ICD-EBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSE0","description":"ICD-PCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAB1","description":"ICD-BBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoplasty congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43313","description":"Esophagoplasty congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD154","description":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneum drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2381","description":"Pneum drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNC0","description":"ICD-BBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PuraPly AM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4196","description":"PuraPly AM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWF0","description":"ICD-PIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETB1","description":"ICD-GETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNC1","description":"ICD-KHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRB1","description":"ICD-CIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of primidone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80188","description":"Assay of primidone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRA0","description":"ICD-OLRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFA0","description":"ICD-NGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0903","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0903","description":"CDT-D0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mmr vaccine sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90707","description":"Mmr vaccine sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWB1","description":"ICD-GIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUF1","description":"ICD-GCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjust finger ext/flex devc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1825","description":"Adjust finger ext/flex devc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Free fascial flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15758","description":"Free fascial flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCA0","description":"ICD-KDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOA0","description":"ICD-LIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDC0","description":"ICD-BGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ spinal_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0785T","description":"Revision or removal of neurostimulator electrode array_ spinal_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB144","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPD1","description":"ICD-CHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBD1","description":"ICD-EDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXD0","description":"ICD-NEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anticoagulant mgmt subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99364","description":"Anticoagulant mgmt subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"At least two orders for the same high-risk medications not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9638","description":"At least two orders for the same high-risk medications not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumoc vac/admin/rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4040F","description":"Pneumoc vac/admin/rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc shoulder les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23071","description":"Exc shoulder les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lower extremity orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2999","description":"Lower extremity orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDB1","description":"ICD-GCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB117","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRE0","description":"ICD-OHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPC1","description":"ICD-GHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE231","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCE0","description":"ICD-MBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace high roll cuff","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4060","description":"Replace high roll cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64473","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","description":"CPT-64473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrde addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61864","description":"Implant neuroelectrde addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCB1","description":"ICD-CGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lt compres band >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6450","description":"Lt compres band >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid caster integrated whl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2222","description":"Solid caster integrated whl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Statin med pres at disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8816","description":"Statin med pres at disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXC0","description":"ICD-NFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD111","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDC0","description":"ICD-ODDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ unilateral (List se","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93569","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ unilateral (List se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC225","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0901","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0901","description":"CDT-D0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSA1","description":"ICD-PKSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA117","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPC0","description":"ICD-KGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUE0","description":"ICD-NDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCD1","description":"ICD-IHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYE1","description":"ICD-CCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHF0","description":"ICD-GHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76498","description":"MRI procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration Not Followed By Surgical Repair_ Artery; Upper Extremity (Eg_ Axillary_ Brachial_ Radial_ Ulnar)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35702","description":"Exploration Not Followed By Surgical Repair_ Artery; Upper Extremity (Eg_ Axillary_ Brachial_ Radial_ Ulnar)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed)_ Single S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78429","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed)_ Single S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fitting of diaphragm/cap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57170","description":"Fitting of diaphragm/cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXE0","description":"ICD-JHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCC0","description":"ICD-NHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQC1","description":"ICD-GAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXD1","description":"ICD-CHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69641","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heterophile antibody titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86309","description":"Heterophile antibody titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21184","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETA0","description":"ICD-IETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQF1","description":"ICD-DCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPE1","description":"ICD-GGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res W/Pne Billd Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9679","description":"Onsite Ac C Tx Nsg Fac Res W/Pne Billd Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJB0","description":"ICD-JCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWF0","description":"ICD-GHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biofeedback train any meth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90901","description":"Biofeedback train any meth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVE0","description":"ICD-OAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18F","description":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQD1","description":"ICD-CIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-H0053","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","description":"HCPCS-H0053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQB0","description":"ICD-CFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL40","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVB1","description":"ICD-GBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17283","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTA1","description":"ICD-MBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAE1","description":"ICD-CIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHB1","description":"ICD-FEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSD1","description":"ICD-PHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of peritoneum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74190","description":"X-ray exam of peritoneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAA1","description":"ICD-NJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFB1","description":"ICD-NCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures rebase part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5720","description":"Dentures rebase part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC21","description":"ICD-1DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd injection varices","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43243","description":"Egd injection varices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Standard control cable extra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6655","description":"Standard control cable extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWF1","description":"ICD-KEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Health Help_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1017","description":"Clinical decision support mechanism Health Help_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of arm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23930","description":"Drainage of arm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC40","description":"High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBC1","description":"ICD-MBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPB1","description":"ICD-NIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJB1","description":"ICD-CBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHE0","description":"ICD-NBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54699","description":"Laparoscope proc testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC15","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWD1","description":"ICD-KHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ear mold/insert_ disp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5265","description":"Ear mold/insert_ disp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58559","description":"Hysteroscopy lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA52","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWC0","description":"ICD-PEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13C","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9697","description":"Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt recvd 2 rx anti-emet agt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4558F","description":"Pt recvd 2 rx anti-emet agt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 3RD DOSE PFIZER","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 3RD DOSE PFIZER","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O2/water vapor enrich w/heat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1405","description":"O2/water vapor enrich w/heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abd imag and followup rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9548","description":"Abd imag and followup rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYB1","description":"ICD-OBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBE0","description":"ICD-IDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01130","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","description":"CPT-01130","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg awake and drowsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95816","description":"Eeg awake and drowsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inter limb compress dev nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0676","description":"Inter limb compress dev nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGB1","description":"ICD-GGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6197","description":"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMA0","description":"ICD-JCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolytic plasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85400","description":"Fibrinolytic plasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB55","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agents (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ and Trichomonas vaginalis_ multiplex amplified probe technique_ vaginal_ endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0455U","description":"Infectious agents (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ and Trichomonas vaginalis_ multiplex amplified probe technique_ vaginal_ endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTB1","description":"ICD-NDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIND1","description":"ICD-NIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27228","description":"Treat hip fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIE1","description":"ICD-BAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asst oocyte fert case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4022","description":"Asst oocyte fert case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cog&behav imprmnt scrng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3755F","description":"Cog&behav imprmnt scrng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft hip bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27067","description":"Remove/graft hip bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg pain was not measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1052","description":"Leg pain was not measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB21","description":"ICD-1GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPD0","description":"ICD-BDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plasma protein fract_5%_50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9043","description":"Plasma protein fract_5%_50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0562U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","description":"CPT-0562U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNB1","description":"ICD-GCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration_ autologous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0540T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration_ autologous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRC0","description":"ICD-DDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJB0","description":"ICD-OHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVB0","description":"ICD-OIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPE1","description":"ICD-BCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWF0","description":"ICD-HHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYC0","description":"ICD-DCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTF0","description":"ICD-MGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIE0","description":"ICD-EAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 3rd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36247","description":"Ins cath abd/l-ext art 3rd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammogram screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77057","description":"Mammogram screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Access av dial grft for proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36148","description":"Access av dial grft for proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITD0","description":"ICD-MITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYD1","description":"ICD-KCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJD1","description":"ICD-KHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDF1","description":"ICD-CDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp ea 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99145","description":"Mod sedat phys/qhp ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8C","description":"Medium Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26045","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control_ including vascular access and closure_ right heart catherization_ venou","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9783","description":"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control_ including vascular access and closure_ right heart catherization_ venou","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Joint survey single view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77077","description":"Joint survey single view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed ditromethamine_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9323","description":"Injection_ pemetrexed ditromethamine_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct capt maxilla","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0382","description":"Cone beam ct capt maxilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nitroblue tetrazolium dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86384","description":"Nitroblue tetrazolium dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYA1","description":"ICD-HEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acute vitreous hemorrhage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1333","description":"Acute vitreous hemorrhage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDA1","description":"ICD-IGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICF0","description":"ICD-NICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJE1","description":"ICD-GGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJA1","description":"ICD-GCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOA0","description":"ICD-KBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVE1","description":"ICD-CBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; 25 Cc Or Less Injectate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15773","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; 25 Cc Or Less Injectate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whchr s-recl fxd arm leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1100","description":"Whchr s-recl fxd arm leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHE1","description":"ICD-JCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYD1","description":"ICD-HEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8H","description":"Very High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOB0","description":"ICD-LAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMD1","description":"ICD-ODMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Str markers spec anal addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81266","description":"Str markers spec anal addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUA0","description":"ICD-CBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seat ht <17 or >=21 ltwt wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0056","description":"Seat ht <17 or >=21 ltwt wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med reas no perf foot exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9502","description":"Med reas no perf foot exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFB1","description":"ICD-JHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC34","description":"Medium Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95975","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUF0","description":"ICD-CBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smoker/exposed 2nd hnd smoke","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1032F","description":"Smoker/exposed 2nd hnd smoke","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHD0","description":"ICD-ECHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYF0","description":"ICD-HCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apis_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2010","description":"Apis_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home injectable therapy_ palivizumab_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9562","description":"Home injectable therapy_ palivizumab_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA55","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Miniature knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5826","description":"Miniature knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAF1","description":"ICD-NDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRA1","description":"ICD-GHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXC1","description":"ICD-NJXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61539","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adj shoulder ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1840","description":"Adj shoulder ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31075","description":"Exploration of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX45","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWB0","description":"ICD-KBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63270","description":"Excise intrspinl lesion crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDD0","description":"ICD-GEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Above knee flex cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5964","description":"Above knee flex cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rolapitant_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9464","description":"Injection_ rolapitant_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ copy number variants_ common variants with reflex to targeted sequence anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0028U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ copy number variants_ common variants with reflex to targeted sequence anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implant from hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26320","description":"Removal of implant from hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHA1","description":"ICD-EEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIA0","description":"ICD-BGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB11","description":"ICD-2LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMC0","description":"ICD-OKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99493","description":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cygnus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4170","description":"Cygnus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; respiratory syncytial virus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87807","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; respiratory syncytial virus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue culture bone marrow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88237","description":"Tissue culture bone marrow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMD0","description":"ICD-NKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0858T","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCD1","description":"ICD-JGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEB0","description":"ICD-JDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRF1","description":"ICD-CBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orth foot non-standard size/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3255","description":"Orth foot non-standard size/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44625","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCE1","description":"ICD-MKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv4 vaccine 6-35 months im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90687","description":"Iiv4 vaccine 6-35 months im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74415","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Quantification Of The Structure And Composition O","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0712T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Quantification Of The Structure And Composition O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood pressure recorded during inpatient stays_ emergency room visits_ urgent care visits_ and patient self-reported BP_s (home and health fair BP results)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9789","description":"Blood pressure recorded during inpatient stays_ emergency room visits_ urgent care visits_ and patient self-reported BP_s (home and health fair BP results)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHD1","description":"ICD-EGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQA0","description":"ICD-OGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTE0","description":"ICD-ACTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB12","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trichinella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86784","description":"Trichinella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPF0","description":"ICD-ODPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCF0","description":"ICD-KHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65755","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIF0","description":"ICD-ECIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28E","description":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUC0","description":"ICD-OIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJE1","description":"ICD-OHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDB1","description":"ICD-BHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26755","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCE0","description":"ICD-EHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Planar back for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2291","description":"Planar back for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSE1","description":"ICD-HDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB11","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDF1","description":"ICD-JBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64408","description":"N block inj vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLA0","description":"ICD-AHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30310","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPE0","description":"ICD-OKPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Report ckd measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8487","description":"Report ckd measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWD1","description":"ICD-ODWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33775","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEF0","description":"ICD-NKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Isoetharine non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7648","description":"Isoetharine non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0933T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","description":"CPT-0933T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ hymovis_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7322","description":"Hyaluronan or derivative_ hymovis_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum dep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27634","description":"Exc leg/ankle tum dep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDC0","description":"ICD-OKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKA1","description":"ICD-GAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMC1","description":"ICD-MGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26685","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQB1","description":"ICD-HFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFF1","description":"ICD-BEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUE1","description":"ICD-IAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD110","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9326","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","description":"HCPCS-J9326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLC1","description":"ICD-NHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLA0","description":"ICD-AFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Derm autograft face/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15135","description":"Derm autograft face/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRF0","description":"ICD-OBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ctlso axilla sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1010","description":"Ctlso axilla sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITE1","description":"ICD-GITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVB1","description":"ICD-CIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ (dr. reddy_s)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9072","description":"Injection_ cyclophosphamide_ (dr. reddy_s)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14D","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0511U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","description":"CPT-0511U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVC0","description":"ICD-CEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acid conc sol per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4709","description":"Acid conc sol per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAME0","description":"ICD-JAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPF0","description":"ICD-OJPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted molecular pathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81479","description":"Unlisted molecular pathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUB0","description":"ICD-MDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of jaw muscle/bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21296","description":"Revision of jaw muscle/bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHC0","description":"ICD-EGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA21","description":"ICD-3DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB146","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63053","description":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Escharotomy addl incision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16036","description":"Escharotomy addl incision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ progressive myoclonic epilepsy type 1A_ Unverricht-Lundborg disease)_ full gene analysis_ including small sequence changes in exonic and intronic region","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0232U","description":"CSTB (cystatin B) (eg_ progressive myoclonic epilepsy type 1A_ Unverricht-Lundborg disease)_ full gene analysis_ including small sequence changes in exonic and intronic region","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4542","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD141","description":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARB1","description":"ICD-LARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHC1","description":"ICD-BFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occult bld feces 1-3 tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82272","description":"Occult bld feces 1-3 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXD0","description":"ICD-BCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures mandibl part metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5214","description":"Dentures mandibl part metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg cerebral death only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95824","description":"Eeg cerebral death only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35372","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIE0","description":"ICD-JFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMA0","description":"ICD-JFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKC0","description":"ICD-NIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percussor elect/pneum home m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0480","description":"Percussor elect/pneum home m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone biopsy excisional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20245","description":"Bone biopsy excisional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLC0","description":"ICD-MCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRA1","description":"ICD-LIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVC1","description":"ICD-JAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gen w/c cushion wdth >=22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2602","description":"Gen w/c cushion wdth >=22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vital signs recorded","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2010F","description":"Vital signs recorded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUB1","description":"ICD-JHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0304","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0304","description":"CDT-D0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Th/wght bear nar m-l brim cu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2526","description":"Th/wght bear nar m-l brim cu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXB0","description":"ICD-GEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antipsychotics nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80342","description":"Antipsychotics nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Type location activityassess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1052F","description":"Type location activityassess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKF1","description":"ICD-CCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESB1","description":"ICD-CESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA215","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIF0","description":"ICD-GHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKF1","description":"ICD-OEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIF0","description":"ICD-OCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMB0","description":"ICD-JAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEED0","description":"ICD-JEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post-operative body jacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1310","description":"Post-operative body jacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHF0","description":"ICD-MEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 VAC AD26 .5ML B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0034A","description":"ADM SARSCOV2 VAC AD26 .5ML B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recd f/u w/in 30d disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9402","description":"Recd f/u w/in 30d disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHA1","description":"ICD-GEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2D","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRF1","description":"ICD-KFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEA1","description":"ICD-ODEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTC0","description":"ICD-FCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVB0","description":"ICD-JBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYD1","description":"ICD-KEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PuraPly XT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4197","description":"PuraPly XT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rubeola ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87283","description":"Rubeola ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urgent Care Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4036","description":"Urgent Care Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIA1","description":"ICD-KHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0485","description":"Oral device/appliance prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVD0","description":"ICD-OBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD117","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANE0","description":"ICD-FANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRA1","description":"ICD-KBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVF0","description":"ICD-BIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMC0","description":"ICD-FDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 25 mcg/0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91321","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 25 mcg/0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62304","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUD1","description":"ICD-JBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4365","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","description":"HCPCS-Q4365","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIB1","description":"ICD-BCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUF0","description":"ICD-JCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBA0","description":"ICD-KEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMC1","description":"ICD-ADMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1100","description":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXD1","description":"ICD-FCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Daprodustat_ oral_ 1 mg_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0889","description":"Daprodustat_ oral_ 1 mg_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dyspnea not screened","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3452F","description":"Dyspnea not screened","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEA0","description":"ICD-BDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKF0","description":"ICD-BDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMC1","description":"ICD-OGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLD1","description":"ICD-ICLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise spermatic cord veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55535","description":"Revise spermatic cord veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFID0","description":"ICD-EFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCD1","description":"ICD-CHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pca3 testing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3721","description":"Pca3 testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFE0","description":"ICD-JBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJC1","description":"ICD-CFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTA1","description":"ICD-KCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort iii w/fhdw/o lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21159","description":"Lefort iii w/fhdw/o lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACME1","description":"ICD-ACME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78710","description":"Kidney imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC150","description":"Special Care High _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIC0","description":"ICD-BHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Serv asmnt/care plan waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2024","description":"Serv asmnt/care plan waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1035T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1035T","description":"CPT-1035T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray adrenal glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75842","description":"Vein x-ray adrenal glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enteral stomach tube levine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4083","description":"Enteral stomach tube levine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Under The Care Of The Same Practitioner Or Group Partner As Of The Last Hemodialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1027","description":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Under The Care Of The Same Practitioner Or Group Partner As Of The Last Hemodialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens variable asphericity bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2430","description":"Lens variable asphericity bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB11","description":"ICD-4GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Installation_ ciprofloxacin otic suspension_ 6mg (Otiprio)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9479","description":"Installation_ ciprofloxacin otic suspension_ 6mg (Otiprio)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25622","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFF0","description":"ICD-NIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJD1","description":"ICD-BCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJA0","description":"ICD-OLJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lt compres band <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6448","description":"Lt compres band <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBC1","description":"ICD-JGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBE0","description":"ICD-MLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Guardant360 CDX_ Guardant Health Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0242U","description":"Guardant360 CDX_ Guardant Health Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBB0","description":"ICD-CFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Transcatheter Ultrasound Ablation Of Nerves Innervating The Pulmonary Arteries_ Including Right Heart Catheterization_ Pulmonary Artery Angiography_ And All Imagi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0632T","description":"Percutaneous Transcatheter Ultrasound Ablation Of Nerves Innervating The Pulmonary Arteries_ Including Right Heart Catheterization_ Pulmonary Artery Angiography_ And All Imagi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMD1","description":"ICD-JCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQD1","description":"ICD-PKQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cultr bacteria except blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87075","description":"Cultr bacteria except blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Td vacc no presv 7 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90714","description":"Td vacc no presv 7 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endocervical curettage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57505","description":"Endocervical curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein four","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33513","description":"Cabg vein four","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction w/percutaneous coronary revascularization during acute myocardial infarction_ including catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0659T","description":"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction w/percutaneous coronary revascularization during acute myocardial infarction_ including catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQD0","description":"ICD-CDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFC1","description":"ICD-KAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFC0","description":"ICD-BDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBC0","description":"ICD-GBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTB0","description":"ICD-ABTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42660","description":"Dilation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC110","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHC1","description":"ICD-FBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28F","description":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with computer-assisted image-guided navigation_ incl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7511","description":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with computer-assisted image-guided navigation_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRE1","description":"ICD-PLRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHA0","description":"ICD-FAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXB1","description":"ICD-FBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ microRNA profiling by RT-PCR of 10 microRNA sequences_ utilizing fine needle aspirate_ algorithm reported as a positive or negative result for moderate to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0018U","description":"Oncology (thyroid)_ microRNA profiling by RT-PCR of 10 microRNA sequences_ utilizing fine needle aspirate_ algorithm reported as a positive or negative result for moderate to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES205","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATB0","description":"ICD-KATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNB0","description":"ICD-FCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Symphony_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2009","description":"Symphony_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epidrm a-grft face/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15115","description":"Epidrm a-grft face/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIF1","description":"ICD-AIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29847","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0554T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB113","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11A","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCB0","description":"ICD-NLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transhepatic biliary drainage with contrast monitoring_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75980","description":"Percutaneous transhepatic biliary drainage with contrast monitoring_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19367","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplcmt defib w/lead(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33249","description":"Insj/rplcmt defib w/lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug confirmation_ each procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6058","description":"Drug confirmation_ each procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploratory shoulder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23044","description":"Exploratory shoulder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multiple sleep latency test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95805","description":"Multiple sleep latency test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knuckle joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26517","description":"Fusion of knuckle joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTB0","description":"ICD-NLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARF0","description":"ICD-GARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPB0","description":"ICD-KIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUD1","description":"ICD-NIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mediskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4135","description":"Mediskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNC0","description":"ICD-NBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Did Not Receive At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period; Or H","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2156","description":"Patient Did Not Receive At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period; Or H","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gingival flap proc w/ planin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4240","description":"Gingival flap proc w/ planin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWB1","description":"ICD-OEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEC0","description":"ICD-CIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYC1","description":"ICD-PHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ear and throat examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92502","description":"Ear and throat examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB135","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maternity care procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59899","description":"Maternity care procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPD1","description":"ICD-NDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIB1","description":"ICD-NCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Core Needle Biopsy_ Lung Or Mediastinum_ Percutaneous_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32408","description":"Core Needle Biopsy_ Lung Or Mediastinum_ Percutaneous_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUD1","description":"ICD-CCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEB1","description":"ICD-GHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous breast biopsies using magnetic resonance guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7502","description":"Percutaneous breast biopsies using magnetic resonance guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1242","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE146","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDD1","description":"ICD-JDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10008","description":"Fine needle aspiration biopsy_ including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCB0","description":"ICD-FFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOC0","description":"ICD-GHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKD1","description":"ICD-FEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable collection and storage bag for breast milk_ any size_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4287","description":"Disposable collection and storage bag for breast milk_ any size_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPA0","description":"ICD-FIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSB0","description":"ICD-PDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA34","description":"Very High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31081","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACB0","description":"ICD-KACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAA1","description":"ICD-MKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXD1","description":"ICD-GFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMA0","description":"ICD-EBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt recvng antivir txmnt hepc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4150F","description":"Pt recvng antivir txmnt hepc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBB0","description":"ICD-IGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj ilio-ing/hypogi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64425","description":"N block inj ilio-ing/hypogi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVC0","description":"ICD-FEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCE1","description":"ICD-BBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mis sup/acc imp vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0508","description":"Mis sup/acc imp vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIE1","description":"ICD-MFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBA1","description":"ICD-EHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC11","description":"ICD-3KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLA0","description":"ICD-KFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA212","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYA0","description":"ICD-DBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBB1","description":"ICD-BCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRB0","description":"ICD-DHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCC1","description":"ICD-MKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA156","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNB1","description":"ICD-CDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thawing cryopresrved embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89352","description":"Thawing cryopresrved embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOD0","description":"ICD-KIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB15","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNA1","description":"ICD-BCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1173","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEB0","description":"ICD-FEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGE0","description":"ICD-JDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX21","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flu vacc iiv4 no preserv id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90630","description":"Flu vacc iiv4 no preserv id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23A","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12C","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inr measurement performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3555F","description":"Pt inr measurement performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGME1","description":"ICD-FGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay dipropylacetic acd tot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80164","description":"Assay dipropylacetic acd tot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv unsure baby of hiv+moms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3491F","description":"Hiv unsure baby of hiv+moms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABB1","description":"ICD-MABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOA0","description":"ICD-GIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision benign lesion compl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7412","description":"Excision benign lesion compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tigecycline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3243","description":"Tigecycline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health club membership yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9970","description":"Health club membership yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAB1","description":"ICD-IBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFA1","description":"ICD-NFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUE1","description":"ICD-IHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKD1","description":"ICD-JAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25350","description":"Revision of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFD1","description":"ICD-JBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim_ excludes biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2506","description":"Injection_ pegfilgrastim_ excludes biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smear gram stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87205","description":"Smear gram stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBME0","description":"ICD-OBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFA1","description":"ICD-JCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETE0","description":"ICD-JETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQC1","description":"ICD-DBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKE0","description":"ICD-BEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8I","description":"Very High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65175","description":"Removal of ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAB1","description":"ICD-EAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGA0","description":"ICD-JGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Yellow fever vaccine subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90717","description":"Yellow fever vaccine subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGD0","description":"ICD-KDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0004","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed semi-elect w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0295","description":"Hosp bed semi-elect w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYA1","description":"ICD-PFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHE1","description":"ICD-OCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77600","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBE1","description":"ICD-AEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTA1","description":"ICD-ADTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21081","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4436","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","description":"HCPCS-Q4436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0611U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","description":"CPT-0611U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNB0","description":"ICD-KFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUE1","description":"ICD-IIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCE1","description":"ICD-BCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVD0","description":"ICD-ODVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFME0","description":"ICD-AFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUC0","description":"ICD-NJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAC1","description":"ICD-OCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/o&w/dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8933","description":"Mra_ w/o&w/dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ face-to-face with multiple patients_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97158","description":"Group adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ face-to-face with multiple patients_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRC0","description":"ICD-CGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEME0","description":"ICD-AEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"One-way allow prorated trip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9604","description":"One-way allow prorated trip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22B","description":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-META0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"META0","description":"ICD-META0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNC1","description":"ICD-OFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tbo-filgrastim_ 5 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1446","description":"Injection_ tbo-filgrastim_ 5 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9985","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCA1","description":"ICD-FHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Middle ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69799","description":"Middle ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJF0","description":"ICD-JBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cipaglucosidase alfa-atga_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1203","description":"Injection_ cipaglucosidase alfa-atga_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIF1","description":"ICD-IEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLA1","description":"ICD-GCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8E","description":"Very High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavior counsel obesity 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0447","description":"Behavior counsel obesity 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast stacked diep/gap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2067","description":"Breast stacked diep/gap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWD1","description":"ICD-OKWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIC0","description":"ICD-NHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITD1","description":"ICD-NITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAME0","description":"ICD-BAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKA0","description":"ICD-BEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGC0","description":"ICD-JFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor renal graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50325","description":"Prep donor renal graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion/graft of finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26862","description":"Fusion/graft of finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54120","description":"Partial removal of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28G","description":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWD1","description":"ICD-PEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skills training and development_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2038","description":"Skills training and development_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 12 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP12","description":"Auto.test pane pricing code_ 12 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIE0","description":"ICD-AFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A8005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","description":"HCPCS-A8005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFB0","description":"ICD-FBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28080","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHB0","description":"ICD-BFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1004","description":"HCPCS-A1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Architect ecm px fx 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4147","description":"Architect ecm px fx 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation wi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7522","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ factor IX_ albumin fusion protein_ (recombinant)_ Idelvion_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7202","description":"Injection_ factor IX_ albumin fusion protein_ (recombinant)_ Idelvion_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative visual axis identification using patient fixation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0514T","description":"Intraoperative visual axis identification using patient fixation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUC0","description":"ICD-ODUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVB0","description":"ICD-KBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWF1","description":"ICD-PFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPC1","description":"ICD-NLPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIC0","description":"ICD-CGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL33","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onsite nursing facility conference_ that is separate and distinct from an Evaluation and Management visit_ including qualified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9686","description":"Onsite nursing facility conference_ that is separate and distinct from an Evaluation and Management visit_ including qualified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAB1","description":"ICD-BHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise finger/toe nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64702","description":"Revise finger/toe nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43830","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHA0","description":"ICD-GBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJF0","description":"ICD-GFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIF1","description":"ICD-BIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCC0","description":"ICD-CFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAD1","description":"ICD-NKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYB1","description":"ICD-HEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPE0","description":"ICD-KGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0101","description":"HCPCS-B0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Procenta_ per 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4310","description":"Procenta_ per 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALC0","description":"ICD-JALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hib-mency vaccine 4 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90644","description":"Hib-mency vaccine 4 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPC0","description":"ICD-KEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEC0","description":"ICD-KHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEA1","description":"ICD-IDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKD0","description":"ICD-CAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin d 25 hydroxy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82306","description":"Vitamin d 25 hydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACF0","description":"ICD-BACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecg/monitoring and analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93271","description":"Ecg/monitoring and analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUA1","description":"ICD-JHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31382","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETD0","description":"ICD-OETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATA0","description":"ICD-GATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumocystis carinii ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87281","description":"Pneumocystis carinii ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"5+ cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4209","description":"5+ cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Legion pneumo dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87542","description":"Legion pneumo dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABD1","description":"ICD-NABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert knee articulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5656","description":"Socket insert knee articulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB21","description":"ICD-1AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting_ including assessment_ referral to ongoing care_ and arranging access to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2213","description":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting_ including assessment_ referral to ongoing care_ and arranging access to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIE1","description":"ICD-JCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urethral insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4336","description":"Urethral insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKA0","description":"ICD-FIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFD1","description":"ICD-OHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMC0","description":"ICD-OBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNB0","description":"ICD-FBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system_ with iterative adjustment of the implantable device to test the function of the device an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0650T","description":"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system_ with iterative adjustment of the implantable device to test the function of the device an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dextran 75 infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7110","description":"Dextran 75 infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance cusfab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0486","description":"Oral device/appliance cusfab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA50","description":"Very High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5298","description":"Hearing aid noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64630","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2B","description":"Ultra High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor pancreas/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48552","description":"Prep donor pancreas/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTC0","description":"ICD-NDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFE1","description":"ICD-JIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIE1","description":"ICD-GHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand restorat thumb/1 finger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6900","description":"Hand restorat thumb/1 finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA121","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCA1","description":"ICD-MKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAED1","description":"ICD-OAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hook to hand cable adapter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6670","description":"Hook to hand cable adapter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEE1","description":"ICD-EEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colistimethate inh sol mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0142","description":"Colistimethate inh sol mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYD1","description":"ICD-DGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid frame hyperex pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0472","description":"Tlso rigid frame hyperex pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Food thickener oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4100","description":"Food thickener oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0240T","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11302","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mesh (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1781","description":"Mesh (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0602","description":"HCPCS-B0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB15","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecg/signal-averaged","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93278","description":"Ecg/signal-averaged","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEF1","description":"ICD-CIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scale","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2140","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scale","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAB0","description":"ICD-EBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound breast complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76641","description":"Ultrasound breast complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy arm/elbow soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24066","description":"Biopsy arm/elbow soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Mrna_ Gene Expression Profiling By Rt-Pcr Of 12 Genes (8 Content And 4 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81522","description":"Oncology (Breast)_ Mrna_ Gene Expression Profiling By Rt-Pcr Of 12 Genes (8 Content And 4 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61584","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9033","description":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0644U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0644U","description":"CPT-0644U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77770","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No 7d f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9407","description":"No 7d f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMB0","description":"ICD-FEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLF1","description":"ICD-MLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8D","description":"Very High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXF0","description":"ICD-GGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"2+ anti-hyprtnsv agents tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4145F","description":"2+ anti-hyprtnsv agents tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microfluid analy tears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83861","description":"Microfluid analy tears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKA1","description":"ICD-KAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIC1","description":"ICD-EFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLF0","description":"ICD-KHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary suspensory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5105","description":"Urinary suspensory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 3.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4168","description":"Parenteral sol amino acid 3.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBD1","description":"ICD-JGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENF1","description":"ICD-OENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBE0","description":"ICD-NEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grafix plus_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4304","description":"Grafix plus_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No sent lymph node biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8882","description":"No sent lymph node biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9812","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9812","description":"HCPCS-C9812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNB0","description":"ICD-CCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGD0","description":"ICD-GHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13C","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Promethazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2550","description":"Promethazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; vascular procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0133U","description":"Anesthesia for intracranial procedures; vascular procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser tx skin < 250 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96920","description":"Laser tx skin < 250 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8H","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYE1","description":"ICD-DHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPE1","description":"ICD-OHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHC0","description":"ICD-NBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWD0","description":"ICD-DCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2105","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xenon xe-129 hyperpolarized gas_ diagnostic_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9150","description":"Xenon xe-129 hyperpolarized gas_ diagnostic_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYD1","description":"ICD-OFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trans shoe caliper plate new","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3610","description":"Trans shoe caliper plate new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHE0","description":"ICD-IGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFA1","description":"ICD-OGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology autism_ 32 amines by LC-MS/MS_ using plasma_ algorithm reported as metabolic signature associated with autism spectrum disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0063U","description":"Neurology autism_ 32 amines by LC-MS/MS_ using plasma_ algorithm reported as metabolic signature associated with autism spectrum disorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEE1","description":"ICD-JHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEE1","description":"ICD-NKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replantation arm complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20802","description":"Replantation arm complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate mets no cast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9132","description":"Onc dx prostate mets no cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVA1","description":"ICD-OEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUC1","description":"ICD-IGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECB1","description":"ICD-AECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6007","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI upper extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73219","description":"MRI upper extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0106","description":"HCPCS-B0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBB1","description":"ICD-GHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation upper jaw artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30920","description":"Ligation upper jaw artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transport port x-ray multipl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0075","description":"Transport port x-ray multipl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contracted services per day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1022","description":"Contracted services per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune (rheumatoid arthritis)_ next-generation sequencing (NGS)_ gene expression testing of 19 genes_ whole blood_ with analysis of anti-cyclic citrullinated peptides (CCP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0456U","description":"Autoimmune (rheumatoid arthritis)_ next-generation sequencing (NGS)_ gene expression testing of 19 genes_ whole blood_ with analysis of anti-cyclic citrullinated peptides (CCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTD1","description":"ICD-ICTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ initial rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9001","description":"Mccd_ initial rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg monitoring/giving drugs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95954","description":"Eeg monitoring/giving drugs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj menotropins 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0122","description":"Inj menotropins 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCB0","description":"ICD-OLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMB1","description":"ICD-AFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEC1","description":"ICD-CCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWE0","description":"ICD-OEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transtracheal oxygen cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4608","description":"Transtracheal oxygen cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWB1","description":"ICD-HBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKC1","description":"ICD-CCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ translumin non-laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1725","description":"Cath_ translumin non-laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJE0","description":"ICD-OGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIA0","description":"ICD-FIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOA1","description":"ICD-CHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIC1","description":"ICD-CHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28E","description":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBB0","description":"ICD-EHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAB0","description":"ICD-BCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAB0","description":"ICD-OLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sip and puff interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2325","description":"Sip and puff interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00796","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","description":"CPT-00796","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAE0","description":"ICD-BHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB21","description":"ICD-3EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMB0","description":"ICD-AHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHA1","description":"ICD-MHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4A","description":"Default_ /PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILF1","description":"ICD-OILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCND0","description":"ICD-KCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00528","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","description":"CPT-00528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALE0","description":"ICD-KALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meg evoked each addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95967","description":"Meg evoked each addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB126","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXD1","description":"ICD-KCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRD1","description":"ICD-PHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scratch resistant coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2760","description":"Scratch resistant coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKD0","description":"ICD-BAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWC1","description":"ICD-DBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion palate prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42281","description":"Insertion palate prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPF0","description":"ICD-OGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Specimen site not esophagus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8797","description":"Specimen site not esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL24","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGD1","description":"ICD-BEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRA1","description":"ICD-PFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67914","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEB0","description":"ICD-OAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAF0","description":"ICD-ABAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXF0","description":"ICD-GAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Folding ped wc adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1236","description":"Folding ped wc adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig for ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8561","description":"Pt inelig for ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD250","description":"Special Care Low _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAC0","description":"ICD-FAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRD0","description":"ICD-HBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBED0","description":"ICD-IBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSF1","description":"ICD-CDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENA1","description":"ICD-GENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unskilled respite care /15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5150","description":"Unskilled respite care /15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of residual cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57550","description":"Removal of residual cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of fibula epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27732","description":"Repair of fibula epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Split flat caliper stirr & p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2230","description":"Split flat caliper stirr & p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0493U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","description":"CPT-0493U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25D","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cannabinoids natural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80349","description":"Cannabinoids natural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albumin (human)_ 5%_ 250 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9045","description":"Albumin (human)_ 5%_ 250 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis c probe&rvrs trnsc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87521","description":"Hepatitis c probe&rvrs trnsc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immed mand part dent metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5224","description":"Immed mand part dent metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6003","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDB0","description":"ICD-EHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBC0","description":"ICD-ICBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHND1","description":"ICD-KHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEA1","description":"ICD-MFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wireless Skin Sensor Thermal Anisotropy Measurement(S) And Assessment Of Flow In Cerebrospinal Fluid Shunt_ Including Ultrasound Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0639T","description":"Wireless Skin Sensor Thermal Anisotropy Measurement(S) And Assessment Of Flow In Cerebrospinal Fluid Shunt_ Including Ultrasound Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOD1","description":"ICD-CBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE215","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35201","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB11","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0269T","description":"Rev/remvl crtd sns dev total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFF0","description":"ICD-OBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Terbutaline sulf comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7680","description":"Terbutaline sulf comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18A","description":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFE0","description":"ICD-CBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUD1","description":"ICD-CAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood methemoglobin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83050","description":"Blood methemoglobin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNE1","description":"ICD-CGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped gastro ed given caregvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4058F","description":"Ped gastro ed given caregvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPB1","description":"ICD-GDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ntrk1 (Neurotrophic Receptor Tyrosine Kinase 1) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81191","description":"Ntrk1 (Neurotrophic Receptor Tyrosine Kinase 1) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99232","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3D","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMD1","description":"ICD-FEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEE1","description":"ICD-CAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWE1","description":"ICD-GHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral - bitewing radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0708","description":"Intraoral - bitewing radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOE0","description":"ICD-OFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostoma filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4481","description":"Tracheostoma filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYC0","description":"ICD-HHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doxorubicin inj 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2050","description":"Doxorubicin inj 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMB1","description":"ICD-IFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBED1","description":"ICD-KBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonneedle injection device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4210","description":"Nonneedle injection device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22C","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKD0","description":"ICD-GAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24C","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDD0","description":"ICD-BFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKA0","description":"ICD-CIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"R&l hrt art/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93461","description":"R&l hrt art/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASF1","description":"ICD-OASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVB1","description":"ICD-OBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDME0","description":"ICD-FDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abut support retainer titani","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6194","description":"Abut support retainer titani","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16077","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Test Appropriate_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1006","description":"Clinical Decision Support Mechanism Test Appropriate_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQC1","description":"ICD-PGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHF0","description":"ICD-BAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECF1","description":"ICD-IECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrizalent (ccIIV4)_ derived from cell cultures_ subunit_ antibiotic free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90756","description":"Influenza virus vaccine_ quadrizalent (ccIIV4)_ derived from cell cultures_ subunit_ antibiotic free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVC0","description":"ICD-JCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","description":"HCPCS-Q4428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBC1","description":"ICD-GBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRC1","description":"ICD-LCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cst hgh nble mtl inlay >=3sr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6603","description":"Cst hgh nble mtl inlay >=3sr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray exam of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74210","description":"Contrst x-ray exam of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC31","description":"ICD-2IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICF1","description":"ICD-CICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMA1","description":"ICD-EBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXB1","description":"ICD-JBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited autopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88037","description":"Limited autopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIC0","description":"ICD-IEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total hip arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27130","description":"Total hip arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIC1","description":"ICD-ADIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES141","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKA0","description":"ICD-JFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOB1","description":"ICD-HDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPF1","description":"ICD-OGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD260","description":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enuresis alarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8270","description":"Enuresis alarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coma stimulation per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9056","description":"Coma stimulation per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMC1","description":"ICD-OLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1603","description":"HCPCS-C1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACD1","description":"ICD-JACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transurethral Ablation Of Malignant Prostate Tissue By High-Energy Water Vapor Thermotherapy_ Including Intraoperative Imaging And Needle Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0582T","description":"Transurethral Ablation Of Malignant Prostate Tissue By High-Energy Water Vapor Thermotherapy_ Including Intraoperative Imaging And Needle Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23A","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERC0","description":"ICD-CERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQB1","description":"ICD-GBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC21","description":"ICD-3GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFME0","description":"ICD-JFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKB1","description":"ICD-JDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGC0","description":"ICD-KBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dinutuximab_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1246","description":"Injection_ dinutuximab_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AmchoPlast_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4316","description":"AmchoPlast_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11421","description":"Exc h-f-nk-sp b9+marg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat combo pwr shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1008","description":"Pwr seat combo pwr shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cell enumeration phys interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86153","description":"Cell enumeration phys interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIE0","description":"ICD-CEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOC0","description":"ICD-CDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJF0","description":"ICD-FHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAD1","description":"ICD-CBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap gastric bypass/roux-en-y","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43644","description":"Lap gastric bypass/roux-en-y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFD1","description":"ICD-NGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUB1","description":"ICD-IIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90281","description":"Human ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBB0","description":"ICD-MBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERF1","description":"ICD-KERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFA0","description":"ICD-FCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antepartum care only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59426","description":"Antepartum care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC21","description":"ICD-4BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAE1","description":"ICD-GHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRF1","description":"ICD-CCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIE1","description":"ICD-OGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Idecabtagene vicleucel_ up to 460 million autologous anti-BCMA CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9081","description":"Idecabtagene vicleucel_ up to 460 million autologous anti-BCMA CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEA1","description":"ICD-JEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay nonendocrine receptor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84238","description":"Assay nonendocrine receptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64840","description":"Repair of leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine ost pouch w faucet/tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4428","description":"Urine ost pouch w faucet/tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj trigger point 1/2 muscl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20552","description":"Inj trigger point 1/2 muscl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo ankle gauntlet pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1902","description":"Afo ankle gauntlet pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Soft protect helmet prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8000","description":"Soft protect helmet prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sewho cap design w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3971","description":"Sewho cap design w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFD0","description":"ICD-CGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice in lt/non-skilled nf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5003","description":"Hospice in lt/non-skilled nf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon metas noevid dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9088","description":"Onc dx colon metas noevid dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEA0","description":"ICD-JFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAC1","description":"ICD-CHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27612","description":"Exploration of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq revasc byp graft addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92938","description":"Prq revasc byp graft addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIC1","description":"ICD-MCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient lift bathroom or toi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0625","description":"Patient lift bathroom or toi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc sinus ct 28d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9349","description":"Doc sinus ct 28d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDA0","description":"ICD-KEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB21","description":"Very High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUA0","description":"ICD-CIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWE0","description":"ICD-GBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE212","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIC1","description":"ICD-OJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLB0","description":"ICD-MLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periodontal scaling 1-3teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4342","description":"Periodontal scaling 1-3teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEF1","description":"ICD-JGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carry d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8986","description":"Carry d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 5/> mus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64644","description":"Chemodenerv 1 extrem 5/> mus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of torus palatinus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7472","description":"Removal of torus palatinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHD1","description":"ICD-OKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rvw meds by rx/dr in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1160F","description":"Rvw meds by rx/dr in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAB0","description":"ICD-EFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96932","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ onasemnogene abeparvovec-xioi_ per treatment_ up to 5x10^15 vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3399","description":"Injection_ onasemnogene abeparvovec-xioi_ per treatment_ up to 5x10^15 vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC130","description":"Special Care High _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDD1","description":"ICD-CCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73580","description":"Contrast x-ray of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy consultation performed prior to a screening colonoscopy procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0285","description":"Colonoscopy consultation performed prior to a screening colonoscopy procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Daunorubicin citrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9151","description":"Daunorubicin citrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8H","description":"Low Rehab_ ADL Index 0-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFB0","description":"ICD-CFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBC1","description":"ICD-NHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optx of rib fx w/fixj scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21811","description":"Optx of rib fx w/fixj scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental prophylaxis adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1110","description":"Dental prophylaxis adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC21","description":"ICD-2JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perphenazine injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3310","description":"Perphenazine injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPE1","description":"ICD-NLPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWE0","description":"ICD-HCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA216","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUA1","description":"ICD-FHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUE0","description":"ICD-KAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20C","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFC0","description":"ICD-OEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MyOwn skin_ includes harvesting and preparation procedures_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4226","description":"MyOwn skin_ includes harvesting and preparation procedures_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEF0","description":"ICD-CIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive assessment of blood oxygenation_ gas exchange efficiency_ and cardiorespiratory status_ with physician or other qualified health care professional interpretation a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0893T","description":"Noninvasive assessment of blood oxygenation_ gas exchange efficiency_ and cardiorespiratory status_ with physician or other qualified health care professional interpretation a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg artery-vein five","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33522","description":"Cabg artery-vein five","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHE0","description":"ICD-EBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLD1","description":"ICD-FHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAE1","description":"ICD-AFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJD0","description":"ICD-GDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBB0","description":"ICD-AHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJD0","description":"ICD-NAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33778","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rsk fx ref w/n 24 hrs xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5100F","description":"Rsk fx ref w/n 24 hrs xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mech remov tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36596","description":"Mech remov tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2053","description":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test 2 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95861","description":"Muscle test 2 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25335","description":"Realignment of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPF1","description":"ICD-JHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [HA]_ procollagen III amino terminal peptide [PIIINP]_ tissue inhibitor of metalloproteinase 1 [TIMP-1])_ using immuno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81517","description":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [HA]_ procollagen III amino terminal peptide [PIIINP]_ tissue inhibitor of metalloproteinase 1 [TIMP-1])_ using immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHC0","description":"ICD-FCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qty act diab retin mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9672","description":"Qty act diab retin mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOD0","description":"ICD-DIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis B screening in non-pregnant_ high risk individual includes hepatitis B surface antigen (HBSAG) followed by a neutralizing confirmatory test for initially reactive re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0499","description":"Hepatitis B screening in non-pregnant_ high risk individual includes hepatitis B surface antigen (HBSAG) followed by a neutralizing confirmatory test for initially reactive re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1105T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1105T","description":"CPT-1105T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sewho airplane w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3967","description":"Sewho airplane w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1126","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84075","description":"Assay alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHD1","description":"ICD-NAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27816","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTE0","description":"ICD-EGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMF1","description":"ICD-KBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nusinersen_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2326","description":"Injection_ nusinersen_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYD0","description":"ICD-CGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVE1","description":"ICD-OGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC212","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prochlorperazine maleate 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0164","description":"Prochlorperazine maleate 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFF1","description":"ICD-OFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPD0","description":"ICD-FAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGB1","description":"ICD-GDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUF1","description":"ICD-MEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64555","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brake for wheeled walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0159","description":"Brake for wheeled walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCB1","description":"ICD-JDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOC1","description":"ICD-CCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0593U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","description":"CPT-0593U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPC1","description":"ICD-JIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst including t/o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58262","description":"Vag hyst including t/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGB0","description":"ICD-JCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA07","description":"Default_ /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8E","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair vagina/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57210","description":"Repair vagina/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBC0","description":"ICD-IGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDA0","description":"ICD-IBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCC0","description":"ICD-KHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEB1","description":"ICD-KGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDND0","description":"ICD-JDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXE0","description":"ICD-OFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postoperative biliary duct calculus removal_ percutaneous via t-tube tract_ basket_ or snare (eg_ burhenne technique)_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74327","description":"Postoperative biliary duct calculus removal_ percutaneous via t-tube tract_ basket_ or snare (eg_ burhenne technique)_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8G","description":"High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPC1","description":"ICD-GBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bacterium antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86609","description":"Bacterium antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLF0","description":"ICD-GHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1001","description":"HCPCS-B1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resp virus 3-5 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87631","description":"Resp virus 3-5 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEED1","description":"ICD-BEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0684U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684U","description":"CPT-0684U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ophth us b & quant a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76510","description":"Ophth us b & quant a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thaw cryoprsvrd reprod tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89354","description":"Thaw cryoprsvrd reprod tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRA0","description":"ICD-HIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phenylephrine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2370","description":"Phenylephrine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUF1","description":"ICD-NHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"KEL GNOTYP KEL EXON 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0194U","description":"KEL GNOTYP KEL EXON 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assist oocyte fertilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89280","description":"Assist oocyte fertilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diphtheria antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86648","description":"Diphtheria antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hgb >= 10 g/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8976","description":"Hgb >= 10 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSA0","description":"ICD-DBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lower limb pros vacuum pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5781","description":"Lower limb pros vacuum pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total lung lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32997","description":"Total lung lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0270T","description":"Rev/remvl crtd sns dev lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy fundoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43280","description":"Laparoscopy fundoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"von Willebrand factor (VWF)_ type 2N_ factor VIII and VWF binding evaluation_ enzyme-linked immunosorbent assays (ELISA)_ plasma (Versiti™ VWD Type 2N Binding)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0284U","description":"von Willebrand factor (VWF)_ type 2N_ factor VIII and VWF binding evaluation_ enzyme-linked immunosorbent assays (ELISA)_ plasma (Versiti™ VWD Type 2N Binding)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAA1","description":"ICD-GHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAF1","description":"ICD-BGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61516","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21084","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1431","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","description":"HCPCS-M1431","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA31","description":"ICD-1LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVF1","description":"ICD-KBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rotation wrst w/ cable lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6625","description":"Rotation wrst w/ cable lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOC1","description":"ICD-CBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4390","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","description":"HCPCS-Q4390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor ix recombinant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7195","description":"Factor ix recombinant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCD1","description":"ICD-IGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL17","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1058T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1058T","description":"CPT-1058T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q9997","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","description":"HCPCS-Q9997","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family stabilization 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9482","description":"Family stabilization 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQC1","description":"ICD-CEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGF0","description":"ICD-OCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCB0","description":"ICD-FGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Statin therapy/currently tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4013F","description":"Statin therapy/currently tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph imped function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91037","description":"Esoph imped function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISB0","description":"ICD-LISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSC0","description":"ICD-PLSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Miro3D_ per cu cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2025","description":"Miro3D_ per cu cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pad band w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6441","description":"Pad band w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGC0","description":"ICD-CGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB150","description":"Reduced Physical Function _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0802","description":"HCPCS-A0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOC0","description":"ICD-DHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended release (brixadi)_ greater than 7 days and up to 28 days of therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0578","description":"Injection_ buprenorphine extended release (brixadi)_ greater than 7 days and up to 28 days of therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25A","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44021","description":"Decompress small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lipoprotein_ blood_ high resolution fractionation and quantitation of lipoproteins_ including all five major lipoprotein classes and subclasses of HDL_ LDL_ and VLDL by vertic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052U","description":"Lipoprotein_ blood_ high resolution fractionation and quantitation of lipoproteins_ including all five major lipoprotein classes and subclasses of HDL_ LDL_ and VLDL by vertic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABC1","description":"ICD-MABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKE1","description":"ICD-JBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Warfrn or othr antcog no rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8971","description":"Warfrn or othr antcog no rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBB0","description":"ICD-MGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWD0","description":"ICD-LCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBA1","description":"ICD-IIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dna analysis apoe alzheimer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3852","description":"Dna analysis apoe alzheimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pow mobil dev no dmepdac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0899","description":"Pow mobil dev no dmepdac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBF0","description":"ICD-JIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24538","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65150","description":"Revise ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWF0","description":"ICD-KDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RARE DS GEN DNA ALYS EA COMP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0213U","description":"RARE DS GEN DNA ALYS EA COMP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLB0","description":"ICD-GGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (congenital coagulation disorders)_ genomic sequence analysis of 20 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Coagulation Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0270U","description":"Hematology (congenital coagulation disorders)_ genomic sequence analysis of 20 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Coagulation Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVA1","description":"ICD-NIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram_ Calculati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77089","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram_ Calculati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96133","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64834","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transvaginal us obstetric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76817","description":"Transvaginal us obstetric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular function screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99172","description":"Ocular function screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACA0","description":"ICD-BACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orbit surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67599","description":"Orbit surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDE1","description":"ICD-CCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC104","description":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES115","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2087","description":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCC1","description":"ICD-MBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUE0","description":"ICD-BHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXC1","description":"ICD-FGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22C","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit cath maintain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99507","description":"Home visit cath maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODED1","description":"ICD-ODED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21089","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWD0","description":"ICD-HDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIC1","description":"ICD-MIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWF0","description":"ICD-PGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMC0","description":"ICD-IFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Additional spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22585","description":"Additional spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytherapy radioelements","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3001","description":"Brachytherapy radioelements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSF1","description":"ICD-HHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temozolomide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8700","description":"Temozolomide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disease mgmt per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0317","description":"Disease mgmt per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of sweat sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84302","description":"Assay of sweat sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFD0","description":"ICD-KBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Avalglucosidase Alfa-Ngpt_ 4 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9085","description":"Injection_ Avalglucosidase Alfa-Ngpt_ 4 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYE1","description":"ICD-OKYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXA1","description":"ICD-KBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAE0","description":"ICD-JHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYB0","description":"ICD-PEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj anesthetic per 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4737","description":"Inj anesthetic per 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAA1","description":"ICD-OLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10C","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUF0","description":"ICD-JBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Root canal therapy 2 canals","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3320","description":"Root canal therapy 2 canals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPB1","description":"ICD-BHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXA0","description":"ICD-CDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0183","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","description":"HCPCS-G0183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEC0","description":"ICD-BDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 4999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4725","description":"Dialys sol fld vol > 4999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit cath repair kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5518","description":"Hit cath repair kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUB0","description":"ICD-NAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dry pressure pad for mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0199","description":"Dry pressure pad for mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0521U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","description":"CPT-0521U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD226","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/maint cont hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4890","description":"Repair/maint cont hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0542","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","description":"HCPCS-G0542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKC0","description":"ICD-BAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocyte culture primed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86822","description":"Lymphocyte culture primed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRA0","description":"ICD-OKRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTD0","description":"ICD-CHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hocm>= 400mg/ml iodine_ 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9964","description":"Hocm>= 400mg/ml iodine_ 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSB0","description":"ICD-CCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAD1","description":"ICD-IGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25240","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lifestyle mod 1st stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0340","description":"Lifestyle mod 1st stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: moderate complexity_ requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97162","description":"Physical therapy evaluation: moderate complexity_ requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0D","description":"Very High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Serial salivary imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78231","description":"Serial salivary imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBE1","description":"ICD-EIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVA1","description":"ICD-JHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEE0","description":"ICD-GEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97036","description":"Hydrotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23615","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd esophagogastrc fndoplsty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43210","description":"Egd esophagogastrc fndoplsty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERF1","description":"ICD-CERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBE1","description":"ICD-BHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCA1","description":"ICD-BCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVA1","description":"ICD-NCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBD0","description":"ICD-KFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNE0","description":"ICD-OBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53215","description":"Removal of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEA0","description":"ICD-MGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFF0","description":"ICD-NFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENC0","description":"ICD-BENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDC0","description":"ICD-IDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ncntc r-t fluor wnd img ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0599T","description":"Ncntc r-t fluor wnd img ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB130","description":"Special Care Low _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXD1","description":"ICD-NEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXB0","description":"ICD-BCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDE1","description":"ICD-NHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Injection Of Cellular Implant Into Knee Joint Including Ultrasound Gu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0566T","description":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Injection Of Cellular Implant Into Knee Joint Including Ultrasound Gu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFD0","description":"ICD-NIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMA0","description":"ICD-FBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQC1","description":"ICD-PAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOC1","description":"ICD-KAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"H2o stat docd dehydrated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2031F","description":"H2o stat docd dehydrated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEA1","description":"ICD-MGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fracture frame attached to b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0920","description":"Fracture frame attached to b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIF1","description":"ICD-KCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLF1","description":"ICD-CDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYC0","description":"ICD-LEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score shdl pt no el","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8665","description":"Fun stat score shdl pt no el","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMB1","description":"ICD-MFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDB1","description":"ICD-JBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCB1","description":"ICD-KGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9987","description":"Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLB1","description":"ICD-JDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy spx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46600","description":"Diagnostic anoscopy spx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQE0","description":"ICD-CCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement nasal pillows","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7033","description":"Replacement nasal pillows","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB21","description":"ICD-4HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKC1","description":"ICD-KIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWA1","description":"ICD-KHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI joint upr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73223","description":"MRI joint upr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc stnt & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37235","description":"Tib/per revasc stnt & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Substernal Implantable Defibrillator Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0573T","description":"Removal Of Substernal Implantable Defibrillator Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External recharg sys intern","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8689","description":"External recharg sys intern","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venous sampling by catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75893","description":"Venous sampling by catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17108","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIC1","description":"ICD-GBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnio quad-core_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4294","description":"Amnio quad-core_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct hrt w/3d image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75572","description":"Ct hrt w/3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB26","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42420","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIA1","description":"ICD-BBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGB0","description":"ICD-CCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGA1","description":"ICD-NAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retinal prosthesis_ includes all internal and external components; add-on to C1841","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1842","description":"Retinal prosthesis_ includes all internal and external components; add-on to C1841","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKF1","description":"ICD-GHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJC0","description":"ICD-OBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEB0","description":"ICD-NBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIA0","description":"ICD-AEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8001","description":"HCPCS-C8001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWC0","description":"ICD-GDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monitor elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0483","description":"Monitor elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSC0","description":"ICD-HDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINF0","description":"ICD-JINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRE0","description":"ICD-GCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHA1","description":"ICD-KFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAA1","description":"ICD-KGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB11","description":"ICD-2KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ siltuximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2860","description":"Injection_ siltuximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXC0","description":"ICD-OCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQB0","description":"ICD-HGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93016","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy lower leg soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27614","description":"Biopsy lower leg soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPE0","description":"ICD-KEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shock absorber for man w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1015","description":"Shock absorber for man w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc serum pretx id dilution","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86976","description":"Rbc serum pretx id dilution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fem/popl revas w/ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37225","description":"Fem/popl revas w/ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAB0","description":"ICD-IFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPB0","description":"ICD-GHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contraceptive hormone patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7304","description":"Contraceptive hormone patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2B","description":"Low Rehab_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUA0","description":"ICD-NFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood clot retraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85170","description":"Blood clot retraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGID1","description":"ICD-IGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIE1","description":"ICD-CHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67808","description":"Remove eyelid lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0564U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","description":"CPT-0564U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"History cd4+ cell count <350","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3492F","description":"History cd4+ cell count <350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAC0","description":"ICD-MGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/substance abuse skil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1012","description":"Alcohol/substance abuse skil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAF1","description":"ICD-KBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBE0","description":"ICD-EHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHB1","description":"ICD-BHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEB0","description":"ICD-NLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1B","description":"Default_ /PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10C","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEE1","description":"ICD-OBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0659","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","description":"HCPCS-E0659","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIF1","description":"ICD-KEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKB0","description":"ICD-GHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKD0","description":"ICD-CEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12C","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx vert fx w/manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22315","description":"Closed tx vert fx w/manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo-vag hyst incl t/o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58552","description":"Laparo-vag hyst incl t/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23B","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1818","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1818","description":"HCPCS-J1818","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vte prophylaxis rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4069F","description":"Vte prophylaxis rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enterectomy w/taper cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44127","description":"Enterectomy w/taper cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKC0","description":"ICD-OGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28E","description":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDB1","description":"ICD-KGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHA0","description":"ICD-IIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB156","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAC0","description":"ICD-BFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYF1","description":"ICD-GDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31529","description":"Laryngoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHA1","description":"ICD-BIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMA0","description":"ICD-EGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCF1","description":"ICD-EDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc Uveal MLNMA MRNA gen xprs prfl 15 gene alg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0081U","description":"Onc Uveal MLNMA MRNA gen xprs prfl 15 gene alg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDD0","description":"ICD-KEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGD0","description":"ICD-BFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","description":"HCPCS-M1376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDE1","description":"ICD-ACDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86850","description":"Rbc antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Idursulfase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1743","description":"Idursulfase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagomyotomy thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43331","description":"Esophagomyotomy thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0673","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0673","description":"HCPCS-G0673","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lpn/lvn services up to 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1003","description":"Lpn/lvn services up to 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOF0","description":"ICD-KEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No pap prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8850","description":"No pap prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12004","description":"Rpr s/n/ax/gen/trk7.6-12.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect prox humerus tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23220","description":"Resect prox humerus tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transparent film > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6259","description":"Transparent film > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEB1","description":"ICD-EAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDF1","description":"ICD-AFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRF0","description":"ICD-HDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIE1","description":"ICD-BBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1A","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1340","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12C","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACB0","description":"ICD-MACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOF0","description":"ICD-OJOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARB1","description":"ICD-GARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of troponin quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84484","description":"Assay of troponin quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQC0","description":"ICD-PLQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit intermit chemo diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9331","description":"Hit intermit chemo diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMC1","description":"ICD-GEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCD0","description":"ICD-MCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLA1","description":"ICD-GBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tb ag response t-cell susp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86481","description":"Tb ag response t-cell susp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"D & c after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59160","description":"D & c after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFF0","description":"ICD-NBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWC1","description":"ICD-OCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELE1","description":"ICD-BELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNA1","description":"ICD-JGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUB0","description":"ICD-BFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep a/hep b vacc adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90636","description":"Hep a/hep b vacc adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c component-accessory nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0108","description":"W/c component-accessory nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPE0","description":"ICD-BCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPE1","description":"ICD-KHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4479","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","description":"HCPCS-A4479","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSE1","description":"ICD-PBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQD1","description":"ICD-LEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDA1","description":"ICD-GIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE151","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repositioning Of Previously Implanted Substernal Implantable Defibrillator-Pacing Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0574T","description":"Repositioning Of Previously Implanted Substernal Implantable Defibrillator-Pacing Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3C","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy remove for body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46608","description":"Anoscopy remove for body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63276","description":"Bx/exc xdrl spine lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDA1","description":"ICD-MFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; cranioplasty or elevation of depres","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0132U","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPB1","description":"ICD-CHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWA1","description":"ICD-DGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNC0","description":"ICD-JFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES236","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPC0","description":"ICD-OEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECD1","description":"ICD-FECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQE1","description":"ICD-LAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria and fungi)_ gram-negative bacterial identification and drug resistance element detection_ DNA (21 gram-negative bacterial targets_ 6 resistance ge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0142U","description":"Infectious disease (bacteria and fungi)_ gram-negative bacterial identification and drug resistance element detection_ DNA (21 gram-negative bacterial targets_ 6 resistance ge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-electronic spirometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9284","description":"Non-electronic spirometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOC0","description":"ICD-HEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYF1","description":"ICD-LBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ace/arb thxpy rxd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8473","description":"Ace/arb thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDA0","description":"ICD-IDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Site not small cell lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9285","description":"Site not small cell lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGB0","description":"ICD-CHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILB0","description":"ICD-NILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCD0","description":"ICD-NCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67917","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHID1","description":"ICD-CHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal or debulking of intracardiac mass (eg_ vegetations_ thrombus) via suction (eg_ vacuum_ aspiration) device_ percutaneous approach_ w/ intraoperative reinf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0644T","description":"Transcatheter removal or debulking of intracardiac mass (eg_ vegetations_ thrombus) via suction (eg_ vacuum_ aspiration) device_ percutaneous approach_ w/ intraoperative reinf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAE1","description":"ICD-KBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAE1","description":"ICD-MCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKA0","description":"ICD-FFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rep dev_ urinary_ w/sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1771","description":"Rep dev_ urinary_ w/sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVE1","description":"ICD-NKVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Agile MD_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1012","description":"Clinical decision support mechanism Agile MD_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33822","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blm gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81209","description":"Blm gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMF1","description":"ICD-EIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHF0","description":"ICD-CFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s])_ including vessel catheterization_ all imaging guidance_ and pulse generator initial ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33276","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s])_ including vessel catheterization_ all imaging guidance_ and pulse generator initial ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIA0","description":"ICD-EDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHB1","description":"ICD-GEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ophth us b w/non-quant a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76512","description":"Ophth us b w/non-quant a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aoe intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9465","description":"Aoe intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELF1","description":"ICD-BELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microprcsr cu combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0482","description":"Microprcsr cu combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINE0","description":"ICD-CINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNA0","description":"ICD-BGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA31","description":"ICD-2DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVE0","description":"ICD-BIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYD0","description":"ICD-KIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINA0","description":"ICD-OINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9256","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","description":"HCPCS-J9256","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILD1","description":"ICD-MILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel sach cushion type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3450","description":"Shoe heel sach cushion type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1159","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL24","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4348","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","description":"HCPCS-Q4348","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCA1","description":"ICD-NDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARB1","description":"ICD-CARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patients with primary headache diagnosis and imaging other than CT or MRI obtained","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1028","description":"Documentation of patients with primary headache diagnosis and imaging other than CT or MRI obtained","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1103","description":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analyze pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93724","description":"Analyze pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0530U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","description":"CPT-0530U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFB0","description":"ICD-CIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUF0","description":"ICD-KAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACE1","description":"ICD-NACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (fresenius kabi)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9048","description":"Injection_ bortezomib (fresenius kabi)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVC1","description":"ICD-FGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx/pro/dx inj new drug addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96375","description":"Tx/pro/dx inj new drug addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFA1","description":"ICD-NLFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICB1","description":"ICD-MICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67901","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNE0","description":"ICD-OKNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of calcium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82310","description":"Assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEB0","description":"ICD-ADEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00820","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","description":"CPT-00820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDA1","description":"ICD-GGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKC0","description":"ICD-BIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKC1","description":"ICD-ODKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage abdom abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49020","description":"Drainage abdom abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise ulnar nerve at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64719","description":"Revise ulnar nerve at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB21","description":"ICD-3JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64822","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood gases o2 sat only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82810","description":"Blood gases o2 sat only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCC1","description":"ICD-KHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSD0","description":"ICD-GFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (ccIIV4)_ derived from cell cultures_ subunit_ preservative and antibiotic free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90674","description":"Influenza virus vaccine_ quadrivalent (ccIIV4)_ derived from cell cultures_ subunit_ preservative and antibiotic free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWC1","description":"ICD-PEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXA0","description":"ICD-NCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNA1","description":"ICD-JBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEED1","description":"ICD-OEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDB1","description":"ICD-GIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal_ entire osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid and involving a bony defect greater t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69728","description":"Removal_ entire osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid and involving a bony defect greater t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCA0","description":"ICD-BHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDB1","description":"ICD-MDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRF1","description":"ICD-CIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1738","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1738","description":"HCPCS-C1738","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens gas permbl bifocl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2512","description":"Cntct lens gas permbl bifocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27475","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy volvul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45321","description":"Proctosigmoidoscopy volvul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHA0","description":"ICD-CGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95719","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBC1","description":"ICD-MGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screen pap by tech w md supv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P3000","description":"Screen pap by tech w md supv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOB0","description":"ICD-HGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self-adher band >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6455","description":"Self-adher band >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQB1","description":"ICD-LBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01992","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","description":"CPT-01992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWA0","description":"ICD-CDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No ret for surg w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9307","description":"No ret for surg w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPC1","description":"ICD-OBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp grade elec breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0604","description":"Hosp grade elec breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWB0","description":"ICD-KHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56637","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMC1","description":"ICD-ACMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWA0","description":"ICD-ODWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHA0","description":"ICD-FCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJB0","description":"ICD-JHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0524","description":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTD0","description":"ICD-KBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4357","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","description":"HCPCS-Q4357","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryoablate prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55873","description":"Cryoablate prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUB1","description":"ICD-KFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue in-situ hybridization","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0479","description":"Tissue in-situ hybridization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOE1","description":"ICD-OHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB34","description":"Medium Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66605","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained with diagnostic magnetic reso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0724T","description":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained with diagnostic magnetic reso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXE1","description":"ICD-FEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of silver diamine fluoride 38%_ by a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0792T","description":"Application of silver diamine fluoride 38%_ by a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc funct and care plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8539","description":"Doc funct and care plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPE1","description":"ICD-JCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB220","description":"Reduced Physical Function _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18B","description":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALF0","description":"ICD-NALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLC0","description":"ICD-ACLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection ext venography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36005","description":"Injection ext venography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDD0","description":"ICD-GCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spirometry up to 2 yrs old","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94011","description":"Spirometry up to 2 yrs old","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD115","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-sterile gauze>16<=48 sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6217","description":"Non-sterile gauze>16<=48 sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0214T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNC0","description":"ICD-KCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen system gas portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0430","description":"Oxygen system gas portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gallium ga-68 psma-11_ diagnostic_ (ucla)_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9594","description":"Gallium ga-68 psma-11_ diagnostic_ (ucla)_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28307","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEC0","description":"ICD-EFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD221","description":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIA1","description":"ICD-CEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sgd prerec msg > 40 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2506","description":"Sgd prerec msg > 40 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stereotactic radiation trmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77432","description":"Stereotactic radiation trmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test for g6pd enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82960","description":"Test for g6pd enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIF0","description":"ICD-KIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of transferrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84466","description":"Assay of transferrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIE1","description":"ICD-FDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Janssen (Johnson & Johnson) COVID-19 vaccine administration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1707","description":"Janssen (Johnson & Johnson) COVID-19 vaccine administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0130U","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc of neg or man pos tb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9360","description":"No doc of neg or man pos tb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmoscopy_ Extended; With Drawing Of Optic Nerve Or Macula (Eg_ For Glaucoma_ Macular Pathology_ Tumor) With Interpretation And Report_ Unilateral Or Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92202","description":"Ophthalmoscopy_ Extended; With Drawing Of Optic Nerve Or Macula (Eg_ For Glaucoma_ Macular Pathology_ Tumor) With Interpretation And Report_ Unilateral Or Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFD1","description":"ICD-BEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replantation of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54438","description":"Replantation of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vbac class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9439","description":"Vbac class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ret dev_ insertable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1773","description":"Ret dev_ insertable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj desmopressin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2597","description":"Inj desmopressin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28455","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIC0","description":"ICD-KAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFC1","description":"ICD-JFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXB0","description":"ICD-OIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of head injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62010","description":"Treatment of head injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0961T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","description":"CPT-0961T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46900","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIC0","description":"ICD-ODIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Care after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59430","description":"Care after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of nucleotidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83915","description":"Assay of nucleotidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEA0","description":"ICD-NKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBE0","description":"ICD-KHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy thigh soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27323","description":"Biopsy thigh soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHE1","description":"ICD-KCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOC1","description":"ICD-GHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEB0","description":"ICD-MAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYD0","description":"ICD-GCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLE1","description":"ICD-IDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACF0","description":"ICD-NACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELA1","description":"ICD-KELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj arthroscopy lysis adhesn","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7873","description":"Tmj arthroscopy lysis adhesn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMB1","description":"ICD-EEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIF1","description":"ICD-OEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCB1","description":"ICD-FDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic elbo simultaneous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7181","description":"Electronic elbo simultaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDA0","description":"ICD-BGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUA1","description":"ICD-BCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYA1","description":"ICD-PEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8I","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPF1","description":"ICD-JBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGA0","description":"ICD-KCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKE0","description":"ICD-OGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low-level laser trmt 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8948","description":"Low-level laser trmt 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHC0","description":"ICD-EEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFA0","description":"ICD-BHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","description":"HCPCS-Q4404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8A","description":"High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB110","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEF1","description":"ICD-OKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 11-20 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99422","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 11-20 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHE1","description":"ICD-BBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mass spectrometry qual/quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83789","description":"Mass spectrometry qual/quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compatibility test spin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86920","description":"Compatibility test spin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ factor VIII (antihemophilic factor_ recombinant) (Afstyla)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9140","description":"Injection_ factor VIII (antihemophilic factor_ recombinant) (Afstyla)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC31","description":"Very High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ histochemical stain on frozen tissue block (List separately in addition to code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0758T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ histochemical stain on frozen tissue block (List separately in addition to code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGD0","description":"ICD-GFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAB1","description":"ICD-IHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srs multisource","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77371","description":"Srs multisource","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLF1","description":"ICD-KCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKE1","description":"ICD-FHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRB0","description":"ICD-CDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway press headgear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7035","description":"Pos airway press headgear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLC1","description":"ICD-IDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace foot drop spint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4394","description":"Replace foot drop spint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBE0","description":"ICD-OCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAD0","description":"ICD-EGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photopheresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36522","description":"Photopheresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKC1","description":"ICD-BIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCF0","description":"ICD-CFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cilastatin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0743","description":"Cilastatin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shock absorber for power w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1016","description":"Shock absorber for power w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDC0","description":"ICD-JFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suture bile duct injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47900","description":"Suture bile duct injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir and rilpivirine_ 2mg/3mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9077","description":"Injection_ cabotegravir and rilpivirine_ 2mg/3mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX53","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD212","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crisis interven waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2034","description":"Crisis interven waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQB0","description":"ICD-CCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKD1","description":"ICD-GBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDB1","description":"ICD-KFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHE0","description":"ICD-CFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy ablate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45320","description":"Proctosigmoidoscopy ablate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEB1","description":"ICD-MDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCE1","description":"ICD-NJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGD0","description":"ICD-JDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelet pheresis irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9036","description":"Platelet pheresis irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWA1","description":"ICD-LCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUD0","description":"ICD-BFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA21","description":"ICD-1GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRF0","description":"ICD-OJRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUE1","description":"ICD-EGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIC0","description":"ICD-OBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHC1","description":"ICD-MEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA31","description":"ICD-4HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOD0","description":"ICD-PLOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMC1","description":"ICD-ODMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8B","description":"Low Rehab_ ADL Index 0-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture type immunologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87147","description":"Culture type immunologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32601","description":"Thoracoscopy diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOD1","description":"ICD-OCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg sacrococ teratoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2405","description":"Fetal surg sacrococ teratoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYF0","description":"ICD-OBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFID1","description":"ICD-IFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amifostine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0207","description":"Amifostine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp fem-ant-post tib/prl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35666","description":"Art byp fem-ant-post tib/prl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUE0","description":"ICD-NHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCC0","description":"ICD-BDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUC1","description":"ICD-MIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frozen blood thaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86931","description":"Frozen blood thaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis glass test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81020","description":"Urinalysis glass test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58925","description":"Removal of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBA0","description":"ICD-EFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABC0","description":"ICD-IABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast add mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19288","description":"Perq dev breast add mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDA1","description":"ICD-AFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATE0","description":"ICD-BATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABC1","description":"ICD-KABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9455","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQB1","description":"ICD-HCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLA1","description":"ICD-EFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKE1","description":"ICD-OAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bso omentectomy w/tah","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58956","description":"Bso omentectomy w/tah","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLA0","description":"ICD-BGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE155","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hippotherapy per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8940","description":"Hippotherapy per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTE0","description":"ICD-NHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99402","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADC0","description":"ICD-AADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSA1","description":"ICD-KBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALF1","description":"ICD-IALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHA0","description":"ICD-CAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61314","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCD1","description":"ICD-AFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXF0","description":"ICD-CEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had more than one emergency department visit in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9850","description":"Patient had more than one emergency department visit in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLF1","description":"ICD-FFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12D","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCD0","description":"ICD-NHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHME1","description":"ICD-GHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYA1","description":"ICD-PHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc drug-el cor stent sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9600","description":"Perc drug-el cor stent sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJD1","description":"ICD-BGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMB1","description":"ICD-IGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLC0","description":"ICD-KBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAC0","description":"ICD-NAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEF1","description":"ICD-OCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEE1","description":"ICD-NGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 6","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA46","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOF0","description":"ICD-HGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change ureter stent percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50382","description":"Change ureter stent percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of acute vitreous hemorrhage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1328","description":"Patients with a diagnosis of acute vitreous hemorrhage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat scapula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23585","description":"Treat scapula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20B","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSC0","description":"ICD-DGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKD0","description":"ICD-FBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAA1","description":"ICD-MAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MECP2 (methyl CpG binding protein 2) (eg_ Rett syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ mobile","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0234U","description":"MECP2 (methyl CpG binding protein 2) (eg_ Rett syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ mobile","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prothrombin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85611","description":"Prothrombin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYC1","description":"ICD-CAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFE0","description":"ICD-FGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace trilateral socket br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4010","description":"Replace trilateral socket br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHB1","description":"ICD-MKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75705","description":"Artery x-rays spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst stg3-hr_ no pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9073","description":"Onc dx brst stg3-hr_ no pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHC0","description":"ICD-BCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain shoulder bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23035","description":"Drain shoulder bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia removal pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54251","description":"Anesthesia removal pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB41","description":"Very High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy stone removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52325","description":"Cystoscopy stone removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA220","description":"Reduced Physical Function _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHME1","description":"ICD-MHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDB1","description":"ICD-ACDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ secukinumab_ intravenous_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9166","description":"Injection_ secukinumab_ intravenous_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQA1","description":"ICD-KBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLF0","description":"ICD-IGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Any patients who had no asthma controller medications dispensed during the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9808","description":"Any patients who had no asthma controller medications dispensed during the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOF1","description":"ICD-OFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPE1","description":"ICD-OAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84392","description":"Assay of urine sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respite care service 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1005","description":"Respite care service 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22855","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXD0","description":"ICD-NIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0704","description":"HCPCS-C0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYE0","description":"ICD-KFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33412","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAB1","description":"ICD-OJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMF0","description":"ICD-MJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31368","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amino acids single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82131","description":"Amino acids single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGE1","description":"ICD-GGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGE0","description":"ICD-KGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEB1","description":"ICD-EEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9844","description":"Patient did not receive anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQA0","description":"ICD-LAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTF1","description":"ICD-NHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8B","description":"Very High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of knee 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73562","description":"X-ray exam of knee 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","description":"HCPCS-J3376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trach/laryn tube cuffed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7521","description":"Trach/laryn tube cuffed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J8522","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","description":"HCPCS-J8522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSD0","description":"ICD-KFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKA0","description":"ICD-NCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epi etiol synd rvwd and docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1205F","description":"Epi etiol synd rvwd and docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJA1","description":"ICD-NGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEB1","description":"ICD-CBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAC0","description":"ICD-MCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSF0","description":"ICD-DBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRC0","description":"ICD-DBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMA0","description":"ICD-GAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adj chem pres ajcc iii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8927","description":"Adj chem pres ajcc iii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVE0","description":"ICD-JIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24A","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc ref upper gi endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3132F","description":"Doc ref upper gi endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99223","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDA0","description":"ICD-AFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eswl for gallstones","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9034","description":"Eswl for gallstones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dark field examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87164","description":"Dark field examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ondansetron oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0162","description":"Ondansetron oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Oncology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4031","description":"Radiation Oncology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sutures same surgeon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15850","description":"Remove sutures same surgeon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vincristine sulfate 1 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9370","description":"Vincristine sulfate 1 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0975T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","description":"CPT-0975T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy swallow tst (fees)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92612","description":"Endoscopy swallow tst (fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01963","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","description":"CPT-01963","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy trisom risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81507","description":"Fetal aneuploidy trisom risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIA1","description":"ICD-NGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPE1","description":"ICD-KBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67880","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC13","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCC1","description":"ICD-GGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAE0","description":"ICD-JFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mycophenolate mofetil oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7517","description":"Mycophenolate mofetil oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX03","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25A","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB14","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWE1","description":"ICD-OHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23802","description":"Fusion of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8I","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKC0","description":"ICD-CGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11440","description":"Exc face-mm b9+marg 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle-skin graft arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15736","description":"Muscle-skin graft arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVF1","description":"ICD-GGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trapezius sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1070","description":"Trapezius sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVD1","description":"ICD-NEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid imaging w/blood flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78013","description":"Thyroid imaging w/blood flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIB0","description":"ICD-MJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2B","description":"Ultra High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXA0","description":"ICD-OCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBME1","description":"ICD-NBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12A","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOD1","description":"ICD-CIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of left heart vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33989","description":"Removal of left heart vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57105","description":"Biopsy of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1075","description":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ezderm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4136","description":"Ezderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBC1","description":"ICD-NFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye socket implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67560","description":"Revise eye socket implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with guided transhepatic cholangiography_ without biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47560","description":"Laparoscopy_ surgical; with guided transhepatic cholangiography_ without biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","description":"HCPCS-M1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGE1","description":"ICD-GHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRA0","description":"ICD-GDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUC1","description":"ICD-AEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRF1","description":"ICD-PGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures maxill part metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5213","description":"Dentures maxill part metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bicarbonate conc pow per pac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4707","description":"Bicarbonate conc pow per pac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJC1","description":"ICD-FIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSA0","description":"ICD-CBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit im injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99506","description":"Home visit im injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert cath pleura w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32556","description":"Insert cath pleura w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJB0","description":"ICD-BBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLF1","description":"ICD-EFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bupren/nal 3.1 to 6mg bupren","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0573","description":"Bupren/nal 3.1 to 6mg bupren","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hast w/oxygen titrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94453","description":"Hast w/oxygen titrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELE0","description":"ICD-CELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0587U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","description":"CPT-0587U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPA0","description":"ICD-BCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHA1","description":"ICD-ACHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUC0","description":"ICD-FAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOF0","description":"ICD-KBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDD1","description":"ICD-BEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMC1","description":"ICD-AHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3B","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9982","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYC1","description":"ICD-PIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14B","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Right ventricular recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93603","description":"Right ventricular recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB46","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVC1","description":"ICD-OHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bladder opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51880","description":"Repair of bladder opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYF0","description":"ICD-LGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCD0","description":"ICD-AGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCA0","description":"ICD-AHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMA0","description":"ICD-OGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNC0","description":"ICD-GCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release knuckle contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26520","description":"Release knuckle contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj calcitriol per 0.1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0636","description":"Inj calcitriol per 0.1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep c rna 4to12 wk after med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9209","description":"Hep c rna 4to12 wk after med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.00d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2105","description":"Spherocylinder 4.00d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No ahi or rdi initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8844","description":"No ahi or rdi initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Activation device for intraurethral drainage device with valve_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1011","description":"Activation device for intraurethral drainage device with valve_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLE0","description":"ICD-GCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not consid poss risk fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3573F","description":"Pt not consid poss risk fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLF1","description":"ICD-AHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMB0","description":"ICD-AAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99304","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKC0","description":"ICD-FEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMA0","description":"ICD-MGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1270","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTA1","description":"ICD-JFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXA1","description":"ICD-ODXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCA1","description":"ICD-OJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUB1","description":"ICD-CBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee detach ar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1172","description":"Wheelchair amputee detach ar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/o stablj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21315","description":"Closed tx nose fx w/o stablj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEF1","description":"ICD-OFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMC0","description":"ICD-FGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14A","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWA0","description":"ICD-CIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERD0","description":"ICD-DERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTA0","description":"ICD-MBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHF1","description":"ICD-GDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of hemoglobin heat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83065","description":"Assay of hemoglobin heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUC0","description":"ICD-IGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJC0","description":"ICD-BCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for non ESRD use)_ 1000 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5106","description":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for non ESRD use)_ 1000 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nurse practr visit outs cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0274","description":"Nurse practr visit outs cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko adj jnt pos r sup pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1833","description":"Ko adj jnt pos r sup pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEC1","description":"ICD-MGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIA1","description":"ICD-AHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFB0","description":"ICD-JAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATD1","description":"ICD-FATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB33","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66500","description":"Incision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assess dyspnea present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1019F","description":"Assess dyspnea present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gauze <= 16 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6219","description":"Gauze <= 16 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pacemaker monitr audible/vis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0610","description":"Pacemaker monitr audible/vis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQF0","description":"ICD-OFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of foot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28022","description":"Exploration of foot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64468","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","description":"CPT-64468","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUD1","description":"ICD-NKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62200","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDD1","description":"ICD-AGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAA1","description":"ICD-AGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIE1","description":"ICD-CCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWD0","description":"ICD-KIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWD0","description":"ICD-KAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJB1","description":"ICD-JEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYE1","description":"ICD-OCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOA0","description":"ICD-GDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35476","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption study (eg_ Schilling test); without intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78270","description":"Vitamin B-12 absorption study (eg_ Schilling test); without intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHC1","description":"ICD-AHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lamellas_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4292","description":"Lamellas_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interferon beta-1a inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1826","description":"Interferon beta-1a inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee control full kneecap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2795","description":"Knee control full kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMD0","description":"ICD-MHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38724","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGED0","description":"ICD-JGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","description":"HCPCS-A2038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove knee cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27347","description":"Remove knee cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of 5-hiaa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83497","description":"Assay of 5-hiaa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMF1","description":"ICD-JFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pland chemo docd b/4 txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0519F","description":"Pland chemo docd b/4 txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a patient navigator; 60 m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0023","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a patient navigator; 60 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood pku","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84030","description":"Assay of blood pku","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nhl trans to lg bcell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9136","description":"Onc dx nhl trans to lg bcell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ crizanlizumab-tmca_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0791","description":"Injection_ crizanlizumab-tmca_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1460","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","description":"HCPCS-M1460","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0486U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","description":"CPT-0486U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81301","description":"Microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No surg site infection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9311","description":"No surg site infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECE1","description":"ICD-CECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect recurrent gyn mal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58957","description":"Resect recurrent gyn mal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA CYTOMEGALOVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87332","description":"IAAD IA CYTOMEGALOVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWC1","description":"ICD-LBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; duplication/deletion variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81269","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; duplication/deletion variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00844","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","description":"CPT-00844","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1479","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","description":"HCPCS-M1479","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVC1","description":"ICD-ODVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8I","description":"High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSE0","description":"ICD-DBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMB1","description":"ICD-BDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOA1","description":"ICD-OGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insrt/redo spine n generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63685","description":"Insrt/redo spine n generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIE0","description":"ICD-GFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGC1","description":"ICD-KDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7518","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEB0","description":"ICD-IBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0503","description":"HCPCS-A0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARD0","description":"ICD-KARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHF1","description":"ICD-GAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69420","description":"Incision of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit picc insert no supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5522","description":"Hit picc insert no supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFE1","description":"ICD-NEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12A","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vancomycin hcl (mylan) not therapeutically equivalent to j3370_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3371","description":"Injection_ vancomycin hcl (mylan) not therapeutically equivalent to j3370_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc pract mgmt differs trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9057","description":"Onc pract mgmt differs trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMB0","description":"ICD-KCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lab pathology consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80502","description":"Lab pathology consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXC0","description":"ICD-GHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous tibial nerve stimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0736","description":"Transcutaneous tibial nerve stimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIB0","description":"ICD-NJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7527","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISE1","description":"ICD-OISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0733","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00948","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","description":"CPT-00948","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9804","description":"Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAE1","description":"ICD-JFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPC0","description":"ICD-OCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYD0","description":"ICD-PKYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDE1","description":"ICD-AFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pegloticase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2507","description":"Pegloticase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0182","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDA0","description":"ICD-CBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJD1","description":"ICD-CCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction eyelid w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67912","description":"Correction eyelid w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAA1","description":"ICD-IGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUA1","description":"ICD-JDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB05","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOE1","description":"ICD-HCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2008","description":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIC0","description":"ICD-ABIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METB1","description":"ICD-METB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spectrophotometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84311","description":"Spectrophotometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGB0","description":"ICD-FBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB246","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVA0","description":"ICD-BEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99191","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQD0","description":"ICD-KIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVA1","description":"ICD-OAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1443","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","description":"HCPCS-M1443","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLB0","description":"ICD-MJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA10","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBND0","description":"ICD-FBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFD0","description":"ICD-JAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPB1","description":"ICD-GEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7509","description":"Methylprednisolone oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECB1","description":"ICD-MECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQC1","description":"ICD-DFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMD1","description":"ICD-AFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt w cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9240","description":"Doc pt w cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGB1","description":"ICD-BCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUE0","description":"ICD-KIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Es sph augmnt device removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0393T","description":"Es sph augmnt device removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crotalidae poly immune fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0840","description":"Crotalidae poly immune fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cranial cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61000","description":"Remove cranial cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKE1","description":"ICD-BGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICB1","description":"ICD-JICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physical therapy treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97039","description":"Physical therapy treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJF0","description":"ICD-OKJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA101","description":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFD0","description":"ICD-NCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise spine eltrd plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63664","description":"Revise spine eltrd plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB31","description":"ICD-2GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAB0","description":"ICD-FGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74246","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fistula repair transperine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57308","description":"Fistula repair transperine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12A","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35207","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cimetidine hydroc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0023","description":"Injection_ cimetidine hydroc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOF1","description":"ICD-HEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXC0","description":"ICD-ODXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIA0","description":"ICD-ABIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44151","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWB1","description":"ICD-HEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOD1","description":"ICD-PEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLF0","description":"ICD-IDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGB0","description":"ICD-NLGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRD0","description":"ICD-CCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj tedizolid phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3090","description":"Inj tedizolid phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGND0","description":"ICD-JGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-elastic extremity binder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4465","description":"Non-elastic extremity binder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXB0","description":"ICD-NGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPA0","description":"ICD-BIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behav chng smoking 3-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99406","description":"Behav chng smoking 3-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVC1","description":"ICD-GCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27479","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFED1","description":"ICD-GFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap part colectomy w/stoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44206","description":"Lap part colectomy w/stoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC211","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDD0","description":"ICD-IHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped home apnea rec hk-up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94775","description":"Ped home apnea rec hk-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dissolve clot heart vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92977","description":"Dissolve clot heart vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIB1","description":"ICD-OKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB31","description":"ICD-2EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee disc/dial lock/adj flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2425","description":"Knee disc/dial lock/adj flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEF1","description":"ICD-MIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (hematolymphoid neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood or bone marrow_ report of specific gene rearra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014U","description":"Hematology (hematolymphoid neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood or bone marrow_ report of specific gene rearra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53460","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHA1","description":"ICD-EDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPA1","description":"ICD-NJPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACF1","description":"ICD-AACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASF0","description":"ICD-GASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57270","description":"Repair of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin beta non esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0888","description":"Epoetin beta non esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01630","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","description":"CPT-01630","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFC1","description":"ICD-FAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0668","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","description":"HCPCS-J0668","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; includes set-up_ patient training_ configuration o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0533T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; includes set-up_ patient training_ configuration o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLA1","description":"ICD-MKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Docking station for use with oral device/appliance used to reduce upper airway collapsibility","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1037","description":"Docking station for use with oral device/appliance used to reduce upper airway collapsibility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c lateral trunk/hip suppor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0956","description":"W/c lateral trunk/hip suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTE1","description":"ICD-NHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC160","description":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE115","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVA1","description":"ICD-FDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHE1","description":"ICD-GAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whirlpool Tub_ Walk-In_ Portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1003","description":"Whirlpool Tub_ Walk-In_ Portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Appliance cleaner","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5131","description":"Appliance cleaner","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8710","description":"Pt pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35011","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBB1","description":"ICD-FBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUC0","description":"ICD-KDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEC1","description":"ICD-IAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA11","description":"ICD-3JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPE0","description":"ICD-GGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D6049","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6049","description":"CDT-D6049","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB11","description":"ICD-1BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","description":"HCPCS-J1807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRB1","description":"ICD-KHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of shoulders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73050","description":"X-ray exam of shoulders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHA0","description":"ICD-ADHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair corporeal tear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54437","description":"Repair corporeal tear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epinephrine (belcher) not therapeutically equivalent to j0171_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0173","description":"Injection_ epinephrine (belcher) not therapeutically equivalent to j0171_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N-et; patient attend/escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2001","description":"N-et; patient attend/escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTD0","description":"ICD-JBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hand tendon reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26502","description":"Hand tendon reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDC1","description":"ICD-ODDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth electroshock","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10451","description":"Anesth electroshock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIF0","description":"ICD-OHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCF0","description":"ICD-JCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISF0","description":"ICD-KISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKA1","description":"ICD-BDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51060","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERC1","description":"ICD-PERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost skn barr extnd =4sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4411","description":"Ost skn barr extnd =4sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHF0","description":"ICD-BEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKF1","description":"ICD-OLKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; 6 Years And Older Without Congenita","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33017","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; 6 Years And Older Without Congenita","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAD0","description":"ICD-JDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYF0","description":"ICD-GAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQB0","description":"ICD-OKQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEC1","description":"ICD-EHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA56","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct colonography screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74263","description":"Ct colonography screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anl sp inf pmp w/mdreprg&fil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62370","description":"Anl sp inf pmp w/mdreprg&fil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIB0","description":"ICD-KIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cosyntropin_ not otherwise specified_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0833","description":"Injection_ cosyntropin_ not otherwise specified_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair retinal detach cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67113","description":"Repair retinal detach cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation)_ full sequence analysis_ including small sequence changes in exonic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0230U","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation)_ full sequence analysis_ including small sequence changes in exonic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 11 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP11","description":"Auto.test pane pricing code_ 11 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYA1","description":"ICD-PIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOD0","description":"ICD-CCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct abd & pelv 1/> regns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74178","description":"Ct abd & pelv 1/> regns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ in the canal (ITC)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5172","description":"Hearing aid_ contralateral routing device_ monaural_ in the canal (ITC)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26390","description":"Revise hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26434","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert 2 electrode pm-defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33217","description":"Insert 2 electrode pm-defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"After cataract laser surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66821","description":"After cataract laser surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA260","description":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD101","description":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29899","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC126","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asthma impairment assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2015F","description":"Asthma impairment assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject spine cerv/thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62310","description":"Inject spine cerv/thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25600","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB31","description":"ICD-4KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00928","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","description":"CPT-00928","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subs visit for episode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0526F","description":"Subs visit for episode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext ecg scan w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0297T","description":"Ext ecg scan w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITF0","description":"ICD-MITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Histotripsy (i.e._ nonthermal ablation via acoustic energy delivery) of malignant renal tissue_ including image gu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9790","description":"Histotripsy (i.e._ nonthermal ablation via acoustic energy delivery) of malignant renal tissue_ including image gu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA240","description":"Clinically Complex _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dostarlimab-gxly_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9082","description":"Injection_ dostarlimab-gxly_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraop cyto path consult 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88334","description":"Intraop cyto path consult 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 1200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0244","description":"Injection_ casirivimab and imdevimab_ 1200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMF1","description":"ICD-FBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIA0","description":"ICD-OGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMB0","description":"ICD-IEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTF1","description":"ICD-FBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBB1","description":"ICD-FIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIA0","description":"ICD-IIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vbac care after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59614","description":"Vbac care after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERA0","description":"ICD-OERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADC1","description":"ICD-AADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBB0","description":"ICD-GHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart/lung resuscitation cpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92950","description":"Heart/lung resuscitation cpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUA0","description":"ICD-FAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skills train and dev_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2014","description":"Skills train and dev_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEE0","description":"ICD-KDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJA0","description":"ICD-OGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8X","description":"Low Rehab_ ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVC0","description":"ICD-OEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWF1","description":"ICD-HCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Slitting of prepuce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54000","description":"Slitting of prepuce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46740","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig footwear evaluatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8416","description":"Pt inelig footwear evaluatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00176","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","description":"CPT-00176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHF0","description":"ICD-FIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVD0","description":"ICD-GDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVC0","description":"ICD-KFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVC0","description":"ICD-GDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRE0","description":"ICD-GBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDE0","description":"ICD-ICDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9302","description":"HCPCS-C9302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPC0","description":"ICD-FHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJF1","description":"ICD-BFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures complete maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5110","description":"Dentures complete maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive ear/neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69155","description":"Extensive ear/neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8A","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21465","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXD0","description":"ICD-GFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emr pwr source elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0490","description":"Emr pwr source elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERB1","description":"ICD-HERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20B","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYE0","description":"ICD-HFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADD0","description":"ICD-BADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCF0","description":"ICD-AFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIF0","description":"ICD-GAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICD1","description":"ICD-KICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lengthen radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25391","description":"Lengthen radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","description":"CPT-01474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUE1","description":"ICD-GAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31090","description":"Exploration of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC234","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINF1","description":"ICD-BINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVF0","description":"ICD-OKVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ethosuximide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80168","description":"Assay of ethosuximide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81400","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHB0","description":"ICD-BDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYE0","description":"ICD-CHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSF0","description":"ICD-KFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"K flow/funct image w/o drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78707","description":"K flow/funct image w/o drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGD1","description":"ICD-NIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood/uric acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84550","description":"Assay of blood/uric acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFA1","description":"ICD-GHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB31","description":"ICD-3BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLC0","description":"ICD-MFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63046","description":"Remove spine lamina 1 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBE0","description":"ICD-JEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETE0","description":"ICD-EETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTA1","description":"ICD-FCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHB1","description":"ICD-ABHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEF0","description":"ICD-CDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDF0","description":"ICD-MGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXF1","description":"ICD-GHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDF0","description":"ICD-IGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tension ring_ vac erect dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7902","description":"Tension ring_ vac erect dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam drg <=16 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6212","description":"Foam drg <=16 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4C","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruct lesion 15 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17111","description":"Destruct lesion 15 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of progesterone 17-d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83498","description":"Assay of progesterone 17-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCE0","description":"ICD-NFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEF1","description":"ICD-FFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost sknbar w/o conv<=4 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4414","description":"Ost sknbar w/o conv<=4 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDC1","description":"ICD-KBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYE0","description":"ICD-DHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB52","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise pharynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42808","description":"Excise pharynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infusion supplies w/o pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4223","description":"Infusion supplies w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0636U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0636U","description":"CPT-0636U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCND1","description":"ICD-KCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical revision intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44680","description":"Surgical revision intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMF1","description":"ICD-MHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFC1","description":"ICD-GDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRD1","description":"ICD-OIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSF1","description":"ICD-HDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBF0","description":"ICD-FFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFD0","description":"ICD-FGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No life asst 2x same/decr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9636","description":"No life asst 2x same/decr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL41","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIA0","description":"ICD-NIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICC0","description":"ICD-KICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration behind abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49010","description":"Exploration behind abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69554","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKD0","description":"ICD-JHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periton dialysis plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0507F","description":"Periton dialysis plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRA0","description":"ICD-OGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conform band s w <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6445","description":"Conform band s w <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd us fine needle bx/aspir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43238","description":"Egd us fine needle bx/aspir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCB0","description":"ICD-NCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Candida species panel (C. albicans_ C. glabrata_ C. parapsilosis_ C. kruseii_ C tropicalis_ and C. auris)_ amplified probe technique with qualitative report of the presence or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0068U","description":"Candida species panel (C. albicans_ C. glabrata_ C. parapsilosis_ C. kruseii_ C tropicalis_ and C. auris)_ amplified probe technique with qualitative report of the presence or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70140","description":"X-ray exam of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCD0","description":"ICD-NFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXC0","description":"ICD-JDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relese_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4257","description":"Relese_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDE0","description":"ICD-BFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dactinomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9120","description":"Dactinomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNA1","description":"ICD-GFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICF1","description":"ICD-GICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0684","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","description":"HCPCS-G0684","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30125","description":"Removal of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-49188","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","description":"CPT-49188","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTD1","description":"ICD-EGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSE0","description":"ICD-CBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25263","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMD1","description":"ICD-EFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMD1","description":"ICD-IIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26535","description":"Revise finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOF0","description":"ICD-OGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNF0","description":"ICD-FHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aortbifemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35540","description":"Art byp grft aortbifemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1135","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"guided tissue regeneration_ edentulous area - resorbable barrier_ per site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7956","description":"guided tissue regeneration_ edentulous area - resorbable barrier_ per site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOF0","description":"ICD-PLOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33030","description":"Partial removal of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIF1","description":"ICD-BBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9698","description":"Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (Baxter)_ not therapeutically equivalent to J0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0874","description":"Injection_ daptomycin (Baxter)_ not therapeutically equivalent to J0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 2 std up to 300lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0806","description":"Pov group 2 std up to 300lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUB0","description":"ICD-KGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Serum immunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86320","description":"Serum immunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEC0","description":"ICD-MBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28X","description":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQE1","description":"ICD-OGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bleeding time test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85002","description":"Bleeding time test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE250","description":"Clinically Complex _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC21","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSF0","description":"ICD-OGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla typing a b or c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86813","description":"Hla typing a b or c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBC1","description":"ICD-OLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Detach adjust armrst upper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0018","description":"Detach adjust armrst upper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optimal care for kidney health mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0002","description":"Optimal care for kidney health mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEB0","description":"ICD-FAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYE1","description":"ICD-OBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4044","description":"Cast sup lng leg splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1189","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ remimazolam_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2249","description":"Injection_ remimazolam_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cyp2c9 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81227","description":"Cyp2c9 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venipuncture home/snf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9529","description":"Venipuncture home/snf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGC1","description":"ICD-FIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIE0","description":"ICD-BEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1C","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASE0","description":"ICD-OASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct entire forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21180","description":"Reconstruct entire forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNE0","description":"ICD-ODNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKB0","description":"ICD-BAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Qualified Healthcare Professional Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 21 Or More Mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2063","description":"Qualified Nonphysician Qualified Healthcare Professional Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 21 Or More Mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIB0","description":"ICD-EIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOE1","description":"ICD-HHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 4 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3380F","description":"Ajcc brstcncr stage 4 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indwelling trach insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8511","description":"Indwelling trach insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPA1","description":"ICD-GIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stent placemt ante carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37218","description":"Stent placemt ante carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUB0","description":"ICD-IAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputate lower leg at knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27598","description":"Amputate lower leg at knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/excise tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52355","description":"Cystouretero w/excise tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISB1","description":"ICD-OISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stnd wt frame power whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0010","description":"Stnd wt frame power whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy bilobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32670","description":"Thoracoscopy bilobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy sterilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58565","description":"Hysteroscopy sterilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHA1","description":"ICD-BAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHA1","description":"ICD-NHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX17","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUE1","description":"ICD-JAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICE1","description":"ICD-JICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42182","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27248","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXD1","description":"ICD-CDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETA0","description":"ICD-KETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1225","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Advancing Care For Heart Disease Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0055","description":"Advancing Care For Heart Disease Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLC0","description":"ICD-IHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ra disease activity mod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3471F","description":"Ra disease activity mod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28D","description":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1091T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1091T","description":"CPT-1091T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFC0","description":"ICD-KGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE256","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00952","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","description":"CPT-00952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALA0","description":"ICD-GALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser in situ keratomileusis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0800","description":"Laser in situ keratomileusis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body-worn hearing aid bone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5040","description":"Body-worn hearing aid bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUC1","description":"ICD-CEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDED0","description":"ICD-KDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML35","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELA1","description":"ICD-MELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOC0","description":"ICD-PJOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOA0","description":"ICD-CFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27566","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc sed rate nonautomated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85651","description":"Rbc sed rate nonautomated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC120","description":"Clinically Complex _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDC1","description":"ICD-MBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXD0","description":"ICD-FDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low (or very low) risk of recurrence_ prostate cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9706","description":"Low (or very low) risk of recurrence_ prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc of pain","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8732","description":"No doc of pain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIA1","description":"ICD-MCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein amniotic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82106","description":"Alpha-fetoprotein amniotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFA0","description":"ICD-KBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58805","description":"Drainage of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dengue vaccine_ quadrivalent_ live_ 3 dose schedule_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90587","description":"Dengue vaccine_ quadrivalent_ live_ 3 dose schedule_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYB1","description":"ICD-LFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFB1","description":"ICD-JFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Isoproterenol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7660","description":"Isoproterenol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDF0","description":"ICD-OBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interphalangeal joint spacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8658","description":"Interphalangeal joint spacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLE1","description":"ICD-GDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gross exam prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0472","description":"Gross exam prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair nasal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30545","description":"Repair nasal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKF1","description":"ICD-JCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB13","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOA0","description":"ICD-ODOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj brachial plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64415","description":"N block inj brachial plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMD1","description":"ICD-NIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin alfa_ 100 units esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4081","description":"Epoetin alfa_ 100 units esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01810","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","description":"CPT-01810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEA0","description":"ICD-GHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPA1","description":"ICD-BIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compatibility test incubate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86921","description":"Compatibility test incubate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0427T","description":"Insj/rplc nstim apnea pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCC0","description":"ICD-NDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14B","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rho(d) immune globulin h_ sd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2792","description":"Rho(d) immune globulin h_ sd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1454","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","description":"HCPCS-M1454","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0204","description":"HCPCS-A0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAA0","description":"ICD-GEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRF0","description":"ICD-PJRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPF1","description":"ICD-NIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVD1","description":"ICD-BAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFD0","description":"ICD-BDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTF1","description":"ICD-KGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 2-3 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72040","description":"X-ray exam neck spine 2-3 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJD1","description":"ICD-GBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMA1","description":"ICD-KFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFED0","description":"ICD-AFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKE1","description":"ICD-CEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rgd ped wc adjstabl w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1237","description":"Rgd ped wc adjstabl w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYF1","description":"ICD-OBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sex chromatin identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88130","description":"Sex chromatin identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVF0","description":"ICD-NIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electro hearng aid tst both","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92595","description":"Electro hearng aid tst both","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTD1","description":"ICD-JBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFC0","description":"ICD-NEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27707","description":"Incision of fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRA0","description":"ICD-CGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAC0","description":"ICD-EDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0903T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","description":"CPT-0903T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBA0","description":"ICD-BIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX55","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBD1","description":"ICD-GBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calcitrol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0169","description":"Calcitrol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0237","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","description":"HCPCS-M0237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNC0","description":"ICD-OHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIF1","description":"ICD-JFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCA0","description":"ICD-GBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB225","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC03","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraop image confirm excise","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8872","description":"Intraop image confirm excise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of arm infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73092","description":"X-ray exam of arm infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYD0","description":"ICD-PEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2126","description":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC07","description":"Medium Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJF1","description":"ICD-OCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27702","description":"Reconstruct ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21183","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indic for head ct valid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9531","description":"Indic for head ct valid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sio flex pelvic/sacr pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0621","description":"Sio flex pelvic/sacr pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/fast/dir lab ldl-c >190","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9675","description":"Pt w/fast/dir lab ldl-c >190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hd low limb pros vacuum pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5782","description":"Hd low limb pros vacuum pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLF0","description":"ICD-NDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHC0","description":"ICD-GGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMA1","description":"ICD-GFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB131","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPA0","description":"ICD-JCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFD1","description":"ICD-NHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair carpal bone shorten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25394","description":"Repair carpal bone shorten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAA1","description":"ICD-KBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB21","description":"Low Rehab_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc arm/elbow les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24075","description":"Exc arm/elbow les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRA0","description":"ICD-GGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15C","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMB0","description":"ICD-IBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harvest eye tissue alograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68371","description":"Harvest eye tissue alograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCF1","description":"ICD-JBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA20","description":"Default_ /14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ABO GNOTYP NEXT GNRJ SEQ ABO","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0221U","description":"ABO GNOTYP NEXT GNRJ SEQ ABO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1043","description":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures rebase cmplt maxil","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5710","description":"Dentures rebase cmplt maxil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCF0","description":"ICD-OBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17273","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocollator unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0225","description":"Hydrocollator unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVC1","description":"ICD-CGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFF1","description":"ICD-OGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90382","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","description":"CPT-90382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFF1","description":"ICD-CCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trluml perip athrc visceral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0235T","description":"Trluml perip athrc visceral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroretinography (ERG)_ with interpretation and report; full field (ie_ ffERG_ flash ERG_ Ganzfeld ERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92273","description":"Electroretinography (ERG)_ with interpretation and report; full field (ie_ ffERG_ flash ERG_ Ganzfeld ERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic induction of intra-brain hypothermia_ including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head_ including monit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0776T","description":"Therapeutic induction of intra-brain hypothermia_ including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head_ including monit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXE0","description":"ICD-KAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJB1","description":"ICD-OGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLD1","description":"ICD-KDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35361","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligate/strip short leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37718","description":"Ligate/strip short leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AJCC breast cancer stage I: T1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9705","description":"AJCC breast cancer stage I: T1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABC1","description":"ICD-OABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWF0","description":"ICD-HBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOB0","description":"ICD-KFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWE1","description":"ICD-LIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure_ unless_ since","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9722","description":"Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure_ unless_ since","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYD1","description":"ICD-GHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVB0","description":"ICD-GIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATE0","description":"ICD-KATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUA1","description":"ICD-AIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAD0","description":"ICD-KBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMB1","description":"ICD-KAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo partial nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50543","description":"Laparo partial nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee joint drop lock ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2405","description":"Knee joint drop lock ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0668U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0668U","description":"CPT-0668U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQE0","description":"ICD-DAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRC0","description":"ICD-LDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Habil sup empl waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2018","description":"Habil sup empl waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC214","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKE0","description":"ICD-BHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis auto w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81003","description":"Urinalysis auto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26562","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplant hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26480","description":"Transplant hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAE0","description":"ICD-GDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXE1","description":"ICD-KCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKED0","description":"ICD-NKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA260","description":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Guide cathet fluid drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10030","description":"Guide cathet fluid drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No bld inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9627","description":"No bld inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c acc_saf belt pelv strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0978","description":"W/c acc_saf belt pelv strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWF1","description":"ICD-LBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXC1","description":"ICD-NFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAA0","description":"ICD-OCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHED1","description":"ICD-NHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQD1","description":"ICD-KDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29837","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tprnl Plmt Biodegradable Matrl Periprostatic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0438T","description":"Tprnl Plmt Biodegradable Matrl Periprostatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTA1","description":"ICD-IHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Offset knee joint each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2390","description":"Offset knee joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFE1","description":"ICD-CAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g._ prior anaphylaxis due to the pneumococcal vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1178","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g._ prior anaphylaxis due to the pneumococcal vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lat lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22533","description":"Lat lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic shoe add rub insl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3510","description":"Orthopedic shoe add rub insl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDD1","description":"ICD-OIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWE1","description":"ICD-DFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKE0","description":"ICD-NAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67710","description":"Incision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOC0","description":"ICD-HBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg) Continuous Recording_ With Video When Performed_ Setup_ Patient Education_ And Takedown When Performed_ Administered In Person By Eeg Technologist_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95700","description":"Electroencephalogram (Eeg) Continuous Recording_ With Video When Performed_ Setup_ Patient Education_ And Takedown When Performed_ Administered In Person By Eeg Technologist_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQB0","description":"ICD-CGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES226","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure of nephrovisceral fistula (eg_ renocolic)_ including visceral repair; thoracic approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50526","description":"Closure of nephrovisceral fistula (eg_ renocolic)_ including visceral repair; thoracic approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art trnsposj carotid subclav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35695","description":"Art trnsposj carotid subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gen_ neuro_ non-hf rechg bat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1820","description":"Gen_ neuro_ non-hf rechg bat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seg pneumatic appli half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0669","description":"Seg pneumatic appli half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGD1","description":"ICD-OIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOD0","description":"ICD-DHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of foot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28020","description":"Exploration of foot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fosaprepitant injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1453","description":"Fosaprepitant injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB31","description":"ICD-4AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMA1","description":"ICD-EGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald telephone amplifier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5268","description":"Ald telephone amplifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHB0","description":"ICD-OHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQC0","description":"ICD-PKQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracorp shock wv tx ms nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019T","description":"Extracorp shock wv tx ms nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLD0","description":"ICD-KHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40520","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj reconstruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7858","description":"Tmj reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ABO GNOTYP ABO 7 EXONS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0180U","description":"ABO GNOTYP ABO 7 EXONS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 20 valent (PCV20)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90677","description":"Pneumococcal conjugate vaccine_ 20 valent (PCV20)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inlay composite/resin one su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2650","description":"Inlay composite/resin one su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55180","description":"Revision of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amitriptyline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6030","description":"Amitriptyline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCC1","description":"ICD-IFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55713","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","description":"CPT-55713","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth facial bone surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19251","description":"Anesth facial bone surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory setting substance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9475","description":"Ambulatory setting substance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKB0","description":"ICD-NGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVE1","description":"ICD-BIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIA1","description":"ICD-KAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34101","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97530","description":"Therapeutic activities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXB1","description":"ICD-FGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB21","description":"ICD-4CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVF0","description":"ICD-GAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA155","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levofloxacin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1956","description":"Levofloxacin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay clozapine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80159","description":"Drug assay clozapine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/con_stres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8928","description":"Tte w or w/o fol w/con_stres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0634U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0634U","description":"CPT-0634U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay rbc cholinesterase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82482","description":"Assay rbc cholinesterase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lat thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22532","description":"Lat thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gammagraft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4111","description":"Gammagraft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61522","description":"Removal of brain abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEA1","description":"ICD-OEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep c quant rna tstng docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3220F","description":"Hep c quant rna tstng docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYF0","description":"ICD-OJYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKE0","description":"ICD-JHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIE0","description":"ICD-IHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27691","description":"Revise lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAC0","description":"ICD-FEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNF0","description":"ICD-NKNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24666","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUD1","description":"ICD-MHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFD1","description":"ICD-NBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bed safety enclosure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0316","description":"Bed safety enclosure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not performing functional status (e.g._ patient is severely impaired and caregiver knowledge is limited_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9917","description":"Documentation of medical reason(s) for not performing functional status (e.g._ patient is severely impaired and caregiver knowledge is limited_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31365","description":"Removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUE0","description":"ICD-OGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac Output Measurement(S)_ Thermodilution Or Other Indicator Dilution Method_ Performed During Cardiac Catheterization For The Evaluation Of Congenital Heart Defects (List","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93598","description":"Cardiac Output Measurement(S)_ Thermodilution Or Other Indicator Dilution Method_ Performed During Cardiac Catheterization For The Evaluation Of Congenital Heart Defects (List","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBD0","description":"ICD-GHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap colectomy part w/ileum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44205","description":"Lap colectomy part w/ileum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ex for speech device rx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92608","description":"Ex for speech device rx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDA1","description":"ICD-MKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA21","description":"ICD-4EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFA1","description":"ICD-JFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJB1","description":"ICD-GIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pappa serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84163","description":"Pappa serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYB1","description":"ICD-PEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAC1","description":"ICD-JEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMD1","description":"ICD-IDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcochlear approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61596","description":"Transcochlear approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genetic counseling 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96040","description":"Genetic counseling 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDE1","description":"ICD-EBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFB1","description":"ICD-GHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRD0","description":"ICD-LFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXE0","description":"ICD-OGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD217","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37277","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","description":"CPT-37277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKB0","description":"ICD-GDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 20-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88245","description":"Chromosome analysis 20-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUD1","description":"ICD-KGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDD1","description":"ICD-GBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIA1","description":"ICD-JGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80400","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychia interven order","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4525F","description":"Neuropsychia interven order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVB1","description":"ICD-KFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysterectomy/bladder repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51925","description":"Hysterectomy/bladder repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANF0","description":"ICD-JANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCA1","description":"ICD-NKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos clin depres scrn f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8431","description":"Pos clin depres scrn f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quinupristin/dalfopristin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2770","description":"Quinupristin/dalfopristin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOD0","description":"ICD-GFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBED0","description":"ICD-JBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUE1","description":"ICD-AFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41010","description":"Incision of tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHD0","description":"ICD-OEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drop lock knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2182","description":"Drop lock knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of foot tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28230","description":"Incision of foot tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHB0","description":"ICD-JFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25425","description":"Repair/graft radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKD1","description":"ICD-FIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 25 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0348U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 25 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21A","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28A","description":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBB0","description":"ICD-KBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIF1","description":"ICD-FCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUF0","description":"ICD-MFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHE0","description":"ICD-KCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUF0","description":"ICD-MIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQA1","description":"ICD-GCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair humerus with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24435","description":"Repair humerus with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLB0","description":"ICD-ODLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSE1","description":"ICD-CCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13B","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB31","description":"ICD-3FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for electron microscopy_ diagnostic (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0856T","description":"Digitization of glass microscope slides for electron microscopy_ diagnostic (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXE0","description":"ICD-OJXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDE1","description":"ICD-CIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med txmnt options rvwd w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4325F","description":"Med txmnt options rvwd w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFC1","description":"ICD-OBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eardrum revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69450","description":"Eardrum revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whirlpool non-portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1310","description":"Whirlpool non-portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMB1","description":"ICD-NHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of toe tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28011","description":"Incision of toe tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDE1","description":"ICD-KEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst stg3-noprogress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9074","description":"Onc dx brst stg3-noprogress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHE0","description":"ICD-AFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01760","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","description":"CPT-01760","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDE1","description":"ICD-FDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0967T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","description":"CPT-0967T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27250","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual wc accessory_ handrim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2205","description":"Manual wc accessory_ handrim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVA0","description":"ICD-CGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interdental wiring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21497","description":"Interdental wiring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45303","description":"Proctosigmoidoscopy dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) dir CAR-positive T cells_ inc leukapheresis and dose prep procs_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2056","description":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) dir CAR-positive T cells_ inc leukapheresis and dose prep procs_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Cyclophosphamide_ (Auromedics)_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9087","description":"Injection_ Cyclophosphamide_ (Auromedics)_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLB1","description":"ICD-EHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vertical shock reducing pylo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5988","description":"Vertical shock reducing pylo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVF1","description":"ICD-BEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth testis exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92451","description":"Anesth testis exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAB1","description":"ICD-KGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0571U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","description":"CPT-0571U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Minor blunt trauma w/head ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9529","description":"Minor blunt trauma w/head ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnicore pro_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4298","description":"Amnicore pro_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27590","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Terbutaline sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3105","description":"Terbutaline sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Fixed Retainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8699","description":"Re-Cement Or Re-Bond Fixed Retainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl met band kafo-afo prox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4080","description":"Repl met band kafo-afo prox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arm pad each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0019","description":"Arm pad each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYC1","description":"ICD-OGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDB1","description":"ICD-OJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aud osseo dev_ abutment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8693","description":"Aud osseo dev_ abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUF1","description":"ICD-AAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC03","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTC1","description":"ICD-ECTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC11","description":"ICD-4JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87471","description":"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUE1","description":"ICD-CEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0627U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","description":"CPT-0627U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGB0","description":"ICD-OLGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Combination oral/nasal mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7027","description":"Combination oral/nasal mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWA0","description":"ICD-PEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEC1","description":"ICD-IBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bio imm resp mod presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9506","description":"Bio imm resp mod presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantation_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69716","description":"Implantation_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWB0","description":"ICD-KAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1901","description":"HCPCS-C1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJC1","description":"ICD-GBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLE1","description":"ICD-GBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFF1","description":"ICD-BBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ziconotide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2278","description":"Ziconotide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home sleep test/type 3 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0399","description":"Home sleep test/type 3 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0491U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","description":"CPT-0491U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELF1","description":"ICD-IELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAB0","description":"ICD-IDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQE1","description":"ICD-PAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBD1","description":"ICD-BHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJB0","description":"ICD-CFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIC0","description":"ICD-AIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUF0","description":"ICD-IIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spec collection for sev acute resp synd coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ from an ind in a SNF or by a lab on behalf of an HH agcy any spec srce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2024","description":"Spec collection for sev acute resp synd coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ from an ind in a SNF or by a lab on behalf of an HH agcy any spec srce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYC1","description":"ICD-PLYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAC1","description":"ICD-GEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ subsequent_ same hospital stay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31646","description":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ subsequent_ same hospital stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX36","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAB0","description":"ICD-OAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCA0","description":"ICD-MBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPD1","description":"ICD-CFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2281","description":"Injection_ moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXA0","description":"ICD-FCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUC1","description":"ICD-MHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rebound matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4296","description":"Rebound matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB06","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28111","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"LW GNOTYP ICAM4 EXON 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0197U","description":"LW GNOTYP ICAM4 EXON 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVD1","description":"ICD-BIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTA1","description":"ICD-BCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVE1","description":"ICD-FHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62115","description":"Reduction of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIED1","description":"ICD-AIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64891","description":"Nerve graft hand/foot >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITF1","description":"ICD-EITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2865","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","description":"HCPCS-J2865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJA0","description":"ICD-FAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTC0","description":"ICD-ABTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy control bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43227","description":"Esophagoscopy control bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1082T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1082T","description":"CPT-1082T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anogenital exam child w imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99170","description":"Anogenital exam child w imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTC0","description":"ICD-GGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDC1","description":"ICD-JHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTB1","description":"ICD-GBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTF0","description":"ICD-MHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8G","description":"Very High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQE1","description":"ICD-GBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5171","description":"HCPCS-Q5171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWF1","description":"ICD-DGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Cystoscopy/Transurethral Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0615","description":"Hospital Special Treatment Room Support Component (Hstrsc) Cystoscopy/Transurethral Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter intraoperative blood vessel microinfusion(s) (e.g._ intraluminal_ vascular wall and/or perivascular) ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9759","description":"Transcatheter intraoperative blood vessel microinfusion(s) (e.g._ intraluminal_ vascular wall and/or perivascular) ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCF0","description":"ICD-BHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTF1","description":"ICD-KHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28636","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; first 60 minutes (List separately in ad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96547","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; first 60 minutes (List separately in ad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat trigeminal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61790","description":"Treat trigeminal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso r fram soft pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0467","description":"Tlso r fram soft pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICB0","description":"ICD-CICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGB1","description":"ICD-GIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4032","description":"Cast sup lng leg ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mini-prop remote joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2312","description":"Mini-prop remote joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12C","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXD0","description":"ICD-FEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL60","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incontinence supply","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4335","description":"Incontinence supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj plantar digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64455","description":"N block inj plantar digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-aafi_ biosimilar_ (Nivestym)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5110","description":"Injection_ filgrastim-aafi_ biosimilar_ (Nivestym)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRD1","description":"ICD-DIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETD0","description":"ICD-AETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYD1","description":"ICD-LGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWF0","description":"ICD-CCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDB1","description":"ICD-MBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analysis of clinical data stored in computers (eg_ ECGs_ blood pressures_ hematologic data)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99090","description":"Analysis of clinical data stored in computers (eg_ ECGs_ blood pressures_ hematologic data)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate (Fresenius Kabi)_ not therapeutically equivalent to J1596_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1598","description":"Injection_ glycopyrrolate (Fresenius Kabi)_ not therapeutically equivalent to J1596_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chron care mgmt srvc 20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99490","description":"Chron care mgmt srvc 20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test socket shldr disart/tho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6684","description":"Test socket shldr disart/tho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABE0","description":"ICD-IABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debride genitalia & perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11004","description":"Debride genitalia & perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lens lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66830","description":"Removal of lens lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERF1","description":"ICD-OERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart first pass single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78481","description":"Heart first pass single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOA0","description":"ICD-CAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXE1","description":"ICD-CIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nhl stg unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9138","description":"Onc dx nhl stg unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRD0","description":"ICD-CIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp carotid-subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35606","description":"Art byp carotid-subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRB1","description":"ICD-LGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB124","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human papillomavirus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ 68)_ male urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0096U","description":"Human papillomavirus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ 68)_ male urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0527T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYA0","description":"ICD-HBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMB0","description":"ICD-IGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIED0","description":"ICD-GIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx bronchoscope/lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31624","description":"Dx bronchoscope/lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLC0","description":"ICD-OGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCA0","description":"ICD-JDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Finger tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26498","description":"Finger tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen-specific nucleic acid (DNA or RNA)_ 22 targets including severe acute respiratory syndrome corona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0223U","description":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen-specific nucleic acid (DNA or RNA)_ 22 targets including severe acute respiratory syndrome corona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of skull seams","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61552","description":"Release of skull seams","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Second level cer diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22858","description":"Second level cer diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolong clincl staff svc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99415","description":"Prolong clincl staff svc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth pharyngeal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17651","description":"Anesth pharyngeal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRA0","description":"ICD-KCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMB0","description":"ICD-GDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALB0","description":"ICD-AALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDC1","description":"ICD-EFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEA0","description":"ICD-FHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVF0","description":"ICD-JBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC21","description":"ICD-2GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTE0","description":"ICD-BHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXA0","description":"ICD-GIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAD1","description":"ICD-MIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETB0","description":"ICD-JETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rolapitant_ oral_ 1mg (Varubi)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9981","description":"Rolapitant_ oral_ 1mg (Varubi)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCB0","description":"ICD-EBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGME1","description":"ICD-KGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo supramalleolar custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1907","description":"Afo supramalleolar custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1901","description":"HCPCS-B1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBE1","description":"ICD-CIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9984","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Visual funct status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1055F","description":"Visual funct status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special eye exam subsequent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92226","description":"Special eye exam subsequent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVE1","description":"ICD-NDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPD0","description":"ICD-KHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth larynx/trach < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32651","description":"Anesth larynx/trach < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24516","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDE0","description":"ICD-KHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73620","description":"X-ray exam of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBA0","description":"ICD-KIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ketogenic steroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83582","description":"Assay of ketogenic steroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCA1","description":"ICD-CHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDC0","description":"ICD-MDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext breastprosthesis garment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8015","description":"Ext breastprosthesis garment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2209","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWF1","description":"ICD-GFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-52443","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","description":"CPT-52443","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTA1","description":"ICD-CCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHF1","description":"ICD-EGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1B","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit enteral pump diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9342","description":"Hit enteral pump diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo plastic pediatric size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2035","description":"Kafo plastic pediatric size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHB0","description":"ICD-MIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUB0","description":"ICD-BHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLA1","description":"ICD-OLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEND0","description":"ICD-CEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx contour defects 1.1-5.0cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11951","description":"Tx contour defects 1.1-5.0cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADD1","description":"ICD-FADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tricyclic & cyclicals 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80337","description":"Tricyclic & cyclicals 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJID0","description":"ICD-NJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27050","description":"Biopsy of sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phq-scr >9 doc in 12m time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9572","description":"Phq-scr >9 doc in 12m time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemipelvectomy canadian sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5341","description":"Hemipelvectomy canadian sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHA1","description":"ICD-JAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALA1","description":"ICD-KALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJB0","description":"ICD-JAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTF1","description":"ICD-JCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBB1","description":"ICD-IGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41899","description":"Dental surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ethanolamine oleate 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1430","description":"Ethanolamine oleate 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA21","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDF0","description":"ICD-JGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNE0","description":"ICD-JCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEE1","description":"ICD-MIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKF1","description":"ICD-CEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test hemidiaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95866","description":"Muscle test hemidiaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged Office Or Other Outpatient Evaluation And Management Service(S) Beyond The Minimum Required Time Of The Primary Procedure Which Has Been Selected Using Total Time_ R","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99417","description":"Prolonged Office Or Other Outpatient Evaluation And Management Service(S) Beyond The Minimum Required Time Of The Primary Procedure Which Has Been Selected Using Total Time_ R","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg_ thoracotomy_ transapical)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0484T","description":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg_ thoracotomy_ transapical)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin frct swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5812","description":"Endo knee-shin frct swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMA0","description":"ICD-CGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINF1","description":"ICD-GINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHC1","description":"ICD-CHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect apical lung tum/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32504","description":"Resect apical lung tum/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lipopro bld electrophoretic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83700","description":"Lipopro bld electrophoretic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXC0","description":"ICD-KDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABID0","description":"ICD-ABID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEC0","description":"ICD-OEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3D printing of a 3D dental surfacet scan","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0396","description":"3D printing of a 3D dental surfacet scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation applicator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5983","description":"Radiation applicator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disease modif pharmacothxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4540F","description":"Disease modif pharmacothxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immntx 2 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95131","description":"Immntx 2 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEF0","description":"ICD-KDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYA0","description":"ICD-PIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGC1","description":"ICD-OJGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC155","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIB0","description":"ICD-OEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj levocarnitine per 1 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1955","description":"Inj levocarnitine per 1 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMD0","description":"ICD-EGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNA1","description":"ICD-KFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ reslizumab_ 1 mg (Cinqair)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9481","description":"Injection_ reslizumab_ 1 mg (Cinqair)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIA1","description":"ICD-EHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYF1","description":"ICD-DFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33238","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECD0","description":"ICD-GECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBB0","description":"ICD-EIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB250","description":"Clinically Complex _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68705","description":"Revise tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epstein-barr nuclear antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86664","description":"Epstein-barr nuclear antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEC0","description":"ICD-MIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech threshold audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92555","description":"Speech threshold audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remov vertbr dcmprn thrclmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63087","description":"Remov vertbr dcmprn thrclmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins endovas vena cava filtr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37191","description":"Ins endovas vena cava filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALA1","description":"ICD-EALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6554","description":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEA0","description":"ICD-CIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJA1","description":"ICD-JIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAC0","description":"ICD-KBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKC0","description":"ICD-GBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGE0","description":"ICD-CGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYE1","description":"ICD-CEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood_ l/r_ froz/degly/wash","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9054","description":"Blood_ l/r_ froz/degly/wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQF0","description":"ICD-KAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Creatine mb fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82553","description":"Creatine mb fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGC0","description":"ICD-BGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove uro sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53446","description":"Remove uro sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB131","description":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp subclav-axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35616","description":"Art byp subclav-axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKF0","description":"ICD-FAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMF1","description":"ICD-ABMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFF1","description":"ICD-FFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening fentanyl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80354","description":"Drug screening fentanyl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEME1","description":"ICD-CEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home Adaptations (>$6_000)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0141","description":"Home Adaptations (>$6_000)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proton trmt intermediate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77523","description":"Proton trmt intermediate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6088","description":"Implant Supported Crown - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Endoscopic Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0616","description":"Hospital Special Treatment Room Support Component (Hstrsc) Endoscopic Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25B","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYE1","description":"ICD-DCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immediate breast prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19340","description":"Immediate breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARD1","description":"ICD-OARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTF0","description":"ICD-NLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High dose rate_electronic bracytherapy_ per fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0182T","description":"High dose rate_electronic bracytherapy_ per fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv eccrine glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64653","description":"Chemodenerv eccrine glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJA0","description":"ICD-NFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of finger tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26471","description":"Fusion of finger tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFE0","description":"ICD-JIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01402","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","description":"CPT-01402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATB1","description":"ICD-AATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHA0","description":"ICD-BCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis_ including fluoroscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0499T","description":"Cystourethroscopy_ with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis_ including fluoroscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy ureterolithotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50945","description":"Laparoscopy ureterolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE112","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENE0","description":"ICD-NENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYB0","description":"ICD-LIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of ankle bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28302","description":"Incision of ankle bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTC1","description":"ICD-KDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef hydrolyzed/amino acids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4153","description":"Ef hydrolyzed/amino acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEA0","description":"ICD-EEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ any specimen source","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2023","description":"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ any specimen source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNE1","description":"ICD-OKNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper gi endoscopy performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3130F","description":"Upper gi endoscopy performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29834","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins vag brachytx device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57156","description":"Ins vag brachytx device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manipulate finger w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26340","description":"Manipulate finger w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli_ Automated Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92650","description":"Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli_ Automated Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspirin or another antiplatelet therapy used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1055","description":"Aspirin or another antiplatelet therapy used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ventral hern init reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49560","description":"Rpr ventral hern init reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUB0","description":"ICD-GDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUF0","description":"ICD-ICUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No conformal radn thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4182F","description":"No conformal radn thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40816","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPB0","description":"ICD-KFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPA0","description":"ICD-NAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antibody testing for a public health related pathogen_ including coronavirus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0605","description":"Antibody testing for a public health related pathogen_ including coronavirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Approp digoxin tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4189F","description":"Approp digoxin tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKC1","description":"ICD-BAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo molded plas rig ant tib","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1945","description":"Afo molded plas rig ant tib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma)_ patients who are h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1018","description":"Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma)_ patients who are h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPD0","description":"ICD-OEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYF0","description":"ICD-CFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Docrsn for cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9264","description":"Docrsn for cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA55","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6195","description":"Abutment Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYD0","description":"ICD-CEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTC0","description":"ICD-GDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJF1","description":"ICD-NEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBC0","description":"ICD-BGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGA1","description":"ICD-OCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUD1","description":"ICD-IDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWA0","description":"ICD-HDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAE1","description":"ICD-MBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIF0","description":"ICD-KGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYA1","description":"ICD-CHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enteral feed sup kit grav by","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4036","description":"Enteral feed sup kit grav by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat tilt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1002","description":"Pwr seat tilt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deoxyribonucleic acid (DNA) antibody_ double stranded_ high avidity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0039U","description":"Deoxyribonucleic acid (DNA) antibody_ double stranded_ high avidity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFD0","description":"ICD-BCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4351","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","description":"HCPCS-Q4351","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPC1","description":"ICD-OHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEID1","description":"ICD-NEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth w/o gen/neurax anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4560F","description":"Anesth w/o gen/neurax anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMC1","description":"ICD-GFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54420","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJA0","description":"ICD-KHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28B","description":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ emicizumab-kxwh_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7170","description":"Injection_ emicizumab-kxwh_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUF1","description":"ICD-JHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore sinus remove polyps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31032","description":"Explore sinus remove polyps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Motor speech goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9186","description":"Motor speech goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impact tooth rem bony w/comp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7241","description":"Impact tooth rem bony w/comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tongue to lip surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41510","description":"Tongue to lip surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBC1","description":"ICD-NBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monovisc inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7327","description":"Monovisc inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Norsn no pros info op rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9303","description":"Norsn no pros info op rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGC1","description":"ICD-OFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reposition gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43761","description":"Reposition gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXC1","description":"ICD-BEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSF0","description":"ICD-PDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBF0","description":"ICD-AGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB50","description":"Very High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJC0","description":"ICD-JGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13C","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81520","description":"Oncology (breast)_ mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAD0","description":"ICD-JGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYB0","description":"ICD-GBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWA1","description":"ICD-PCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIA1","description":"ICD-IAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEF0","description":"ICD-CBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBME1","description":"ICD-IBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cva lumen obstruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75902","description":"Remove cva lumen obstruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX34","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert 1 electrode pm-defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33216","description":"Insert 1 electrode pm-defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCME1","description":"ICD-CCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD146","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care pl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9038","description":"Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care pl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35092","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sclerotx fluid collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49185","description":"Sclerotx fluid collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phenotype infect agent drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87900","description":"Phenotype infect agent drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost a/e ultlite mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7401","description":"Add ue prost a/e ultlite mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHE0","description":"ICD-CDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient lift sling or seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0621","description":"Patient lift sling or seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enema tube_ any type_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1013","description":"Enema tube_ any type_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vaginal endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95051","description":"Anesth vaginal endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDC1","description":"ICD-AGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHA0","description":"ICD-EIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB131","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/abn lvef b-bloc no rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8452","description":"Pt w/abn lvef b-bloc no rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical conference_ 60 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0221","description":"Medical conference_ 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHB1","description":"ICD-KHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct colonography dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74261","description":"Ct colonography dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75807","description":"Lymph vessel x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incis addl spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22216","description":"Incis addl spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCC1","description":"ICD-CDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVC0","description":"ICD-CDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJE1","description":"ICD-BIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJME0","description":"ICD-OJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Padding for comprssn bdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8430","description":"Padding for comprssn bdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15C","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Forearm/arm cuffs ext/flex a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3730","description":"Forearm/arm cuffs ext/flex a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOE1","description":"ICD-HGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFB1","description":"ICD-BIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tenolysis triceps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24332","description":"Tenolysis triceps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering influenza vaccine (e.g._ prior anaphylaxis due to the influenza vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1169","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g._ prior anaphylaxis due to the influenza vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD210","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE255","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALC1","description":"ICD-OALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKF1","description":"ICD-OHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQC0","description":"ICD-HFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAB0","description":"ICD-CEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ givosiran_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0223","description":"Injection_ givosiran_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61537","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Single visn sphere 4.12-7.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2101","description":"Single visn sphere 4.12-7.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhc slp ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0161","description":"Hhc slp ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVF0","description":"ICD-JAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRC0","description":"ICD-GGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSB0","description":"ICD-DFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair valve femoral vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34501","description":"Repair valve femoral vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cdifficile testing performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3520F","description":"Cdifficile testing performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9538","description":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1115","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert cath pleura w/ image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32557","description":"Insert cath pleura w/ image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18I","description":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBB1","description":"ICD-JEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGC1","description":"ICD-CCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESB0","description":"ICD-KESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) and SMN2 (survival of motor neuron 2_ centromeric) (eg_ spinal muscular atrophy) full gene analysis_ including small sequence chan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0236U","description":"SMN1 (survival of motor neuron 1_ telomeric) and SMN2 (survival of motor neuron 2_ centromeric) (eg_ spinal muscular atrophy) full gene analysis_ including small sequence chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interv req for leak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9306","description":"Interv req for leak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stab phleb veins xtr 10-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37765","description":"Stab phleb veins xtr 10-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tract frame attach footboard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0870","description":"Tract frame attach footboard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIA0","description":"ICD-GAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFB1","description":"ICD-JCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBA1","description":"ICD-BEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUE0","description":"ICD-GAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA21","description":"ICD-1CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth tubal ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85151","description":"Anesth tubal ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKE1","description":"ICD-NIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/abn lvef inelig b-bloc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8451","description":"Pt w/abn lvef inelig b-bloc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped complete soy based","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4159","description":"Ef ped complete soy based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAE0","description":"ICD-EFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nos flu vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2039","description":"Nos flu vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1036","description":"Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HTR2A (5-hydroxytryptamine receptor 2A)_ HTR2C (5-hydroxytryptamine receptor 2C) (eg_ citalopram metabolism) gene analysis_ common variants (ie_ HTR2A rs7997012 [c.614-2211T>C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0033U","description":"HTR2A (5-hydroxytryptamine receptor 2A)_ HTR2C (5-hydroxytryptamine receptor 2C) (eg_ citalopram metabolism) gene analysis_ common variants (ie_ HTR2A rs7997012 [c.614-2211T>C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHC0","description":"ICD-FGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLC0","description":"ICD-ABLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acute venous thrombus image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78456","description":"Acute venous thrombus image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1072","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","description":"HCPCS-J1072","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBB0","description":"ICD-IDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Co57/58","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9546","description":"Co57/58","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone srgry cmptr CT/MRI imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0055T","description":"Bone srgry cmptr CT/MRI imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBA1","description":"ICD-FDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJD1","description":"ICD-GAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Services provided as part of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9991","description":"Services provided as part of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUE0","description":"ICD-ICUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leukacyte transfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86950","description":"Leukacyte transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUB1","description":"ICD-NGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUA0","description":"ICD-GAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMD0","description":"ICD-OKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAC0","description":"ICD-MFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp femoral-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35661","description":"Art byp femoral-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUE0","description":"ICD-AHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61534","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIA1","description":"ICD-AFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC16","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHF0","description":"ICD-NIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB214","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixed patient lift system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0640","description":"Fixed patient lift system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHC1","description":"ICD-JEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01996","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","description":"CPT-01996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MOST_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4328","description":"MOST_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEA0","description":"ICD-OKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQD0","description":"ICD-KFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIB0","description":"ICD-FDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFED0","description":"ICD-EFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPA1","description":"ICD-OEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUC0","description":"ICD-AFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVE0","description":"ICD-GEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fimbrioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58760","description":"Fimbrioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDB0","description":"ICD-MHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIE0","description":"ICD-JAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27286","description":"Fusion of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEF0","description":"ICD-MCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Segmental pneumatic trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0656","description":"Segmental pneumatic trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFE0","description":"ICD-JGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLD1","description":"ICD-AHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9010","description":"Mccd_ risk adj_ level 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIB0","description":"ICD-JIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXF1","description":"ICD-FEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Using Multimodal Pain Management (E.G._ Allergy To Multiple Classes Of Analgesics_ Intubated Patient_ Hepatic Failure_ Patient Repor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2149","description":"Documentation Of Medical Reason(S) For Not Using Multimodal Pain Management (E.G._ Allergy To Multiple Classes Of Analgesics_ Intubated Patient_ Hepatic Failure_ Patient Repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/sac drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32659","description":"Thoracoscopy w/sac drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACE1","description":"ICD-GACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIID1","description":"ICD-FIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFB1","description":"ICD-GIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","description":"HCPCS-J3387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc of dsm-iv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9213","description":"No doc of dsm-iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHF0","description":"ICD-KIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0B","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOC1","description":"ICD-HCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA21","description":"Default_ /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9970","description":"Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTF0","description":"ICD-GFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRB0","description":"ICD-OFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIF1","description":"ICD-FGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home sleep test/type 2 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0398","description":"Home sleep test/type 2 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAE0","description":"ICD-OKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone_ lacrimal opthalamic insert_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9048","description":"Dexamethasone_ lacrimal opthalamic insert_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICE1","description":"ICD-FICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCA1","description":"ICD-ODCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Full length surg stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4510","description":"Full length surg stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQC1","description":"ICD-PBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant spine infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62362","description":"Implant spine infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAB1","description":"ICD-FFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aminolevulinic acid hcl for topical administration_ 10% gel_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7345","description":"Aminolevulinic acid hcl for topical administration_ 10% gel_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No reason for no hep c geno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9208","description":"No reason for no hep c geno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21432","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOB1","description":"ICD-LAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1069T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1069T","description":"CPT-1069T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGD0","description":"ICD-KIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBE1","description":"ICD-IIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ each additional 15 minutes_ provided remotely by hospital staff who are licensed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7902","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ each additional 15 minutes_ provided remotely by hospital staff who are licensed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHD0","description":"ICD-MLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFID1","description":"ICD-AFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cyanide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82600","description":"Assay of cyanide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25C","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDB0","description":"ICD-MDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27665","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscop ultrasound exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43231","description":"Esophagoscop ultrasound exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICF1","description":"ICD-BICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gi protein loss exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78282","description":"Gi protein loss exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLB0","description":"ICD-FBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15C","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2641","description":"Brachytx_ non-stranded_p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOE0","description":"ICD-HAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMD0","description":"ICD-NDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCD0","description":"ICD-BCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDE0","description":"ICD-AFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28435","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLE1","description":"ICD-OLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQF0","description":"ICD-DGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limb nerve surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64783","description":"Limb nerve surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRE0","description":"ICD-OKRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9959","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9959","description":"CDT-D9959","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth hernia repair < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83451","description":"Anesth hernia repair < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEB1","description":"ICD-EGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAE0","description":"ICD-NLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx vert fx w/o manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22310","description":"Closed tx vert fx w/o manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive chemotherapy in the last 14 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9848","description":"Patient did not receive chemotherapy in the last 14 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis (ie_ CYP1A2_ CYP2C19_ CYP2C9_ CYP2D6_ CYP3A4_ CYP3A5_ CYP4F2_ SLCO1B1_ VKORC1 and rs1277","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0029U","description":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis (ie_ CYP1A2_ CYP2C19_ CYP2C9_ CYP2D6_ CYP3A4_ CYP3A5_ CYP4F2_ SLCO1B1_ VKORC1 and rs1277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUF0","description":"ICD-FBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Placement of a custom removable clear plastic temporary aesthetic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9939","description":"Placement of a custom removable clear plastic temporary aesthetic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"General anesthesia_ first 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9222","description":"General anesthesia_ first 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0495U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","description":"CPT-0495U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fracture assessment via dxa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77086","description":"Fracture assessment via dxa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHID1","description":"ICD-IHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq card angio/athrect addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92925","description":"Prq card angio/athrect addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","description":"HCPCS-J3392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBB1","description":"ICD-JCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCC1","description":"ICD-GDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJB0","description":"ICD-OBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27664","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHF1","description":"ICD-KBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ preF_ recombinant subunit_ adjuvanted_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90679","description":"Respiratory syncytial virus vaccine_ preF_ recombinant subunit_ adjuvanted_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9395","description":"Injection_ fulvestrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L8697","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8697","description":"HCPCS-L8697","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Harvest cultured skin graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15040","description":"Harvest cultured skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2789","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2789","description":"HCPCS-J2789","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whfo w/o joints pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3807","description":"Whfo w/o joints pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXC0","description":"ICD-GBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDE0","description":"ICD-NGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEB0","description":"ICD-ACEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hair trnspl 1-15 punch grfts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15775","description":"Hair trnspl 1-15 punch grfts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDE1","description":"ICD-MEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTC0","description":"ICD-ECTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8G","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARA0","description":"ICD-HARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal Nativ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93596","description":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal Nativ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spacer with mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8101","description":"Spacer with mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHA1","description":"ICD-NJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of b hexosaminidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83080","description":"Assay of b hexosaminidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shrinker below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8440","description":"Shrinker below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQB1","description":"ICD-DDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ileoscopy_through stoma; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6018","description":"Ileoscopy_through stoma; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0369T","description":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUC1","description":"ICD-FHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPF1","description":"ICD-OAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYF0","description":"ICD-CBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHC1","description":"ICD-KIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD156","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFE1","description":"ICD-OGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67999","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Baclofen 10 mg injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0475","description":"Baclofen 10 mg injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFA1","description":"ICD-CFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYF1","description":"ICD-PGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75651","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNC1","description":"ICD-NCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28X","description":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUF1","description":"ICD-JAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht muscle image spect sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78451","description":"Ht muscle image spect sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Sage Health Management Solutions_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1009","description":"Clinical Decision Support Mechanism Sage Health Management Solutions_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear localization/abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78807","description":"Nuclear localization/abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJA0","description":"ICD-NEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCD0","description":"ICD-NKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAD1","description":"ICD-BBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27227","description":"Treat hip fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair paravag defect open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57284","description":"Repair paravag defect open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28F","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB25","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYC1","description":"ICD-KGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie_ previously diagnosed) tissue(s) for molecular analysis (eg_ KRAS mutational an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0847T","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie_ previously diagnosed) tissue(s) for molecular analysis (eg_ KRAS mutational an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc stage docd b/4 thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3300F","description":"Ajcc stage docd b/4 thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVF0","description":"ICD-KAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Below knee suction socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5647","description":"Below knee suction socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implnt_bon void filler-putty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9359","description":"Implnt_bon void filler-putty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNB1","description":"ICD-KBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOC1","description":"ICD-OIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shingrix vaccine was not administered for reasons documented by clinician (e.g._ patient administered vaccine other than Shingr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1065","description":"Shingrix vaccine was not administered for reasons documented by clinician (e.g._ patient administered vaccine other than Shingr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quant pupillometry w/rprt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0341T","description":"Quant pupillometry w/rprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA46","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2B","description":"Medium Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAF1","description":"ICD-OJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy orchiectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54690","description":"Laparoscopy orchiectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA21","description":"Medium Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trim skin lesions over 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11057","description":"Trim skin lesions over 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACB1","description":"ICD-NACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOF0","description":"ICD-DGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTC0","description":"ICD-JCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnio or biodmatrix_ inj 1cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4139","description":"Amnio or biodmatrix_ inj 1cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albumin; other source_ quantitative_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82042","description":"Albumin; other source_ quantitative_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ low complexity_ requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An exami","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97169","description":"Athletic training evaluation_ low complexity_ requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An exami","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01502","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","description":"CPT-01502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYA0","description":"ICD-CEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61581","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBF0","description":"ICD-KDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWC0","description":"ICD-ODWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHD1","description":"ICD-JHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARF1","description":"ICD-DARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7504","description":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTF0","description":"ICD-MKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37284","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","description":"CPT-37284","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVE0","description":"ICD-OIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTF0","description":"ICD-FCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA115","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28760","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27886","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXE1","description":"ICD-CGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVB0","description":"ICD-FDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEF1","description":"ICD-NLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXC1","description":"ICD-BCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE234","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAA1","description":"ICD-KEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIF0","description":"ICD-MKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myringotomy laser-assist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2225","description":"Myringotomy laser-assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLB1","description":"ICD-EDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC31","description":"ICD-4LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITB0","description":"ICD-IITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA CLOSTRIDIUM DIFFICILE TOXIN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87324","description":"IAAD IA CLOSTRIDIUM DIFFICILE TOXIN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBE0","description":"ICD-GEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lipid profile not perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8728","description":"Lipid profile not perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVA0","description":"ICD-FHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVA0","description":"ICD-GFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLA1","description":"ICD-EHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTB0","description":"ICD-NKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGA1","description":"ICD-GCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIA1","description":"ICD-FGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0303","description":"HCPCS-A0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCB1","description":"ICD-MHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01650","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","description":"CPT-01650","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrst mld sck flx hng tri pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6050","description":"Wrst mld sck flx hng tri pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVF0","description":"ICD-NBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0082","description":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCB1","description":"ICD-IHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Image cath fluid peri/retro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49406","description":"Image cath fluid peri/retro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFC0","description":"ICD-BEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonpowered pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0373","description":"Nonpowered pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOC1","description":"ICD-GBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTF1","description":"ICD-NBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATB0","description":"ICD-OATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKB1","description":"ICD-OJKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of knee ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27405","description":"Repair of knee ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trb@ gene rearrange amplify","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81340","description":"Trb@ gene rearrange amplify","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISD1","description":"ICD-CISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTD1","description":"ICD-ADTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including MR guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10011","description":"Fine needle aspiration biopsy_ including MR guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAE0","description":"ICD-FAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVC1","description":"ICD-CIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Measure venous pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93770","description":"Measure venous pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHD1","description":"ICD-MAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lithium batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4235","description":"Lithium batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pcv13 vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90670","description":"Pcv13 vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAC1","description":"ICD-OIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHB1","description":"ICD-KBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYC0","description":"ICD-DDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Approp oral rehyd recommd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4056F","description":"Approp oral rehyd recommd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21B","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject pulm art hrt cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93568","description":"Inject pulm art hrt cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11422","description":"Exc h-f-nk-sp b9+marg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUB1","description":"ICD-FGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTA0","description":"ICD-MCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNB1","description":"ICD-OLNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"INJECTION_ OCRELIZUMAB_ 1 MG (OCREVUS)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9494","description":"INJECTION_ OCRELIZUMAB_ 1 MG (OCREVUS)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHA1","description":"ICD-NEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPD0","description":"ICD-NLPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA256","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5160","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","description":"HCPCS-Q5160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (neoplasia)_ exome and transcriptome sequence analysis for sequence variants_ gene copy number amplifications and deletions_ gene rearrangements_ microsatellite insta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0329U","description":"Oncology (neoplasia)_ exome and transcriptome sequence analysis for sequence variants_ gene copy number amplifications and deletions_ gene rearrangements_ microsatellite insta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXF0","description":"ICD-CGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGA1","description":"ICD-CGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPB1","description":"ICD-BFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nipple Prosthesis_ Custom Fabricated_ Reusable_ Any Material_ Any Type_ Each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8033","description":"Nipple Prosthesis_ Custom Fabricated_ Reusable_ Any Material_ Any Type_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCD0","description":"ICD-FFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pralidoxime chloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2730","description":"Pralidoxime chloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures rebase part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5721","description":"Dentures rebase part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5156","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","description":"HCPCS-Q5156","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECD1","description":"ICD-EECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTE0","description":"ICD-GFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANE1","description":"ICD-FANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE144","description":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEC1","description":"ICD-JHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADB0","description":"ICD-EADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOA0","description":"ICD-PLOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ionm in operatng room 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95940","description":"Ionm in operatng room 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain external ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69000","description":"Drain external ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGED1","description":"ICD-JGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric speech aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5952","description":"Pediatric speech aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate inf turbinate superf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30801","description":"Ablate inf turbinate superf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLF1","description":"ICD-NHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantable access syst perc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4301","description":"Implantable access syst perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJA0","description":"ICD-GHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAB1","description":"ICD-NCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWD1","description":"ICD-CGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB155","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCF1","description":"ICD-IGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Polysom <6 yrs 4/> paramtrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95782","description":"Polysom <6 yrs 4/> paramtrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29823","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNB0","description":"ICD-OKNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFA1","description":"ICD-OIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUB1","description":"ICD-KEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJC1","description":"ICD-JFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13132","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prkns diag rviewed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1400F","description":"Prkns diag rviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAD0","description":"ICD-CGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFF0","description":"ICD-CCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy irrigation set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4400","description":"Ostomy irrigation set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49618","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81415","description":"Exome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spec site no lung","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9420","description":"Spec site no lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEC0","description":"ICD-ECEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEF0","description":"ICD-FEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBA0","description":"ICD-NKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8953","description":"Oncology mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTD1","description":"ICD-EHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multi-position stnd fram sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0641","description":"Multi-position stnd fram sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMC1","description":"ICD-OFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIA0","description":"ICD-IAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAE1","description":"ICD-KGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACA1","description":"ICD-FACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWC1","description":"ICD-ODWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bile duct tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47712","description":"Excision of bile duct tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARC0","description":"ICD-OARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBA1","description":"ICD-KHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYA1","description":"ICD-HGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEC0","description":"ICD-JDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLC1","description":"ICD-MFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ant fusion 2-3 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22808","description":"Ant fusion 2-3 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-52597","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","description":"CPT-52597","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAF1","description":"ICD-NKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPC0","description":"ICD-NFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEE0","description":"ICD-MDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ linezolid (hospira) not therapeutically equivalent to j2020_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2021","description":"Injection_ linezolid (hospira) not therapeutically equivalent to j2020_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBD1","description":"ICD-CIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15941","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHC1","description":"ICD-EAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMF0","description":"ICD-ECMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hzv vaccine live subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90736","description":"Hzv vaccine live subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upgrade of pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33214","description":"Upgrade of pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Refer to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9524","description":"Refer to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPC0","description":"ICD-GFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQB1","description":"ICD-CHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSB1","description":"ICD-OCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADC1","description":"ICD-FADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23A","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPC1","description":"ICD-BCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9803","description":"Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSD0","description":"ICD-OKSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ureter lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51535","description":"Repair of ureter lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTD0","description":"ICD-GHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cftr gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81223","description":"Cftr gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01920","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","description":"CPT-01920","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXD1","description":"ICD-OKXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX23","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXB0","description":"ICD-JGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAF0","description":"ICD-CCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJC1","description":"ICD-JAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFC1","description":"ICD-CEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMB0","description":"ICD-FHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELF0","description":"ICD-GELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj cutting into joint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7860","description":"Tmj cutting into joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation heart device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93640","description":"Evaluation heart device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tract frame attach headboard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0840","description":"Tract frame attach headboard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray stress view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77071","description":"X-ray stress view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tub stool or bench","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0245","description":"Tub stool or bench","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTC0","description":"ICD-KDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asthma risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2016F","description":"Asthma risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUC1","description":"ICD-FCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12B","description":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test_ or patient has a reactive hcv antibody test and has a follow up hcv viral test that dete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1230","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test_ or patient has a reactive hcv antibody test and has a follow up hcv viral test that dete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIA0","description":"ICD-OHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWA1","description":"ICD-HEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIA1","description":"ICD-FAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXC0","description":"ICD-JIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42831","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulm function test by gas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94727","description":"Pulm function test by gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGE0","description":"ICD-NCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dent sutur recent wnd to 5cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7910","description":"Dent sutur recent wnd to 5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multiple family group psytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90849","description":"Multiple family group psytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTD1","description":"ICD-KCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosth retina receive&gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0100T","description":"Prosth retina receive&gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICF0","description":"ICD-AICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIID0","description":"ICD-JIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert i-aort percut device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33967","description":"Insert i-aort percut device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQA0","description":"ICD-LCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPF1","description":"ICD-GGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYB1","description":"ICD-OHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lever-activated wheel drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0988","description":"Lever-activated wheel drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gen use back cush wdth <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2611","description":"Gen use back cush wdth <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGB0","description":"ICD-BGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28570","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJD0","description":"ICD-OFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWB0","description":"ICD-DDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36011","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd dilate stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43245","description":"Egd dilate stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmprsburngrmnt glove-axilla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6506","description":"Cmprsburngrmnt glove-axilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNB1","description":"ICD-FHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99245","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCB1","description":"ICD-MGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQE0","description":"ICD-DEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTC0","description":"ICD-JDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8914","description":"Mra w/o fol w/cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRA0","description":"ICD-OJRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSC0","description":"ICD-HFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neonate crit care subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99469","description":"Neonate crit care subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerv flex n/adj foam pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0120","description":"Cerv flex n/adj foam pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late closure of wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13160","description":"Late closure of wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRF1","description":"ICD-LHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17286","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMF1","description":"ICD-BDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of toe lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28108","description":"Removal of toe lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5136","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","description":"HCPCS-Q5136","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA31","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX34","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPD0","description":"ICD-GEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01991","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","description":"CPT-01991","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anchor/screw bn/bn_tis/bn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1713","description":"Anchor/screw bn/bn_tis/bn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43888","description":"Change gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFD1","description":"ICD-BCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fev <40% predicted value","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3040F","description":"Fev <40% predicted value","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKC0","description":"ICD-FBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHF0","description":"ICD-AEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEC1","description":"ICD-JDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6023","description":"Sigmoidoscopy_ flexible; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Splice spleen/kidney veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37181","description":"Splice spleen/kidney veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXC1","description":"ICD-CAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection abdominal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49427","description":"Injection abdominal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE204","description":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indwelling catheter special","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4340","description":"Indwelling catheter special","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYC0","description":"ICD-OKYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLC1","description":"ICD-NLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18I","description":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERF1","description":"ICD-HERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEF1","description":"ICD-FDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9702","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLF0","description":"ICD-NFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWB1","description":"ICD-LBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB05","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21120","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt referral psych docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4062F","description":"Pt referral psych docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRC0","description":"ICD-CBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJID1","description":"ICD-MJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL25","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00938","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","description":"CPT-00938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogen_ semiquantitative identification_ DNA from 16 bacterial organisms and 1 fungal organism_ multip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0371U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogen_ semiquantitative identification_ DNA from 16 bacterial organisms and 1 fungal organism_ multip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/replace ur sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53447","description":"Remove/replace ur sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20D","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLB0","description":"ICD-ICLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC54","description":"Medium Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Maxillofacial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5999","description":"Maxillofacial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES101","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUB0","description":"ICD-MBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retrograde filling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3430","description":"Retrograde filling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFA1","description":"ICD-NJFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSD1","description":"ICD-PDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAD1","description":"ICD-IFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVF1","description":"ICD-GIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC212","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glucose blood test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82962","description":"Glucose blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31080","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCE0","description":"ICD-MGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 3999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4724","description":"Dialys sol fld vol > 3999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gliadin (Deamidated) (Dgp) Antibody_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86258","description":"Gliadin (Deamidated) (Dgp) Antibody_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUA0","description":"ICD-IDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYE0","description":"ICD-PKYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB101","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVC0","description":"ICD-GBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLE1","description":"ICD-KDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFB0","description":"ICD-BDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXC1","description":"ICD-KDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33364","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1301","description":"HCPCS-C1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recorder without 24 hour attended moni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0497T","description":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recorder without 24 hour attended moni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUC1","description":"ICD-KFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray bend only l-s spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72120","description":"X-ray bend only l-s spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQA0","description":"ICD-LGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB114","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; initial wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0512T","description":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; initial wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10C","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXB1","description":"ICD-GFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24D","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWA1","description":"ICD-OJWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photodynmc tx 30 min add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96570","description":"Photodynmc tx 30 min add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQC1","description":"ICD-HGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2A","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBA0","description":"ICD-ICBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0681","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","description":"HCPCS-J0681","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABB0","description":"ICD-IABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54700","description":"Drainage of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shrt leg plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4037","description":"Cast sup shrt leg plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDF0","description":"ICD-NJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"L colectomy/coloproctostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44208","description":"L colectomy/coloproctostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fx radial 3+ frag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25609","description":"Treat fx radial 3+ frag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39499","description":"Chest procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBD0","description":"ICD-CDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIB0","description":"ICD-FEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas on statin or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9507","description":"Doc reas on statin or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHC0","description":"ICD-ADHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis access study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90940","description":"Hemodialysis access study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tacrol astagraf ex rel oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7508","description":"Tacrol astagraf ex rel oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHE0","description":"ICD-GHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUC1","description":"ICD-KBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brentuximab vedotin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9042","description":"Brentuximab vedotin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allergy immunology services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95199","description":"Allergy immunology services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHID0","description":"ICD-NHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHA0","description":"ICD-JEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28I","description":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB116","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJA0","description":"ICD-FEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0189T","description":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phoenix wound matrix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2015","description":"Phoenix wound matrix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool withi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1045","description":"Functional status measurement with score was obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool withi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0825T","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIE0","description":"ICD-OBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tourniquet for dialysis_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4929","description":"Tourniquet for dialysis_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADB1","description":"ICD-IADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFB0","description":"ICD-CDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHB0","description":"ICD-AEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLC0","description":"ICD-CCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSE1","description":"ICD-HBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRF0","description":"ICD-ODRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rural health clinic or federally qualified health center (RHC/FQHC) only_ psychiatric collaborative care model (psychiatric COCM)_ 60 minutes or more of clinical staff time fo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0512","description":"Rural health clinic or federally qualified health center (RHC/FQHC) only_ psychiatric collaborative care model (psychiatric COCM)_ 60 minutes or more of clinical staff time fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 1","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA26","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18A","description":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHD1","description":"ICD-MJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQA1","description":"ICD-LDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33417","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLD1","description":"ICD-NJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDD1","description":"ICD-NIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy)_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9908","description":"Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy)_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHB0","description":"ICD-IEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMA1","description":"ICD-ICMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETB1","description":"ICD-AETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBF1","description":"ICD-KEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Barrera sl or barrera dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4281","description":"Barrera sl or barrera dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINB0","description":"ICD-JINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPE1","description":"ICD-CDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILC0","description":"ICD-IILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45341","description":"Sigmoidoscopy w/ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vital capacity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94150","description":"Vital capacity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33999","description":"Cardiac surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoglobulin paraprotein (M-protein)_ qualitative_ immunoprecipitation and mass spectrometry_ blood or urine_ including isotype","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0077U","description":"Immunoglobulin paraprotein (M-protein)_ qualitative_ immunoprecipitation and mass spectrometry_ blood or urine_ including isotype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKA1","description":"ICD-ODKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCC1","description":"ICD-AHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression glove_ custom_ medium weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6579","description":"Gradient compression glove_ custom_ medium weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLF0","description":"ICD-MLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOC0","description":"ICD-DGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVA0","description":"ICD-NDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXE1","description":"ICD-NLXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQA1","description":"ICD-KAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEA1","description":"ICD-CDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCME1","description":"ICD-NCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meningococcal pentavalent vaccine_ conjugated Men A_ C_ W_ Y- tetanus toxoid carrier_ and Men B-FHbp_ for intracmuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90623","description":"Meningococcal pentavalent vaccine_ conjugated Men A_ C_ W_ Y- tetanus toxoid carrier_ and Men B-FHbp_ for intracmuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVD0","description":"ICD-BEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not recvng antiv hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4151F","description":"Pt not recvng antiv hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYA1","description":"ICD-OLYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIC1","description":"ICD-OBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOE0","description":"ICD-CHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28B","description":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDE0","description":"ICD-BGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","description":"HCPCS-Q4414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tumor immunohistochem/manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88360","description":"Tumor immunohistochem/manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4383","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","description":"HCPCS-Q4383","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASE1","description":"ICD-DASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myelogphy 2/> spine regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72270","description":"Myelogphy 2/> spine regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDA0","description":"ICD-ICDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACE1","description":"ICD-JACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonstnd lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0581","description":"Nonstnd lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ilr device interrogate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93291","description":"Ilr device interrogate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eo rigid w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3762","description":"Eo rigid w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUD1","description":"ICD-BFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26841","description":"Fusion of thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSF1","description":"ICD-PBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft subclav-axilary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35516","description":"Art byp grft subclav-axilary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOC0","description":"ICD-GBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc acc_ lith-based battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2397","description":"Pwc acc_ lith-based battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHF0","description":"ICD-ICHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w iv ab not given on time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8917","description":"Pt w iv ab not given on time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKA1","description":"ICD-FIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPE1","description":"ICD-CGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPE1","description":"ICD-GCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of skin abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10060","description":"Drainage of skin abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWC1","description":"ICD-GDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASD1","description":"ICD-OASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8046","description":"Partial facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKE1","description":"ICD-CAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1439","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","description":"HCPCS-M1439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFA1","description":"ICD-NGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEA0","description":"ICD-CAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBD0","description":"ICD-ABBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUB0","description":"ICD-JCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2472","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","description":"HCPCS-J2472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLD1","description":"ICD-IBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8C","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthodontic treatment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8690","description":"Orthodontic treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNB0","description":"ICD-NLNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Water circ heat pad w pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0217","description":"Water circ heat pad w pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVC1","description":"ICD-JHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88000","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain stem w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70551","description":"MRI brain stem w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Delay flap trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15600","description":"Delay flap trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAA1","description":"ICD-FGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil (Aristada Initio)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9035","description":"Injection_ aripiprazole lauroxil (Aristada Initio)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endodontic endosseous implan","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3460","description":"Endodontic endosseous implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITB1","description":"ICD-CITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1097","description":"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYC1","description":"ICD-OHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","description":"CPT-92930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88154","description":"Cytopath c/v select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEB0","description":"ICD-JGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2596","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","description":"HCPCS-J2596","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVE1","description":"ICD-FEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDF0","description":"ICD-OLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEA0","description":"ICD-FCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWF1","description":"ICD-OGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTB0","description":"ICD-GFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS BE ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87350","description":"IAAD IA HEPATITIS BE ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft carotid-brchial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35510","description":"Art byp grft carotid-brchial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKD1","description":"ICD-CFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightweight leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1270","description":"Wheelchair lightweight leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of breath ethanol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82075","description":"Assay of breath ethanol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC11","description":"ICD-4AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWB1","description":"ICD-LIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8X","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB134","description":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1319","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Optokinetic nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92534","description":"Optokinetic nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMA1","description":"ICD-EDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJF1","description":"ICD-BBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leads any type vad_ rep only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0487","description":"Leads any type vad_ rep only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANC0","description":"ICD-FANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTA0","description":"ICD-EGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ash fibrosure (tm)_ labcorp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002M","description":"Ash fibrosure (tm)_ labcorp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIB0","description":"ICD-BGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFD0","description":"ICD-BFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1B","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLB0","description":"ICD-BBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18A","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mitochondrial gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81440","description":"Mitochondrial gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mrs disc pain transmis data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0610T","description":"Mrs disc pain transmis data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3B","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30450","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHB1","description":"ICD-OFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBF0","description":"ICD-MHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare sh","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA16","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous rf vein add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36476","description":"Endovenous rf vein add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Powered w/c cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2610","description":"Powered w/c cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQE0","description":"ICD-LHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ pmkr_ other than trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1898","description":"Lead_ pmkr_ other than trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOF1","description":"ICD-OAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea stm ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0426T","description":"Insj/rplc nstim apnea stm ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQE1","description":"ICD-OJQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTB1","description":"ICD-JBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92652","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEA1","description":"ICD-AFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"2 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4207","description":"2 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSD0","description":"ICD-OJSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62269","description":"Needle biopsy spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAID1","description":"ICD-AAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compression bandage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8431","description":"Compression bandage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWD0","description":"ICD-DFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPB0","description":"ICD-FDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJF1","description":"ICD-OAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDED0","description":"ICD-FDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBC0","description":"ICD-MKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1604","description":"HCPCS-A1604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28A","description":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","description":"HCPCS-M1386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXC1","description":"ICD-GBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA204","description":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove mandible cyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21046","description":"Remove mandible cyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBE1","description":"ICD-FBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHME1","description":"ICD-FHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPD1","description":"ICD-FAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKD0","description":"ICD-CIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0020","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC221","description":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspirin recvd w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4084F","description":"Aspirin recvd w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDA1","description":"ICD-GEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Io ga n-stim subsq w/reprog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95982","description":"Io ga n-stim subsq w/reprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUD0","description":"ICD-CCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASD0","description":"ICD-KASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDND1","description":"ICD-GDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC30","description":"Medium Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGB1","description":"ICD-JBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8564","description":"Pt ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-inhalation drug for dme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7799","description":"Non-inhalation drug for dme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Loxapine for inhalation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2062","description":"Loxapine for inhalation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anabolic steroid 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80327","description":"Anabolic steroid 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILF0","description":"ICD-EILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJB1","description":"ICD-FGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism_ Qualified Tool Not Otherwise Specified_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1011","description":"Clinical Decision Support Mechanism_ Qualified Tool Not Otherwise Specified_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy w/bx & op scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31536","description":"Laryngoscopy w/bx & op scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including frontal sinus exploration_ with removal of tissue from frontal sinus_ when perfor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31253","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including frontal sinus exploration_ with removal of tissue from frontal sinus_ when perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sales tax","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9999","description":"Sales tax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21A","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC140","description":"Reduced Physical Function _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUD0","description":"ICD-OKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99217","description":"Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVC1","description":"ICD-CEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHE0","description":"ICD-OEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAE1","description":"ICD-NBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infusion pump_ non-prog_temp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2626","description":"Infusion pump_ non-prog_temp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AJCC stage at breast cancer diagnosis = I (Ia or Ib) and T-stage at breast cancer diagnosis does not equal = T1_ T1a_ T1b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9832","description":"AJCC stage at breast cancer diagnosis = I (Ia or Ib) and T-stage at breast cancer diagnosis does not equal = T1_ T1a_ T1b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEA1","description":"ICD-AHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKC1","description":"ICD-CHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHC0","description":"ICD-GEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25B","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69801","description":"Incise inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOD0","description":"ICD-DDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOF1","description":"ICD-CIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELB1","description":"ICD-GELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSA1","description":"ICD-HGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATE1","description":"ICD-GATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCD0","description":"ICD-EGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health risk assessment test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99420","description":"Health risk assessment test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrocardiogram complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93000","description":"Electrocardiogram complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWE0","description":"ICD-OAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8F","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFD1","description":"ICD-CGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEC0","description":"ICD-BCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA45","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92642","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","description":"CPT-92642","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBE0","description":"ICD-EDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/replace penis prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54410","description":"Remove/replace penis prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTE1","description":"ICD-ACTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal foreign body jawbone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41806","description":"Removal foreign body jawbone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ dom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0077","description":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ dom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHE1","description":"ICD-JDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPF1","description":"ICD-GEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCF1","description":"ICD-NKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15012","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","description":"CPT-15012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIED0","description":"ICD-BIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64784","description":"Remove nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) (list separately in addition to code for primary procedure(s))","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31620","description":"Endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) (list separately in addition to code for primary procedure(s))","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE126","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAB1","description":"ICD-IFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech audiom thresh & recog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0211T","description":"Speech audiom thresh & recog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIB0","description":"ICD-JGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary Disease (Idiopathic Pulmonary Fibrosis [Ipf])_ Mrna_ Gene Expression Analysis Of 190 Genes_ Utilizing Transbronchial Biopsies_ Diagnostic Algorithm Reported As Categ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81554","description":"Pulmonary Disease (Idiopathic Pulmonary Fibrosis [Ipf])_ Mrna_ Gene Expression Analysis Of 190 Genes_ Utilizing Transbronchial Biopsies_ Diagnostic Algorithm Reported As Categ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHC1","description":"ICD-JFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHE0","description":"ICD-FEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAF1","description":"ICD-GIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comm trans waiver/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2038","description":"Comm trans waiver/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLF1","description":"ICD-BDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGB0","description":"ICD-FHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDA1","description":"ICD-FDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BMI is documented as being outside of normal limits_ follow-up plan is not completed for documented reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9716","description":"BMI is documented as being outside of normal limits_ follow-up plan is not completed for documented reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTF0","description":"ICD-GGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual fully reclining back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1226","description":"Manual fully reclining back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33935","description":"Transplantation heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVF1","description":"ICD-FCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQC1","description":"ICD-CFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE204","description":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6122","description":"Implant Supported Retainer For Metal Fpd - Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFND1","description":"ICD-NFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTD1","description":"ICD-KDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom shoes depth inlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3230","description":"Custom shoes depth inlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; Each Additional 50 Cc Injectate_ Or Part Thereof (List Separately In","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15772","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; Each Additional 50 Cc Injectate_ Or Part Thereof (List Separately In","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXF1","description":"ICD-OLXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria lmtd endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33265","description":"Ablate atria lmtd endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 9 PFAS compounds by LC-MS/MS_ plasma or serum_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0457U","description":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 9 PFAS compounds by LC-MS/MS_ plasma or serum_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISD1","description":"ICD-HISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymph choriomeningitis ab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86727","description":"Lymph choriomeningitis ab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB111","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86451","description":"Anesth removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUB1","description":"ICD-FAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEF0","description":"ICD-CCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRE0","description":"ICD-KDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hgb lvl >/= 13 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3279F","description":"Hgb lvl >/= 13 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stainless steel any wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6630","description":"Stainless steel any wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAB1","description":"ICD-GDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46999","description":"Anus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHA0","description":"ICD-GAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKC1","description":"ICD-NIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWF0","description":"ICD-PLWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICA1","description":"ICD-OICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJF1","description":"ICD-BAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABC0","description":"ICD-EABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSD1","description":"ICD-KCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCC1","description":"ICD-FGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61601","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERB0","description":"ICD-CERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGA0","description":"ICD-FFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXA1","description":"ICD-JAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20C","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOE1","description":"ICD-CEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLD0","description":"ICD-EBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAC0","description":"ICD-NFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCC0","description":"ICD-IGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXF0","description":"ICD-NDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue localization-excision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1819","description":"Tissue localization-excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAE1","description":"ICD-OJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBB1","description":"ICD-EGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0656U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0656U","description":"CPT-0656U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNC1","description":"ICD-GGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGA0","description":"ICD-OLGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjust wrist ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1805","description":"Adjust wrist ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8D","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45308","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18C","description":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38500","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; osteoarticular_ including articular surface and contiguous bone (List separately in a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20932","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; osteoarticular_ including articular surface and contiguous bone (List separately in a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4021","description":"Orthopedic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAC0","description":"ICD-OEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEC1","description":"ICD-NDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEB1","description":"ICD-KEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit est age 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99392","description":"Prev visit est age 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place cath carotid/inom art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36223","description":"Place cath carotid/inom art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIF1","description":"ICD-GEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXE0","description":"ICD-BGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; read by instrument assisted direct optical observation (eg_ utilizing immunoassay [","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80306","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; read by instrument assisted direct optical observation (eg_ utilizing immunoassay [","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIC0","description":"ICD-KIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWE1","description":"ICD-GCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8920","description":"Mra w/o fol w/cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMD0","description":"ICD-CAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRE0","description":"ICD-LCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYA0","description":"ICD-PHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASE1","description":"ICD-HASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDF0","description":"ICD-CFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKF1","description":"ICD-CIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of toe joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28272","description":"Release of toe joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9313","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9313","description":"HCPCS-C9313","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92993","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gallium ga-68_ dotatoc_ diagnostic_ 0.01 mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9067","description":"Gallium ga-68_ dotatoc_ diagnostic_ 0.01 mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBC0","description":"ICD-AGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tacrolimus injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7525","description":"Tacrolimus injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA235","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRB1","description":"ICD-OFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUA1","description":"ICD-OKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow molded w/ expand inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6205","description":"Elbow molded w/ expand inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIE1","description":"ICD-BFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQA1","description":"ICD-OKQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Legg perthes orthosis trilat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1720","description":"Legg perthes orthosis trilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIE0","description":"ICD-CHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXE1","description":"ICD-FDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20200","description":"Muscle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1471","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","description":"HCPCS-M1471","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gonadotropin hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80426","description":"Gonadotropin hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser tx skin >500 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96922","description":"Laser tx skin >500 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWE0","description":"ICD-LCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIE0","description":"ICD-IGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00902","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","description":"CPT-00902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multidisciplinary care plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0580F","description":"Multidisciplinary care plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.00d/>6.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2106","description":"Spherocylinder 4.00d/>6.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFD1","description":"ICD-GAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33641","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suicide risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3085F","description":"Suicide risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXC0","description":"ICD-NGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXA1","description":"ICD-NHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHME1","description":"ICD-CHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWA1","description":"ICD-CHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVA1","description":"ICD-KEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJD0","description":"ICD-JBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NEURO MUSC DYS DMD SEQ ALYS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0218U","description":"NEURO MUSC DYS DMD SEQ ALYS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6058","description":"Abutment supported crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVE1","description":"ICD-OKVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ntiol category 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q1004","description":"Ntiol category 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOD0","description":"ICD-PFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGA1","description":"ICD-GEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC21","description":"ICD-3LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQA1","description":"ICD-LFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I125 iothalamate_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9554","description":"I125 iothalamate_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 30-60 minutes_ provided remotely by hospital staff who are licensed to pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7901","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 30-60 minutes_ provided remotely by hospital staff who are licensed to pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSD1","description":"ICD-OGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBA0","description":"ICD-MJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corneal trnspl endothelial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65756","description":"Corneal trnspl endothelial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIB1","description":"ICD-MEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICF0","description":"ICD-IICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCD1","description":"ICD-FGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject r ventr/atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93566","description":"Inject r ventr/atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDE1","description":"ICD-OLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dihydrocodeinone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6045","description":"Dihydrocodeinone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ anesthetic agent; spinal accessory nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64412","description":"Injection_ anesthetic agent; spinal accessory nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronidase recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3473","description":"Hyaluronidase recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysterectomy/revise vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58275","description":"Hysterectomy/revise vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth bladder stone surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87051","description":"Anesth bladder stone surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPE0","description":"ICD-GFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEC0","description":"ICD-NIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-2 quant&revrse trnscripj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87539","description":"Hiv-2 quant&revrse trnscripj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHB1","description":"ICD-OJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71551","description":"MRI chest w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABC1","description":"ICD-JABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTB0","description":"ICD-CGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4440","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","description":"HCPCS-Q4440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCC0","description":"ICD-JBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQC0","description":"ICD-DIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asympt carot/vrtbrbas sten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9005F","description":"Asympt carot/vrtbrbas sten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJD1","description":"ICD-FBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMD0","description":"ICD-GHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Management of established patient with dementia_ moderate to high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0528","description":"Management of established patient with dementia_ moderate to high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPD0","description":"ICD-GCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74260","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng arm splint plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4017","description":"Cast sup lng arm splint plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUD1","description":"ICD-IAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10A","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Air pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0186","description":"Air pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debride skin musc at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11011","description":"Debride skin musc at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIF0","description":"ICD-JGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-25448","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","description":"CPT-25448","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct capt mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0381","description":"Cone beam ct capt mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC21","description":"ICD-1FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient transfer system <300","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1035","description":"Patient transfer system <300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCD1","description":"ICD-IBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEF1","description":"ICD-IDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMD1","description":"ICD-OFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFF1","description":"ICD-NFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCME0","description":"ICD-BCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC246","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKID0","description":"ICD-MKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUA0","description":"ICD-NGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lactate (ld) (ldh) enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83615","description":"Lactate (ld) (ldh) enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJA1","description":"ICD-OBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCC0","description":"ICD-GFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKA0","description":"ICD-GHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCC1","description":"ICD-EFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp axillary-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35621","description":"Art byp axillary-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWC1","description":"ICD-PHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sphenoid sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31051","description":"Sphenoid sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBB0","description":"ICD-JIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSA0","description":"ICD-PKSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Influenza","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87804","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Influenza","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alternating pressure pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4640","description":"Alternating pressure pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB135","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGB0","description":"ICD-OBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ cryoablation nasal tissue(s) and/or nerve(s)_ unilateral or bilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9771","description":"Nasal/sinus endoscopy_ cryoablation nasal tissue(s) and/or nerve(s)_ unilateral or bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUF1","description":"ICD-FHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKC1","description":"ICD-NEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSC1","description":"ICD-GDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWB1","description":"ICD-GAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQB1","description":"ICD-PGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFF1","description":"ICD-BAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE225","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMD0","description":"ICD-AFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIE0","description":"ICD-IFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB31","description":"ICD-2BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20251","description":"Open bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITE0","description":"ICD-FITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRF1","description":"ICD-DBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp pop-tibl-prl-other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35671","description":"Art byp pop-tibl-prl-other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFC1","description":"ICD-CHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMD1","description":"ICD-IBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTB0","description":"ICD-GBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVC1","description":"ICD-OLVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUC0","description":"ICD-OEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCB0","description":"ICD-FHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unplnd hosp readm in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9310","description":"Unplnd hosp readm in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dwelling lead investigation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1029","description":"Dwelling lead investigation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apheresis plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36514","description":"Apheresis plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srch for ct w in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9341","description":"Srch for ct w in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVC1","description":"ICD-JFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVA0","description":"ICD-NIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrog device eval heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93289","description":"Interrog device eval heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPD1","description":"ICD-OBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVD1","description":"ICD-GAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXD1","description":"ICD-ODXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWB0","description":"ICD-DEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEE0","description":"ICD-MIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism National Decision Support Company_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1004","description":"Clinical Decision Support Mechanism National Decision Support Company_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHF0","description":"ICD-OLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDB0","description":"ICD-CDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43338","description":"Esoph lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUC1","description":"ICD-MJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skel musc relaxant 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80370","description":"Skel musc relaxant 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intrinsic factor antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86340","description":"Intrinsic factor antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXB1","description":"ICD-FCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERE1","description":"ICD-GERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEE1","description":"ICD-NLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0504","description":"HCPCS-C0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High mount flip-up footrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0037","description":"High mount flip-up footrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFD1","description":"ICD-GEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc back tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21933","description":"Exc back tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTF0","description":"ICD-MDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9140","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVD1","description":"ICD-NCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20D","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENE0","description":"ICD-BENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQC1","description":"ICD-GCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHC1","description":"ICD-EHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Service Coordination**","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1011","description":"Service Coordination**","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Canal prep/fitting of dowel","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3950","description":"Canal prep/fitting of dowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB44","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levamisole 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0177","description":"Levamisole 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18G","description":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDA1","description":"ICD-AEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGC0","description":"ICD-KFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISD1","description":"ICD-DISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Additive for enteral formula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4104","description":"Additive for enteral formula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA11","description":"ICD-1JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHME0","description":"ICD-IHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOA1","description":"ICD-GGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; transmitter component only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0863T","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; transmitter component only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1001T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","description":"CPT-1001T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8H","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBF0","description":"ICD-OBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCB0","description":"ICD-GCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAF0","description":"ICD-IAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Safety concerns screen provided and if positive then documented mitigation recommendations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9922","description":"Safety concerns screen provided and if positive then documented mitigation recommendations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7554","description":"Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJF0","description":"ICD-BIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBD1","description":"ICD-MFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10A","description":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMA1","description":"ICD-NDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMC0","description":"ICD-KDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMD1","description":"ICD-OIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81258","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1002","description":"HCPCS-A1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA RESPIRATORY SYNCTIAL VIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87420","description":"IAAD IA RESPIRATORY SYNCTIAL VIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFED1","description":"ICD-JFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLE1","description":"ICD-JHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth trachea bronchi surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54851","description":"Anesth trachea bronchi surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPA0","description":"ICD-NFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDC1","description":"ICD-NGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE246","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXB1","description":"ICD-GBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTC1","description":"ICD-IDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEF1","description":"ICD-BEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15D","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGB0","description":"ICD-GGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISB1","description":"ICD-LISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA217","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72170","description":"X-ray exam of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINC1","description":"ICD-BINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCA1","description":"ICD-JDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNB1","description":"ICD-NBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHB1","description":"ICD-CEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDF0","description":"ICD-NEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker folding adjust/fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0135","description":"Walker folding adjust/fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63082","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPD1","description":"ICD-JIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDF1","description":"ICD-BFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA130","description":"Clinically Complex _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLED0","description":"ICD-MLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kyphectomy 1-2 segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22818","description":"Kyphectomy 1-2 segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHC1","description":"ICD-GIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUC0","description":"ICD-BAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKE0","description":"ICD-FEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDD0","description":"ICD-GGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Not Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2122","description":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Not Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESA1","description":"ICD-DESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L5992","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","description":"HCPCS-L5992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohols biomarkers 1or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80321","description":"Alcohols biomarkers 1or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLA0","description":"ICD-MKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNC0","description":"ICD-FBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABF1","description":"ICD-MABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary pan cancer (eg_ hereditary breast and ovarian cancer_ hereditary endometrial cancer_ hereditary colorectal cancer)_ genomic sequence analysis panel utilizing a comb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0104U","description":"Hereditary pan cancer (eg_ hereditary breast and ovarian cancer_ hereditary endometrial cancer_ hereditary colorectal cancer)_ genomic sequence analysis panel utilizing a comb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQE1","description":"ICD-PFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFC1","description":"ICD-FBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWC0","description":"ICD-CAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJE1","description":"ICD-BGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyperphenylalaninemia monitoring by patient-collected blood card sample_ quantitative measurement of phenylalanine and tyrosine_ liquid chromatography with tandem mass spectro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0382U","description":"Hyperphenylalaninemia monitoring by patient-collected blood card sample_ quantitative measurement of phenylalanine and tyrosine_ liquid chromatography with tandem mass spectro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac rehab/monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93798","description":"Cardiac rehab/monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95715","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iliac revasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37220","description":"Iliac revasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analyze neurostim complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95972","description":"Analyze neurostim complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLC0","description":"ICD-AGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVD1","description":"ICD-FDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXD1","description":"ICD-NHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLC1","description":"ICD-FHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAB1","description":"ICD-ICAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX14","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCB0","description":"ICD-MBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50600","description":"Exploration of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGID1","description":"ICD-AGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1464","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","description":"HCPCS-M1464","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVF0","description":"ICD-ODVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQB0","description":"ICD-KEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC216","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPF0","description":"ICD-GCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9730","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQC1","description":"ICD-CHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct perfusion w/contrast cbf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042T","description":"Ct perfusion w/contrast cbf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of skull with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62147","description":"Repair of skull with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBE1","description":"ICD-MEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bile duct revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47701","description":"Bile duct revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICC1","description":"ICD-FICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLC0","description":"ICD-GGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply r&l pulm art bands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33620","description":"Apply r&l pulm art bands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transvaginal us non-ob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76830","description":"Transvaginal us non-ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Capecitabine_ oral_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8521","description":"Capecitabine_ oral_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ (aponvie)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9145","description":"Injection_ aprepitant_ (aponvie)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIC1","description":"ICD-GCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Laser Surgical Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0617","description":"Hospital Special Treatment Room Support Component (Hstrsc) Laser Surgical Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMB1","description":"ICD-GDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42310","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUF1","description":"ICD-OHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mifepristone_ oral_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0190","description":"Mifepristone_ oral_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHE0","description":"ICD-FHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJD1","description":"ICD-FCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1802","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1802","description":"CDT-D1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1077T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1077T","description":"CPT-1077T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICID0","description":"ICD-ICID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tumor imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78803","description":"Tumor imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe outflare wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3390","description":"Shoe outflare wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNE1","description":"ICD-FCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antineutrophil Cytoplasmic Antibody (Anca); Screen_ Each Antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86036","description":"Antineutrophil Cytoplasmic Antibody (Anca); Screen_ Each Antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAA0","description":"ICD-FCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99152","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACB0","description":"ICD-OACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICD0","description":"ICD-IICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINC0","description":"ICD-NINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBB1","description":"ICD-JGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSA1","description":"ICD-GHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB07","description":"Low Rehab_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery of breast capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19370","description":"Surgery of breast capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supp maint employ_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2026","description":"Supp maint employ_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61867","description":"Implant neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGB1","description":"ICD-OLGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVD0","description":"ICD-KCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIF0","description":"ICD-NAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27758","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAF0","description":"ICD-JGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo variable frict","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5714","description":"Knee-shin exo variable frict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/M","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0394U","description":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor x stuart-power","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85260","description":"Clot factor x stuart-power","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teplizumab-mzwv_ 5 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9149","description":"Injection_ teplizumab-mzwv_ 5 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hmes filter holder or cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7503","description":"Hmes filter holder or cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home mgmt gest hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9211","description":"Home mgmt gest hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOD1","description":"ICD-LIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYD0","description":"ICD-PJYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRE1","description":"ICD-HIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSE0","description":"ICD-HCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEB1","description":"ICD-AHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRE0","description":"ICD-LBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47740","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35131","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPE1","description":"ICD-CHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIB0","description":"ICD-CGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete ft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4271","description":"Complete ft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flulaval vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2036","description":"Flulaval vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBC1","description":"ICD-NKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQF1","description":"ICD-PCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC44","description":"Medium Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88261","description":"Chromosome analysis 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDB1","description":"ICD-IIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CoreCyte_ for topical use only_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4240","description":"CoreCyte_ for topical use only_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQD0","description":"ICD-PCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albumin; urine (eg_ microalbumin)_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82043","description":"Albumin; urine (eg_ microalbumin)_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC234","description":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAC1","description":"ICD-GHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJA1","description":"ICD-KGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNF0","description":"ICD-KGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"E-Graft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4318","description":"E-Graft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTF0","description":"ICD-ODTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited occlusal adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9951","description":"Limited occlusal adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise sacral spine tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49215","description":"Excise sacral spine tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ C-1 esterase inhibitor (human)_ (Haegarda)_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0599","description":"Injection_ C-1 esterase inhibitor (human)_ (Haegarda)_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPE0","description":"ICD-FCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98005","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","description":"CPT-98005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair accessory_ lateral thigh or knee support_ any type including fixed mounting hardware_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0953","description":"Wheelchair accessory_ lateral thigh or knee support_ any type including fixed mounting hardware_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC02","description":"High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45116","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Als routine disposble suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0398","description":"Als routine disposble suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVF0","description":"ICD-OJVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (multiple myeloma)_ LC-MS/MS_ peptide ion quantification_ serum_ results compared with baseline to determine monoclonal paraprotein abundance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0451U","description":"Oncology (multiple myeloma)_ LC-MS/MS_ peptide ion quantification_ serum_ results compared with baseline to determine monoclonal paraprotein abundance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVA1","description":"ICD-BFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0675","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","description":"HCPCS-J0675","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29838","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYB0","description":"ICD-PLYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ gene-drug interactions_ variant analysis of 16 genes_ including deletion/duplication an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0392U","description":"Drug metabolism (depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ gene-drug interactions_ variant analysis of 16 genes_ including deletion/duplication an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXE0","description":"ICD-GHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHE0","description":"ICD-NHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXE0","description":"ICD-JAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Valrubicin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9357","description":"Valrubicin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0581U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","description":"CPT-0581U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOF0","description":"ICD-OCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYA1","description":"ICD-LDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hgb not doc rns not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8974","description":"Hgb not doc rns not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECC0","description":"ICD-KECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTB0","description":"ICD-KFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block spenopalatine gangl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64505","description":"N block spenopalatine gangl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calc bmi blw low param f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8418","description":"Calc bmi blw low param f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tray w/o bag/cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4310","description":"Insert tray w/o bag/cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aerosol compressor adjust pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0572","description":"Aerosol compressor adjust pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMF0","description":"ICD-EGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40845","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOC0","description":"ICD-OFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBF0","description":"ICD-NBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13C","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of arm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24200","description":"Removal of arm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trach/laryn tube plug/stop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7527","description":"Trach/laryn tube plug/stop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suture complicate wnd > 5 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7912","description":"Suture complicate wnd > 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOF1","description":"ICD-DFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEE1","description":"ICD-JEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Or Replacement Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0680T","description":"Insertion Or Replacement Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63655","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthesis_ penile_ inflatab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1813","description":"Prosthesis_ penile_ inflatab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0480U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","description":"CPT-0480U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJE1","description":"ICD-FEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0094U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICA1","description":"ICD-NICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antid glbln rcvd w/in 26wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4178F","description":"Antid glbln rcvd w/in 26wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIA0","description":"ICD-EGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRF0","description":"ICD-PBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMD0","description":"ICD-NFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGF0","description":"ICD-BFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATC1","description":"ICD-CATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILB0","description":"ICD-EILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incomplete endodontic tx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3332","description":"Incomplete endodontic tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bl draw < 3 yrs fem/jugular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36400","description":"Bl draw < 3 yrs fem/jugular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADE0","description":"ICD-BADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA251","description":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair calf rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0995","description":"Wheelchair calf rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10C","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise tendon(s) & muscle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23406","description":"Incise tendon(s) & muscle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA13","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBE1","description":"ICD-BFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv3 vaccine 6-35 months im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90657","description":"Iiv3 vaccine 6-35 months im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECED1","description":"ICD-ECED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOE0","description":"ICD-KAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt scrnd hgh-risk sex behav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4293F","description":"Pt scrnd hgh-risk sex behav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYE0","description":"ICD-DIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYD0","description":"ICD-KEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALF1","description":"ICD-NALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVC0","description":"ICD-KHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDD1","description":"ICD-CIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No eval riskk vte card prior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9299","description":"No eval riskk vte card prior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27236","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUC0","description":"ICD-CEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPB1","description":"ICD-OIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKF1","description":"ICD-JHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBF0","description":"ICD-IBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB26","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPE1","description":"ICD-KGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRC1","description":"ICD-PIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14A","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28G","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLD1","description":"ICD-KGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWC0","description":"ICD-HFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk knee joints single axis p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5676","description":"Bk knee joints single axis p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin frct swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5818","description":"Endo knee-shin frct swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv adduct vocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2341","description":"Chemodenerv adduct vocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQF0","description":"ICD-LGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCE0","description":"ICD-CCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/subs interv >30 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0397","description":"Alcohol/subs interv >30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBD0","description":"ICD-FGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDA1","description":"ICD-NFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOC0","description":"ICD-LEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDE0","description":"ICD-OHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASF0","description":"ICD-PASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cannabinoids synthetic 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80350","description":"Cannabinoids synthetic 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAD1","description":"ICD-JDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2C","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24577","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20A","description":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess susp docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3344F","description":"Mammo assess susp docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESE1","description":"ICD-HESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scan proc cranial extra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61782","description":"Scan proc cranial extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86710","description":"Influenza virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenomic Neoplasia (Genome-Wide) Microarray Analysis_ Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants For Chromosomal Abnormalities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81277","description":"Cytogenomic Neoplasia (Genome-Wide) Microarray Analysis_ Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants For Chromosomal Abnormalities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHD0","description":"ICD-BCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFA0","description":"ICD-JEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCD1","description":"ICD-NBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/reline occlusal guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9942","description":"Repair/reline occlusal guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKB0","description":"ICD-CDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUC1","description":"ICD-GIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXC0","description":"ICD-KGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRC0","description":"ICD-PJRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt_ pn_ hist grade doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8721","description":"Pt_ pn_ hist grade doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28400","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXD1","description":"ICD-FBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTF0","description":"ICD-NKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNF0","description":"ICD-NDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWB0","description":"ICD-GEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ifosfamide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9208","description":"Ifosfamide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXC0","description":"ICD-FHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvef mod/sever deprs syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3021F","description":"Lvef mod/sever deprs syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacotherapy for OUD initiated after June 30th of performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1033","description":"Pharmacotherapy for OUD initiated after June 30th of performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLA1","description":"ICD-NLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTE1","description":"ICD-BGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy w/rf delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0288T","description":"Anoscopy w/rf delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINF0","description":"ICD-KINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"L ventric pacing lead add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33225","description":"L ventric pacing lead add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0837","description":"Pwc gp 2 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJA0","description":"ICD-NHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTF1","description":"ICD-EFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0624T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulpal regeneration initial","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3355","description":"Pulpal regeneration initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44340","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGC0","description":"ICD-GCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQD1","description":"ICD-OGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2001","description":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRB1","description":"ICD-PCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place device/marker_ non pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9728","description":"Place device/marker_ non pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL34","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0624U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","description":"CPT-0624U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27823","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEE0","description":"ICD-IHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINA0","description":"ICD-KINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33474","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28E","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHA0","description":"ICD-MHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJF0","description":"ICD-NIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20A","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB113","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAB1","description":"ICD-JDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJD1","description":"ICD-FHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA51","description":"High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOA0","description":"ICD-HAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0584U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","description":"CPT-0584U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo ia infuse each addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96423","description":"Chemo ia infuse each addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYA0","description":"ICD-HFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHED1","description":"ICD-KHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin fungi culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87101","description":"Skin fungi culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXE0","description":"ICD-BDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8I","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01924","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","description":"CPT-01924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWE0","description":"ICD-DAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNC0","description":"ICD-NDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENC0","description":"ICD-CENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJA1","description":"ICD-FCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOE1","description":"ICD-DCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML20","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant spine infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62361","description":"Implant spine infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQF1","description":"ICD-HGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJF0","description":"ICD-JAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWC1","description":"ICD-DDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PreTRM®_ Sera Prognostics_ Sera Prognostics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0247U","description":"PreTRM®_ Sera Prognostics_ Sera Prognostics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSB1","description":"ICD-PCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJB1","description":"ICD-FDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILE1","description":"ICD-AILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETE0","description":"ICD-KETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colon ca scrn; barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0122","description":"Colon ca scrn; barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4359","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","description":"HCPCS-Q4359","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic eye other type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2629","description":"Prosthetic eye other type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect enlarged toe tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28340","description":"Resect enlarged toe tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUF0","description":"ICD-NHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hg a1c level lt 7.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3044F","description":"Hg a1c level lt 7.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx isodose intermed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77317","description":"Brachytx isodose intermed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0870","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","description":"HCPCS-J0870","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEA1","description":"ICD-OLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYD1","description":"ICD-PDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gated heart multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78473","description":"Gated heart multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAB0","description":"ICD-IIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pediatrics (congenital epigenetic disorders)_ whole genome methylation analysis by microarray for 50 or more genes_ blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0318U","description":"Pediatrics (congenital epigenetic disorders)_ whole genome methylation analysis by microarray for 50 or more genes_ blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject/aspirate liver cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47015","description":"Inject/aspirate liver cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDID0","description":"ICD-KDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMB1","description":"ICD-BCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASA0","description":"ICD-LASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0807T","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAD0","description":"ICD-AHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; subcutaneous electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0460T","description":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; subcutaneous electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.25-7/.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2307","description":"Lens sphcy trifocal 4.25-7/.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Store prev froz embryos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4027","description":"Store prev froz embryos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDA0","description":"ICD-MJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEB0","description":"ICD-FGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCB0","description":"ICD-GHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVC1","description":"ICD-NCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1705","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1705","description":"HCPCS-B1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVF0","description":"ICD-OGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVB0","description":"ICD-BEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTE1","description":"ICD-FHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJE1","description":"ICD-FGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc medrsn no compl antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9300","description":"Doc medrsn no compl antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOF1","description":"ICD-ODOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Musc test done w/n test comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95886","description":"Musc test done w/n test comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTE1","description":"ICD-MKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"repair cast partial framework_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5622","description":"repair cast partial framework_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmoscopy_ Extended; With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease (Eg_ For Retinal Tear_ Retinal Detachment_ Retinal Tumor) With Interpretati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92201","description":"Ophthalmoscopy_ Extended; With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease (Eg_ For Retinal Tear_ Retinal Detachment_ Retinal Tumor) With Interpretati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPA1","description":"ICD-FAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEA0","description":"ICD-CGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEA1","description":"ICD-MEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGB1","description":"ICD-NAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phenytoin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1165","description":"Phenytoin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILB1","description":"ICD-EILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1037T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1037T","description":"CPT-1037T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear antigen antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86235","description":"Nuclear antigen antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABC0","description":"ICD-JABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCA1","description":"ICD-OGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSA1","description":"ICD-PFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIB1","description":"ICD-JAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22850","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1410","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","description":"HCPCS-M1410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11306","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB31","description":"ICD-4EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77772","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1736","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1736","description":"HCPCS-C1736","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEA1","description":"ICD-FBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [ha]_ procollagen iii amino terminal peptide [piiinp]_ tissue inhibitor of metalloproteinase 1 [timp-1])_ using immuno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014M","description":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [ha]_ procollagen iii amino terminal peptide [piiinp]_ tissue inhibitor of metalloproteinase 1 [timp-1])_ using immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19316","description":"Suspension of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antithrombin iii activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85300","description":"Antithrombin iii activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWB0","description":"ICD-HHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unpln rup post cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9389","description":"Unpln rup post cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52301","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tmp manipulation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7820","description":"Closed tmp manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLC0","description":"ICD-ECLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vacc 2 dose adolesc im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90743","description":"Hepb vacc 2 dose adolesc im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSA1","description":"ICD-KFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Beclomethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7622","description":"Beclomethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36570","description":"Insert picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMD1","description":"ICD-JDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXE0","description":"ICD-FCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult companioncare per 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5135","description":"Adult companioncare per 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLD1","description":"ICD-JDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEB1","description":"ICD-MIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXE0","description":"ICD-OCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLD0","description":"ICD-CGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0247","description":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIF0","description":"ICD-BAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQD1","description":"ICD-GDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPF1","description":"ICD-BCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB35","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29850","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8B","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKE1","description":"ICD-NFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPC1","description":"ICD-JFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJF0","description":"ICD-OJJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stance phase only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5858","description":"Stance phase only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRC1","description":"ICD-GDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0570","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","description":"HCPCS-G0570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69320","description":"Rebuild outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid plastic cust fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0484","description":"Tlso rigid plastic cust fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAB0","description":"ICD-NBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNF1","description":"ICD-KBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCD0","description":"ICD-GGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"1st course antitnf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8868","description":"1st course antitnf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDE1","description":"ICD-BDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of omentum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49255","description":"Removal of omentum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILB0","description":"ICD-IILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prostatic rf thermotx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53852","description":"Prostatic rf thermotx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA43","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLB1","description":"ICD-CFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPB0","description":"ICD-NCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIA0","description":"ICD-CDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESA0","description":"ICD-LESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEB0","description":"ICD-BAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"So hard plas stabili pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3677","description":"So hard plas stabili pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRC1","description":"ICD-GCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mycobacteria dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87552","description":"Mycobacteria dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMF0","description":"ICD-FEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adults who are not ambulatory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1068","description":"Adults who are not ambulatory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0C","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECF1","description":"ICD-NECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methadone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1230","description":"Methadone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVE0","description":"ICD-GIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKB1","description":"ICD-FDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAD1","description":"ICD-NJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKD1","description":"ICD-OLKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Near ifr guide of vasc site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0287T","description":"Near ifr guide of vasc site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Av fuse uppr arm cephalic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36818","description":"Av fuse uppr arm cephalic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-cov proc_ clinical trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0294","description":"Non-cov proc_ clinical trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treponema pallidum ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87285","description":"Treponema pallidum ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMC1","description":"ICD-BFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0044A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX25","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFC0","description":"ICD-OBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap ablat uterine fibroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0336T","description":"Lap ablat uterine fibroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test for chlorohydrocarbons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82441","description":"Test for chlorohydrocarbons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPA1","description":"ICD-CDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mitoxantrone hydrochl / 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9293","description":"Mitoxantrone hydrochl / 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult size pull-on med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4526","description":"Adult size pull-on med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYF0","description":"ICD-ODYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYE1","description":"ICD-KFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDC0","description":"ICD-MBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87637","description":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISD0","description":"ICD-DISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTB1","description":"ICD-AGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cltx thigh fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27267","description":"Cltx thigh fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQD0","description":"ICD-OHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8I","description":"Medium Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spec childcare waiver 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2027","description":"Spec childcare waiver 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMA0","description":"ICD-FAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFB1","description":"ICD-KDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc foot/toe tum deep <1.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28045","description":"Exc foot/toe tum deep <1.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELF0","description":"ICD-NELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPD1","description":"ICD-NBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self care goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8988","description":"Self care goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Op rad mg intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9238","description":"Op rad mg intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection of sinus tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20500","description":"Injection of sinus tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUF0","description":"ICD-CEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74019","description":"Radiologic examination_ abdomen; 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0102","description":"HCPCS-B0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLC0","description":"ICD-FBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; First Le","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0627T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; First Le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lith ion non prosth recharge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4601","description":"Lith ion non prosth recharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acute pvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1337","description":"Acute pvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evidence-based therapy was prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1227","description":"Evidence-based therapy was prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOF0","description":"ICD-LEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dornase alfa non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7639","description":"Dornase alfa non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8X","description":"Very High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"P32 na phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9563","description":"P32 na phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADA1","description":"ICD-CADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Using A Catheter Continuously For Three Months Or Longer Under The Care Of The Same","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1026","description":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Using A Catheter Continuously For Three Months Or Longer Under The Care Of The Same","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDE0","description":"ICD-ECDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/4.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2305","description":"Lens sphcy trifocal 4.0/4.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMA1","description":"ICD-NIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient not receiving a first course of anti-tnf therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8871","description":"Patient not receiving a first course of anti-tnf therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1380","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","description":"HCPCS-M1380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKA0","description":"ICD-NAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft carotid-vertbrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35508","description":"Art byp grft carotid-vertbrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEC1","description":"ICD-AEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDB0","description":"ICD-AIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHF1","description":"ICD-OBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYF0","description":"ICD-KIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39541","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWA0","description":"ICD-KCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88167","description":"Cytopath tbs c/v select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETE0","description":"ICD-AETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLA0","description":"ICD-IDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB50","description":"Low Rehab_ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of knee ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27409","description":"Repair of knee ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOD1","description":"ICD-PLOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay bld/serum cholesterol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82465","description":"Assay bld/serum cholesterol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"VEKLURY - Injection_ remdesivir_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0248","description":"VEKLURY - Injection_ remdesivir_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBB1","description":"ICD-GIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUA1","description":"ICD-NAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ocrelizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2350","description":"Injection_ ocrelizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hhs/hospice of rn ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0299","description":"Hhs/hospice of rn ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYA0","description":"ICD-KGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special reports or forms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99080","description":"Special reports or forms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest wall manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94668","description":"Chest wall manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYB0","description":"ICD-CGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELA1","description":"ICD-FELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFB1","description":"ICD-ODFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27254","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPC0","description":"ICD-CHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXE0","description":"ICD-NJXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75710","description":"Artery x-rays arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBA0","description":"ICD-MHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMD1","description":"ICD-MJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC10","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61543","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWE1","description":"ICD-GAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trim skin lesions 2 to 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11056","description":"Trim skin lesions 2 to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOB1","description":"ICD-DGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB31","description":"ICD-3EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNC0","description":"ICD-KDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gr27 non-sealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2372","description":"Gr27 non-sealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo removal donor kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50547","description":"Laparo removal donor kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSD0","description":"ICD-OCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge resin w/high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6250","description":"Bridge resin w/high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPE1","description":"ICD-CEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAF1","description":"ICD-BFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aripiprazole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0400","description":"Aripiprazole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1030T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1030T","description":"CPT-1030T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSA0","description":"ICD-PJSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antiemetic rectal/supp nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8498","description":"Antiemetic rectal/supp nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSB0","description":"ICD-PCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKA0","description":"ICD-CEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVD1","description":"ICD-CGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAC1","description":"ICD-NBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Slitting of prepuce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54001","description":"Slitting of prepuce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUD1","description":"ICD-MIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWF1","description":"ICD-LDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINE0","description":"ICD-FINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKID1","description":"ICD-NKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vitreoretinal surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14551","description":"Anesth vitreoretinal surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caloric vestibular test_ each irrigation (binaural_ bithermalstimulation constitutes four tests)_ with recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92543","description":"Caloric vestibular test_ each irrigation (binaural_ bithermalstimulation constitutes four tests)_ with recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0C","description":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAD0","description":"ICD-NDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCF0","description":"ICD-KBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPA1","description":"ICD-FFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow harvest allogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38230","description":"Bone marrow harvest allogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDE1","description":"ICD-IBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISD1","description":"ICD-GISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSF1","description":"ICD-KCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTE1","description":"ICD-OBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDA0","description":"ICD-AHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Athletic train reeval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97006","description":"Athletic train reeval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCA1","description":"ICD-ABCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FlowerAmnioFlo_ 0.1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4177","description":"FlowerAmnioFlo_ 0.1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC212","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6071","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fix g/colon tube w/device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49460","description":"Fix g/colon tube w/device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10B","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQF0","description":"ICD-CGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0603","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0603","description":"CDT-D0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP1A2 (cytochrome P450 family 1_ subfamily A_ member 2)(eg_ drug metabolism) gene analysis_ common variants (ie_ *1F_ *1K_ *6_ *7)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0031U","description":"CYP1A2 (cytochrome P450 family 1_ subfamily A_ member 2)(eg_ drug metabolism) gene analysis_ common variants (ie_ *1F_ *1K_ *6_ *7)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPA1","description":"ICD-GAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTD1","description":"ICD-OCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0599U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","description":"CPT-0599U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWC1","description":"ICD-HGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neg pres wound ther drsg set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6550","description":"Neg pres wound ther drsg set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBC0","description":"ICD-MGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGA0","description":"ICD-FGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/4.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2313","description":"Lens sphc trifo 7.25-12/4.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sleeve_ inter limb comp dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4600","description":"Sleeve_ inter limb comp dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOB0","description":"ICD-PBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVF1","description":"ICD-BDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28E","description":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of digoxin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80162","description":"Assay of digoxin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTC0","description":"ICD-OLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKC1","description":"ICD-CFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPF0","description":"ICD-BGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUF1","description":"ICD-JGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEB1","description":"ICD-JBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOB0","description":"ICD-CCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIE0","description":"ICD-IIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23C","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDE0","description":"ICD-EHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC244","description":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIC1","description":"ICD-MDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCV2 10MCG TRS-SUCR 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072A","description":"ADM SARSCV2 10MCG TRS-SUCR 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1A","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evaluate pt use of inhaler","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94664","description":"Evaluate pt use of inhaler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair venous anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33724","description":"Repair venous anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ tumor immunohistochemistry (eg_ Her-2/neu_ estrogen receptor/progesterone receptor)_ quantitative or semiqua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0763T","description":"Digitization of glass microscope slides for morphometric analysis_ tumor immunohistochemistry (eg_ Her-2/neu_ estrogen receptor/progesterone receptor)_ quantitative or semiqua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJE0","description":"ICD-NEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Placement And Subsequent Removal Of Cerebral Embolic Protection Device(S)_ Including Arterial Access_ Catheterization_ Imaging_ And Radiological Supervision And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33370","description":"Transcatheter Placement And Subsequent Removal Of Cerebral Embolic Protection Device(S)_ Including Arterial Access_ Catheterization_ Imaging_ And Radiological Supervision And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65410","description":"Biopsy of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absorp drg >16<=48 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0745","description":"Absorp drg >16<=48 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCB0","description":"ICD-NJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0714T","description":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1001","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1001","description":"CDT-D1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64818","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSC1","description":"ICD-KGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDA0","description":"ICD-MIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWB0","description":"ICD-OEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Symptom&sign symm polyneuro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1500F","description":"Symptom&sign symm polyneuro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHE1","description":"ICD-IAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCE1","description":"ICD-ACCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFD0","description":"ICD-CAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQA1","description":"ICD-GHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crutch underarm pair no wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0114","description":"Crutch underarm pair no wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKE0","description":"ICD-NLKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-htn/htn_ no f/u_ not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8952","description":"Pre-htn/htn_ no f/u_ not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast ductal carcinoma in situ)_ mRNA_ gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0045U","description":"Oncology (breast ductal carcinoma in situ)_ mRNA_ gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX46","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5125","description":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQF0","description":"ICD-OGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSE1","description":"ICD-PKSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMC1","description":"ICD-KEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us leiomyomata ablate >200","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072T","description":"Us leiomyomata ablate >200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYE1","description":"ICD-PJYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove elbow joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24102","description":"Remove elbow joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAE1","description":"ICD-MKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGD0","description":"ICD-GAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTA1","description":"ICD-IGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35102","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pentamidine iseth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0080","description":"Injection_ pentamidine iseth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Greater Than 22 And Functional Status Measured","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2143","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Greater Than 22 And Functional Status Measured","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTB0","description":"ICD-IFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of tobramycin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80200","description":"Assay of tobramycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phys review of motion tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96004","description":"Phys review of motion tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microbe susceptible enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87185","description":"Microbe susceptible enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGF1","description":"ICD-FHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"American amnion ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4306","description":"American amnion ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoelectrophoresis assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86327","description":"Immunoelectrophoresis assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLE1","description":"ICD-FHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEF1","description":"ICD-AHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUA1","description":"ICD-OAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 2 genotyping (HPA-2)_ GP1BA (glycoprotein Ib [platelet]_ alpha polypeptide [GPIba]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81106","description":"Human Platelet Antigen 2 genotyping (HPA-2)_ GP1BA (glycoprotein Ib [platelet]_ alpha polypeptide [GPIba]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNE1","description":"ICD-JDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4A","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8692","description":"Replacement retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSE0","description":"ICD-GGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKE1","description":"ICD-BCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYE0","description":"ICD-CAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHD1","description":"ICD-KIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWB1","description":"ICD-KBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGID1","description":"ICD-GGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFF0","description":"ICD-GBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKA1","description":"ICD-CGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place breast rad tube/caths","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19298","description":"Place breast rad tube/caths","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE124","description":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0666U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0666U","description":"CPT-0666U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE155","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5A","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQE0","description":"ICD-PJQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28C","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKF1","description":"ICD-OKKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQE1","description":"ICD-HIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIB1","description":"ICD-IAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJF1","description":"ICD-GAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQC1","description":"ICD-OLQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PrecisionBlood™_ San Diego Blood Bank","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0246U","description":"PrecisionBlood™_ San Diego Blood Bank","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIB0","description":"ICD-KDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1110T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1110T","description":"CPT-1110T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg3a no progre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9065","description":"Onc dx nsclc stg3a no progre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24B","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2114","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLC1","description":"ICD-NKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBA1","description":"ICD-MCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAF1","description":"ICD-GCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMD0","description":"ICD-OEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFB1","description":"ICD-GFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m apcitide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9504","description":"Tc99m apcitide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL16","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB25","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastroenterology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91299","description":"Gastroenterology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Male condom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4267","description":"Male condom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1455","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","description":"HCPCS-M1455","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXA1","description":"ICD-OLXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ptfalls assess-docd ge2>/yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1100F","description":"Ptfalls assess-docd ge2>/yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: abnormal neurologic exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2189","description":"Patients with clinical indications for imaging of the head: abnormal neurologic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB256","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSF1","description":"ICD-GDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCED0","description":"ICD-GCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg_CT studies performed for radiation treatment planning)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9320","description":"Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg_CT studies performed for radiation treatment planning)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ coated/cov w/del sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1874","description":"Stent_ coated/cov w/del sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thrombolytic therapy stroke","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37195","description":"Thrombolytic therapy stroke","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct lip with flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40525","description":"Reconstruct lip with flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive mastoid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69511","description":"Extensive mastoid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQC0","description":"ICD-PCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJF1","description":"ICD-FEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exsufflation belt_ includes all supplies and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4468","description":"Exsufflation belt_ includes all supplies and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIME1","description":"ICD-FIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHF1","description":"ICD-GFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAC0","description":"ICD-BDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place ndl musc/tis for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20555","description":"Place ndl musc/tis for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87592","description":"N.gonorrhoeae dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJE0","description":"ICD-NJJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA21","description":"ICD-2JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKD1","description":"ICD-CAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Admit w/in 180d req surg rev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9412","description":"Admit w/in 180d req surg rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEF0","description":"ICD-AHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periodic oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0120","description":"Periodic oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal t1-2 no progr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9090","description":"Onc dx rectal t1-2 no progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Forearm or wrist surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25999","description":"Forearm or wrist surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTF0","description":"ICD-ABTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pseudoaneurysm injection trt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36002","description":"Pseudoaneurysm injection trt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYB1","description":"ICD-GFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coombs test indirect qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86885","description":"Coombs test indirect qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathogen Test For Platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9987","description":"Pathogen Test For Platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWE1","description":"ICD-GEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPB0","description":"ICD-FFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKND0","description":"ICD-OKND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTE1","description":"ICD-KGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Multiple Studies At","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78431","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Multiple Studies At","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy oocyte polar body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89291","description":"Biopsy oocyte polar body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMD1","description":"ICD-NLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDED1","description":"ICD-IDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1002","description":"HCPCS-C1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21242","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens trifocal seg width > 28","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2319","description":"Lens trifocal seg width > 28","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXE0","description":"ICD-OAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHB0","description":"ICD-EDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ secukinumab_ IV_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3247","description":"Injection_ secukinumab_ IV_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0877T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMC0","description":"ICD-IGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place cath carotd art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36224","description":"Place cath carotd art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBA1","description":"ICD-KGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria_ fungi_ parasites_ and DNA viruses)_ DNA_ PCR and next-generation sequencing_ plasma_ detection of >1_000 potential microbial organisms for signif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0152U","description":"Infectious disease (bacteria_ fungi_ parasites_ and DNA viruses)_ DNA_ PCR and next-generation sequencing_ plasma_ detection of >1_000 potential microbial organisms for signif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBE0","description":"ICD-EIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orth foot add charge split s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3257","description":"Orth foot add charge split s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 25MCG/0.25ML IM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91311","description":"SARSCOV2 VAC 25MCG/0.25ML IM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUA1","description":"ICD-MCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCD1","description":"ICD-CDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01712","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","description":"CPT-01712","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHD0","description":"ICD-BIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calcitonin salmon injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0630","description":"Calcitonin salmon injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy forearm soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25066","description":"Biopsy forearm soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDD1","description":"ICD-BDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBID0","description":"ICD-KBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lutetium lu 177_ dotatate_ therapeutic_ 1 millicure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9513","description":"Lutetium lu 177_ dotatate_ therapeutic_ 1 millicure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter implantation of coronary sinus reduction device including vascular access and closure_ right heart catheterization_ venous angiography_ coronary sinus angiograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0645T","description":"Transcatheter implantation of coronary sinus reduction device including vascular access and closure_ right heart catheterization_ venous angiography_ coronary sinus angiograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg ak ea add cast ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5430","description":"Postop dsg ak ea add cast ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA36","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0224","description":"Injection_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEB0","description":"ICD-IEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMA1","description":"ICD-BIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infusion ther other than che","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0081","description":"Infusion ther other than che","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHE0","description":"ICD-GCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of arm bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24140","description":"Partial removal of arm bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hair analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2031","description":"Hair analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"L hrt cath trnsptl puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93462","description":"L hrt cath trnsptl puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tendon transfer with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26492","description":"Tendon transfer with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYD1","description":"ICD-CDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Housing & integrated adhesiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7508","description":"Housing & integrated adhesiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4D","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFE1","description":"ICD-KFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intestinal stricturoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44615","description":"Intestinal stricturoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXB1","description":"ICD-KDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply multlay comprs lwr leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29581","description":"Apply multlay comprs lwr leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathogen reduced platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9072","description":"Pathogen reduced platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Audiometry for hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0618","description":"Audiometry for hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYE0","description":"ICD-LGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALC1","description":"ICD-CALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upr/lxtr art stdy 3+ lvls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93923","description":"Upr/lxtr art stdy 3+ lvls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCE0","description":"ICD-FGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJD1","description":"ICD-CDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMB1","description":"ICD-OHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","description":"CPT-98015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFD0","description":"ICD-ODFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX01","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVE1","description":"ICD-KEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHC0","description":"ICD-IEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Uvl replacement bulb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4633","description":"Uvl replacement bulb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48153","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASC0","description":"ICD-DASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHC0","description":"ICD-JHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25111","description":"Remove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of rectocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45560","description":"Repair of rectocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2102","description":"HCPCS-A2102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRF0","description":"ICD-GGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2D","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Porc/ceram inlay >= 3 surfac","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6601","description":"Porc/ceram inlay >= 3 surfac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colorectal scrn; hi risk ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0105","description":"Colorectal scrn; hi risk ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB244","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Warfarin or another FDA-approved anticoagulant not prescribed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9928","description":"Warfarin or another FDA-approved anticoagulant not prescribed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWA1","description":"ICD-OFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of carnitine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82379","description":"Assay of carnitine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art pancreas ext receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1037","description":"Art pancreas ext receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert ant segment drain int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0191T","description":"Insert ant segment drain int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB211","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAD0","description":"ICD-MGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQE1","description":"ICD-KGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTC1","description":"ICD-NCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXC1","description":"ICD-GGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUF0","description":"ICD-FGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRB0","description":"ICD-CBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGA0","description":"ICD-NEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIF1","description":"ICD-IFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJF0","description":"ICD-JHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair hvy duty detach a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1290","description":"Wheelchair hvy duty detach a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPC0","description":"ICD-FGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; qualitative_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82541","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; qualitative_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHB1","description":"ICD-CGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFE1","description":"ICD-KHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peripheral vascular rehab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93668","description":"Peripheral vascular rehab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLF0","description":"ICD-FFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD234","description":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPF0","description":"ICD-JCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic shoe modifica nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3649","description":"Orthopedic shoe modifica nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXF0","description":"ICD-NIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33692","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D6193","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6193","description":"CDT-D6193","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASC0","description":"ICD-HASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ copanlisib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9057","description":"Injection_ copanlisib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMF0","description":"ICD-FAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB21","description":"ICD-2EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIF0","description":"ICD-CCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSB1","description":"ICD-GCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISC0","description":"ICD-GISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86337","description":"Insulin antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77262","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist endoscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29848","description":"Wrist endoscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA07","description":"Ultra High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11402","description":"Exc tr-ext b9+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIB1","description":"ICD-GAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ in the ear (ITE)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5171","description":"Hearing aid_ contralateral routing device_ monaural_ in the ear (ITE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABB0","description":"ICD-AABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCE0","description":"ICD-BHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung cancer)_ four-probe FISH (3q29_ 3p22.1_ 10q22.3_ 10cen) assay_ whole blood_ predictive algorithm-generated evaluation reported as decreased or increased risk fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0317U","description":"Oncology (lung cancer)_ four-probe FISH (3q29_ 3p22.1_ 10q22.3_ 10cen) assay_ whole blood_ predictive algorithm-generated evaluation reported as decreased or increased risk fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMC1","description":"ICD-MBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNB0","description":"ICD-ODNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADC1","description":"ICD-MADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWB1","description":"ICD-KDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction rectal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45190","description":"Destruction rectal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ a","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ non-cor_ tem w/del sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2625","description":"Stent_ non-cor_ tem w/del sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial hip replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27125","description":"Partial hip replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aspirin/clopidogrel rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4086F","description":"Aspirin/clopidogrel rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27556","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec osteogen stim implanted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0749","description":"Elec osteogen stim implanted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC217","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01961","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","description":"CPT-01961","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVF1","description":"ICD-NDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBB1","description":"ICD-CHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1832","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","description":"HCPCS-E1832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Migration inhibitory factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86378","description":"Migration inhibitory factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJD1","description":"ICD-NBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"remove broken implant retaining screw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6096","description":"remove broken implant retaining screw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral; with removal of intragastric bariatric balloon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43291","description":"Esophagogastroduodenoscopy_ flexible_ transoral; with removal of intragastric bariatric balloon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ any specimen source)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9803","description":"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ any specimen source)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE141","description":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAA0","description":"ICD-FGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1946","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1946","description":"HCPCS-J1946","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAE0","description":"ICD-CCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFD0","description":"ICD-GBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJF0","description":"ICD-CGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVD0","description":"ICD-OLVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLB1","description":"ICD-ADLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIF0","description":"ICD-ADIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFA0","description":"ICD-OIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMB1","description":"ICD-CIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (genetic platelet function disorder)_ genomic sequence analysis of 31 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Platelet Function Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0277U","description":"Hematology (genetic platelet function disorder)_ genomic sequence analysis of 31 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Platelet Function Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained With Diagnostic Ultrasound Examination Of The Same Anatomy (","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0690T","description":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained With Diagnostic Ultrasound Examination Of The Same Anatomy (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECB0","description":"ICD-NECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hfe gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81256","description":"Hfe gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50390","description":"Drainage of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFE0","description":"ICD-FEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUD1","description":"ICD-GGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01716","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","description":"CPT-01716","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDF0","description":"ICD-KIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen_ qualitative; single drug class method (e.g._ immunoassay_ enzyme assay)_ each drug class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0431","description":"Drug screen_ qualitative; single drug class method (e.g._ immunoassay_ enzyme assay)_ each drug class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPF0","description":"ICD-JHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQC1","description":"ICD-DCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECD0","description":"ICD-IECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq card revasc chronic addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92944","description":"Prq card revasc chronic addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFB1","description":"ICD-BHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracorp shockwv tx anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0102T","description":"Extracorp shockwv tx anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mthfr gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81291","description":"Mthfr gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1404","description":"HCPCS-B1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJA1","description":"ICD-CBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRF0","description":"ICD-PIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Naltrexone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Tes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2073","description":"Medication Assisted Treatment_ Naltrexone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Tes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 4 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34844","description":"Endovasc visc aorta 4 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES244","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAE1","description":"ICD-NJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB55","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEB1","description":"ICD-CIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUF1","description":"ICD-FAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat uterus infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59830","description":"Treat uterus infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJC0","description":"ICD-FIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDF1","description":"ICD-KIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJB1","description":"ICD-OLJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADC1","description":"ICD-JADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYE0","description":"ICD-CDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX32","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHF1","description":"ICD-FDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid lined pre one pie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0488","description":"Tlso rigid lined pre one pie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRC0","description":"ICD-HDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNB0","description":"ICD-OGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress forearm 2 spaces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25024","description":"Decompress forearm 2 spaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEA1","description":"ICD-NFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28D","description":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emer rspns system purchase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5162","description":"Emer rspns system purchase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNA1","description":"ICD-GGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCF1","description":"ICD-GBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8H","description":"Medium Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27238","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sesamoid bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28315","description":"Removal of sesamoid bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2B","description":"Low Rehab_ ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWC1","description":"ICD-PIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUE1","description":"ICD-OBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with ureteroscopy and/or pyeloscopy_ with lithotripsy (ureteral catheterization is included) and vacuum aspiration of the kidney_ collecting system and uret","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9761","description":"Cystourethroscopy_ with ureteroscopy and/or pyeloscopy_ with lithotripsy (ureteral catheterization is included) and vacuum aspiration of the kidney_ collecting system and uret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryosurgery anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46916","description":"Cryosurgery anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKC0","description":"ICD-ODKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJA1","description":"ICD-OLJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUA1","description":"ICD-ADUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1168","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCB0","description":"ICD-BHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgraft ft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4268","description":"Surgraft ft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped term dev_ hand_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6713","description":"Ped term dev_ hand_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBD0","description":"ICD-GBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYF1","description":"ICD-KGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSE1","description":"ICD-LDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pmp22 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81325","description":"Pmp22 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIB0","description":"ICD-NGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56159","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13A","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61557","description":"Incise skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLD1","description":"ICD-JBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1190","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18F","description":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Toilet rail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0243","description":"Toilet rail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA31","description":"ICD-3AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCB1","description":"ICD-NBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00630","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","description":"CPT-00630","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBE1","description":"ICD-AIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95070","description":"Bronchial allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of halo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20664","description":"Application of halo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPB1","description":"ICD-NDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of retinal detachment; by scleral buckling or vitrectomy_ on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67112","description":"Repair of retinal detachment; by scleral buckling or vitrectomy_ on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUA1","description":"ICD-BEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dextran 40 infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7100","description":"Dextran 40 infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODME0","description":"ICD-ODME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABD1","description":"ICD-GABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of throat abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42720","description":"Drainage of throat abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRC1","description":"ICD-PHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJC0","description":"ICD-JBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10B","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1062T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1062T","description":"CPT-1062T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHF0","description":"ICD-CAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKC0","description":"ICD-KDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLB0","description":"ICD-FHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect distal humerus tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24150","description":"Resect distal humerus tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXE0","description":"ICD-GDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINB1","description":"ICD-KINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMB0","description":"ICD-AIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB11","description":"ICD-3EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carrier screening for severe inherited conditions (eg_ cystic fibrosis_ spinal muscular atrophy_ beta hemoglobinopathies [including sickle cell disease]_ alpha thalassemia)_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0449U","description":"Carrier screening for severe inherited conditions (eg_ cystic fibrosis_ spinal muscular atrophy_ beta hemoglobinopathies [including sickle cell disease]_ alpha thalassemia)_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTD0","description":"ICD-AHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB46","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECA1","description":"ICD-NECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXC1","description":"ICD-CCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Com wrap-around sv_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2022","description":"Com wrap-around sv_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB55","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSB1","description":"ICD-HCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo torsion ball bearing j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2060","description":"Hkafo torsion ball bearing j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKB1","description":"ICD-NEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dementia measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8902","description":"Dementia measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDA1","description":"ICD-JEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15200","description":"Skin full graft trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Memoderm/derma/tranz/integup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4126","description":"Memoderm/derma/tranz/integup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mech remov tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36595","description":"Mech remov tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXB0","description":"ICD-OJXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator chi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3206","description":"Hightop w/ supp/pronator chi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93621","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLF1","description":"ICD-OJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIE1","description":"ICD-MKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHF1","description":"ICD-IHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMA0","description":"ICD-KFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egfr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81235","description":"Egfr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNC0","description":"ICD-BFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44361","description":"Small bowel endoscopy/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDC1","description":"ICD-JFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPE1","description":"ICD-FHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDA1","description":"ICD-OBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLF1","description":"ICD-NFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQC0","description":"ICD-KBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIB1","description":"ICD-FAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sperm duct(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55250","description":"Removal of sperm duct(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gsc >15 & hd ct by ed md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9594","description":"Gsc >15 & hd ct by ed md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACE1","description":"ICD-KACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDC1","description":"ICD-ACDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDB1","description":"ICD-FCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice long term care_ r&b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2046","description":"Hospice long term care_ r&b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFF0","description":"ICD-BIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESD0","description":"ICD-PESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGF0","description":"ICD-GIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glucose other fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82945","description":"Glucose other fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXA1","description":"ICD-BBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open/perq place stent ea add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37237","description":"Open/perq place stent ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBD1","description":"ICD-OJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6515","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","description":"HCPCS-A6515","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATC1","description":"ICD-IATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair pail or pan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0167","description":"Commode chair pail or pan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj metaraminol bitartrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0380","description":"Inj metaraminol bitartrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imaging Of Retina For Detection Or Monitoring Of Disease; Point-Of-Care Automated Analysis And Report_ Unilateral Or Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92229","description":"Imaging Of Retina For Detection Or Monitoring Of Disease; Point-Of-Care Automated Analysis And Report_ Unilateral Or Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXA0","description":"ICD-CHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88165","description":"Cytopath tbs c/v redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip orthosis (HO)_ bilateral hip joints and thigh cuffs_ adjustable flexion_ extension_ abduction control of hip joint_ postoperative hip abduction type_ prefabricated item th","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1681","description":"Hip orthosis (HO)_ bilateral hip joints and thigh cuffs_ adjustable flexion_ extension_ abduction control of hip joint_ postoperative hip abduction type_ prefabricated item th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement breastpump adpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4282","description":"Replacement breastpump adpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMA0","description":"ICD-BBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES321","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m succimer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9551","description":"Tc99m succimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0941T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","description":"CPT-0941T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWC0","description":"ICD-DFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"First Medicare Diabetes Prevention Program (MDPP) core session was attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service tha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9873","description":"First Medicare Diabetes Prevention Program (MDPP) core session was attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service tha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ apadamtase alfa_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9167","description":"Injection_ apadamtase alfa_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDD1","description":"ICD-GGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home modifications per serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5165","description":"Home modifications per serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iron binding test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83550","description":"Iron binding test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES254","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAD1","description":"ICD-KIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11A","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICD0","description":"ICD-EICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHF1","description":"ICD-CHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1302","description":"HCPCS-B1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temp anchorage dev w flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7293","description":"Temp anchorage dev w flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval npgs apnea study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0436T","description":"Prgrmg eval npgs apnea study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82627","description":"Dehydroepiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE244","description":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68335","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXC1","description":"ICD-OGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0716T","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJF1","description":"ICD-FAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUA1","description":"ICD-GHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRB0","description":"ICD-ODRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE141","description":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVD0","description":"ICD-FFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSC1","description":"ICD-DFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFF1","description":"ICD-OBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neonatal emergency transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0225","description":"Neonatal emergency transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHE1","description":"ICD-EEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by bulk acoustic wave biosensor immunoassay_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0408U","description":"Infectious agent antigen detection by bulk acoustic wave biosensor immunoassay_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temsirolimus injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9330","description":"Temsirolimus injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGC1","description":"ICD-GDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHA0","description":"ICD-OCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXB1","description":"ICD-JEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA215","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVE0","description":"ICD-FEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQF1","description":"ICD-DGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCA1","description":"ICD-JHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ofloxacin_ 400 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0034","description":"Injection_ ofloxacin_ 400 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHB1","description":"ICD-ACHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMF0","description":"ICD-JAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13D","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy vulva lesion/s compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56515","description":"Destroy vulva lesion/s compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKE0","description":"ICD-CEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUF1","description":"ICD-OGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Detect agent nos dna dir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87797","description":"Detect agent nos dna dir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDF1","description":"ICD-MFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation tx management x5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77427","description":"Radiation tx management x5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVC0","description":"ICD-BDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis_ nuclear-encoded mitochondrial gene a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0417U","description":"Rare diseases (constitutional/heritable disorders)_ whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis_ nuclear-encoded mitochondrial gene a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHF0","description":"ICD-EBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAC1","description":"ICD-BAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of pregnenolone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84140","description":"Assay of pregnenolone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0557","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","description":"HCPCS-G0557","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYB0","description":"ICD-HFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETC0","description":"ICD-FETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","description":"HCPCS-L6033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peak expiratory flow rate (p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8110","description":"Peak expiratory flow rate (p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1356","description":"Patients who died during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCB0","description":"ICD-OFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endometrial sampling or hysteroscopy with biopsy and results not documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9824","description":"Endometrial sampling or hysteroscopy with biopsy and results not documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWD0","description":"ICD-GFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICB0","description":"ICD-KICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 3 piece rigid shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0492","description":"Tlso 3 piece rigid shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARD1","description":"ICD-CARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body jacket mold to patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1300","description":"Body jacket mold to patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hist type doc on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9283","description":"Hist type doc on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLA1","description":"ICD-EBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95714","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stomach surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43999","description":"Stomach surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Air ambulan nonemerg rotary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9961","description":"Air ambulan nonemerg rotary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDC1","description":"ICD-KFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00862","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","description":"CPT-00862","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJA0","description":"ICD-JDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIA1","description":"ICD-KIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digoxin immune fab (ovine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1162","description":"Digoxin immune fab (ovine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1402","description":"HCPCS-A1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Handgrip for cane etc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4636","description":"Handgrip for cane etc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment Of Amblyopia Using An Online Digital Program; Assessment Of Patient Performance And Program Data By Physician Or Other Qualified Health Care Professional_ With Repor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0688T","description":"Treatment Of Amblyopia Using An Online Digital Program; Assessment Of Patient Performance And Program Data By Physician Or Other Qualified Health Care Professional_ With Repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLC1","description":"ICD-KHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOF1","description":"ICD-GDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rep dev_ urinary_ w/o sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2631","description":"Rep dev_ urinary_ w/o sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHA0","description":"ICD-JAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCC0","description":"ICD-ICCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy inner cannula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4623","description":"Tracheostomy inner cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIF0","description":"ICD-FCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMC1","description":"ICD-MEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tendon & muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23405","description":"Incision of tendon & muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear matrix protein 22","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86386","description":"Nuclear matrix protein 22","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) Wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2147","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) Wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRA0","description":"ICD-KBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGE1","description":"ICD-OKGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOD1","description":"ICD-HCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLF0","description":"ICD-MKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1302","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1302","description":"CDT-D1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDF1","description":"ICD-MJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66630","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTB1","description":"ICD-JDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ granisetron_ extended-release_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1627","description":"Injection_ granisetron_ extended-release_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOD1","description":"ICD-CAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAB1","description":"ICD-CBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clsd reduct compd mandble fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7740","description":"Clsd reduct compd mandble fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUC0","description":"ICD-NKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CT/MRI brain done 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3112F","description":"CT/MRI brain done 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDD1","description":"ICD-IFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deluxe item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1001","description":"Deluxe item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOB1","description":"ICD-OGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQF0","description":"ICD-DBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDB1","description":"ICD-AIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSA1","description":"ICD-CCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRA1","description":"ICD-LFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJE0","description":"ICD-CHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCB1","description":"ICD-ABCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5162","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","description":"HCPCS-Q5162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDE1","description":"ICD-ABDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score le < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8656","description":"Fun stat score le < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJD0","description":"ICD-OBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIB0","description":"ICD-NDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D8671","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D8671","description":"CDT-D8671","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hd shck absrbr for hd man wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1017","description":"Hd shck absrbr for hd man wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHD0","description":"ICD-GFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEE0","description":"ICD-FIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDE1","description":"ICD-OBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVC1","description":"ICD-OEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary angiography of major aortopulmonary colla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93575","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary angiography of major aortopulmonary colla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj pembrolizumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9271","description":"Inj pembrolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWB1","description":"ICD-KEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHA1","description":"ICD-MFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLF1","description":"ICD-BCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCC1","description":"ICD-OGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUF1","description":"ICD-NEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92639","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","description":"CPT-92639","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBC1","description":"ICD-OEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hsv dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87529","description":"Hsv dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILA0","description":"ICD-MILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resin-based composite - four or more surfaces (anterior)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2335","description":"Resin-based composite - four or more surfaces (anterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8911","description":"Mra w/o fol w/cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Accessory for gradient compression garment or wrap with adjustable straps_ non-otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6593","description":"Accessory for gradient compression garment or wrap with adjustable straps_ non-otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADE0","description":"ICD-AADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJE1","description":"ICD-KAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percut ablate liver rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47382","description":"Percut ablate liver rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECC0","description":"ICD-NECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARF1","description":"ICD-LARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ spherical_ photochromic additive_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2524","description":"Contact lens_ hydrophilic_ spherical_ photochromic additive_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECC1","description":"ICD-IECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83528","description":"Assay of intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anal sp inf pmp w/reprg&fill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62369","description":"Anal sp inf pmp w/reprg&fill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBB0","description":"ICD-FBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0D","description":"Low Rehab_ ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXD0","description":"ICD-FCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Txmnts 2 phys/qhp by 1 mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5020F","description":"Txmnts 2 phys/qhp by 1 mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUD1","description":"ICD-MEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mw therapy for breast tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0301T","description":"Mw therapy for breast tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDB1","description":"ICD-JEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth pacemaker insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53051","description":"Anesth pacemaker insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sps elbow device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1801","description":"Sps elbow device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj excisn of joint membrane","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7854","description":"Tmj excisn of joint membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24B","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVE1","description":"ICD-CIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHE1","description":"ICD-BFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVB1","description":"ICD-NEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0739","description":"Injection_ cabotegravir_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB21","description":"ICD-4GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tap block bi by infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64489","description":"Tap block bi by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQA0","description":"ICD-CBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair detachable foot r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1070","description":"Wheelchair detachable foot r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDID1","description":"ICD-MDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31510","description":"Laryngoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQD0","description":"ICD-HHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy infusion method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96425","description":"Chemotherapy infusion method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETB0","description":"ICD-BETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRC0","description":"ICD-GBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDF1","description":"ICD-GEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13D","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAB1","description":"ICD-ACAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tebentafusp-tebn_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9274","description":"Injection_ tebentafusp-tebn_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB54","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bath tub rail floor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0242","description":"Bath tub rail floor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise graft w/nonauto graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35883","description":"Revise graft w/nonauto graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEC1","description":"ICD-GGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCC0","description":"ICD-GCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDF1","description":"ICD-MCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHC1","description":"ICD-CCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq card stent w/angio addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92929","description":"Prq card stent w/angio addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exposure behavior treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0373T","description":"Exposure behavior treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1059T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1059T","description":"CPT-1059T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBA0","description":"ICD-EIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc order given stop antibio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4043F","description":"Doc order given stop antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBE0","description":"ICD-JDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0217T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQA0","description":"ICD-PCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSD1","description":"ICD-HHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83051","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pilonidal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10080","description":"Drainage of pilonidal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext h rate sz 15-30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0383T","description":"Ext h rate sz 15-30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASE1","description":"ICD-PASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHC1","description":"ICD-EBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syst bp >/= 140 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3077F","description":"Syst bp >/= 140 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert electrodes for eeg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95830","description":"Insert electrodes for eeg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33900","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFA0","description":"ICD-NLFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUD0","description":"ICD-NDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVF0","description":"ICD-BAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATA0","description":"ICD-KATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD120","description":"Special Care High _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating below the heart (e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93588","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating below the heart (e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEE1","description":"ICD-JFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Smear wet mount saline/ink","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87210","description":"Smear wet mount saline/ink","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Round caliper and plate atta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2240","description":"Round caliper and plate atta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc daily aspirin or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9277","description":"Doc daily aspirin or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICD0","description":"ICD-JICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid lined custom fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0482","description":"Tlso rigid lined custom fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Atropine comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7635","description":"Atropine comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERB0","description":"ICD-KERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWE0","description":"ICD-ODWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ isavuconazonium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1833","description":"Injection_ isavuconazonium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2389","description":"Foam caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of inner eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67036","description":"Removal of inner eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of rectal narrowing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45910","description":"Dilation of rectal narrowing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUC0","description":"ICD-FFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJF0","description":"ICD-CFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31000","description":"Irrigation maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACC1","description":"ICD-CACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTC0","description":"ICD-IBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHA0","description":"ICD-BDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFC0","description":"ICD-GDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIC0","description":"ICD-JAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJB1","description":"ICD-GGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant spinal canal cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62350","description":"Implant spinal canal cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVA0","description":"ICD-GDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14C","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDF0","description":"ICD-NBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKC0","description":"ICD-JCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA36","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPC1","description":"ICD-FAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O2 saturation >88%/pao>55 hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3037F","description":"O2 saturation >88%/pao>55 hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repr pul art unifocal w/cpb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33926","description":"Repr pul art unifocal w/cpb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37294","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","description":"CPT-37294","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCB0","description":"ICD-JDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI uppr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73220","description":"MRI uppr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMF1","description":"ICD-CHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv musc neck dyston","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64616","description":"Chemodenerv musc neck dyston","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX15","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUC0","description":"ICD-EBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spectinomycn di-hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3320","description":"Spectinomycn di-hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGF0","description":"ICD-NKGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPC1","description":"ICD-GCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62117","description":"Reduction of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWD1","description":"ICD-DFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak pelvic control belt pad/l","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5694","description":"Ak pelvic control belt pad/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ex arm/elbow tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24073","description":"Ex arm/elbow tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1060T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1060T","description":"CPT-1060T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko elastic with joints","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1810","description":"Ko elastic with joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIF0","description":"ICD-KAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESC0","description":"ICD-DESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBB1","description":"ICD-FGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPF1","description":"ICD-FHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAID1","description":"ICD-FAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins bone device for rsa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0347T","description":"Ins bone device for rsa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTD0","description":"ICD-MFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Er+ or pr+ breast cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3315F","description":"Er+ or pr+ breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWC0","description":"ICD-LEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDD0","description":"ICD-ACDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE105","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther/prop/diag inj/inf proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96379","description":"Ther/prop/diag inj/inf proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8C","description":"Very High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHB1","description":"ICD-OCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"L colectomy/coloproctostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44207","description":"L colectomy/coloproctostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJC0","description":"ICD-KFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLF0","description":"ICD-MHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKD0","description":"ICD-FDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB246","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUC1","description":"ICD-FBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1361","description":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADD1","description":"ICD-MADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUB0","description":"ICD-CGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWD1","description":"ICD-KFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEE0","description":"ICD-OCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Island pedicle flap graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15740","description":"Island pedicle flap graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAD1","description":"ICD-OBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLA1","description":"ICD-ACLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular Repair Of Iliac Artery At The Time Of Aorto-Iliac Artery Endograft Placement By Deployment Of An Iliac Branched Endograft Including Pre-Procedure Sizing And Devic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34717","description":"Endovascular Repair Of Iliac Artery At The Time Of Aorto-Iliac Artery Endograft Placement By Deployment Of An Iliac Branched Endograft Including Pre-Procedure Sizing And Devic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic band & belt thigh fla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2192","description":"Pelvic band & belt thigh fla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10C","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX30","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUB1","description":"ICD-CAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC31","description":"ICD-4GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAA1","description":"ICD-BCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVD1","description":"ICD-CHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert_ pneum wheel drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2383","description":"Insert_ pneum wheel drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of protein serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84155","description":"Assay of protein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1297","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMF1","description":"ICD-BBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ovine_ up to 999 usp units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3471","description":"Ovine_ up to 999 usp units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAF0","description":"ICD-MGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/drug service 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0050","description":"Alcohol/drug service 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foot longitud/metatarsal sup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3020","description":"Foot longitud/metatarsal sup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASC1","description":"ICD-KASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arsenic trioxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9017","description":"Arsenic trioxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application long leg splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29505","description":"Application long leg splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNC1","description":"ICD-CDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ diagnostic algorithm reported as a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0367U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ diagnostic algorithm reported as a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDF1","description":"ICD-AIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVD1","description":"ICD-GDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Io rad tx deliver by elctrns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77425","description":"Io rad tx deliver by elctrns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6067","description":"Implant supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKB1","description":"ICD-GCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Position back cush wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2614","description":"Position back cush wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lower extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93925","description":"Lower extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko double upright pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1845","description":"Ko double upright pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOD1","description":"ICD-OFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak 4 bar ling w/hydraul swig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5613","description":"Ak 4 bar ling w/hydraul swig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69642","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQD1","description":"ICD-KIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53605","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor ix complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7194","description":"Factor ix complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHF0","description":"ICD-GEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lith ion batt cid_non-earlvl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8623","description":"Lith ion batt cid_non-earlvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66720","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIC1","description":"ICD-FFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUF0","description":"ICD-BCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOB1","description":"ICD-OJOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ clevidipine butyrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9248","description":"Inj_ clevidipine butyrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lenacapavir_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1961","description":"Injection_ lenacapavir_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE140","description":"Special Care High _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abduction bar-straight","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2310","description":"Abduction bar-straight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSD1","description":"ICD-OFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACD0","description":"ICD-JACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAF0","description":"ICD-KBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26785","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJF1","description":"ICD-FFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD236","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHF1","description":"ICD-EHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAC0","description":"ICD-ADAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve pedicle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64907","description":"Nerve pedicle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWE0","description":"ICD-OIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINA0","description":"ICD-JINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADA1","description":"ICD-OADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHC0","description":"ICD-AHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVB1","description":"ICD-BAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFE0","description":"ICD-NGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB11","description":"ICD-4FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDE0","description":"ICD-BDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJC1","description":"ICD-NCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11300","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2206","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCF0","description":"ICD-FDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJA1","description":"ICD-CGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hexagnal phosph pltlt neutrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85598","description":"Hexagnal phosph pltlt neutrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBC1","description":"ICD-IIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXA1","description":"ICD-KGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt surv results not avail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9604","description":"Pt surv results not avail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALC1","description":"ICD-MALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Man w/ch acc seat w>=20in<24in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2201","description":"Man w/ch acc seat w>=20in<24in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery translocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33506","description":"Repair artery translocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28E","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYB1","description":"ICD-LAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20B","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKA1","description":"ICD-OGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB236","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ hydroxocobalamin_ intravenous_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3424","description":"Injection_ hydroxocobalamin_ intravenous_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Etoposide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9181","description":"Etoposide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUA0","description":"ICD-ICUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab_ 10 mg and hyaluronidase-oysk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9356","description":"Injection_ trastuzumab_ 10 mg and hyaluronidase-oysk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBB0","description":"ICD-EDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction_ hallux valgus (bunionectomy)_ with sesamoidectomy_ when performed; with proximal metatarsal osteotomy_ any method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28295","description":"Correction_ hallux valgus (bunionectomy)_ with sesamoidectomy_ when performed; with proximal metatarsal osteotomy_ any method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQD1","description":"ICD-OAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0025","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPE1","description":"ICD-NKPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKD1","description":"ICD-NFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHF0","description":"ICD-CBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0642U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0642U","description":"CPT-0642U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27824","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 22 And Functional Status Measure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2145","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 22 And Functional Status Measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTB0","description":"ICD-MCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDE0","description":"ICD-BIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clean rem part denture max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9934","description":"Clean rem part denture max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSF1","description":"ICD-KBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCE1","description":"ICD-JBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRA0","description":"ICD-DGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYF0","description":"ICD-OHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ von Willebrand factor (recombinant)_ (Vonvendi)_ 1 IU VWF:RCo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7179","description":"Injection_ von Willebrand factor (recombinant)_ (Vonvendi)_ 1 IU VWF:RCo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINE0","description":"ICD-KINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat skull fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62005","description":"Treat skull fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNC0","description":"ICD-JCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2215","description":"Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJB0","description":"ICD-NFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJA1","description":"ICD-NCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism EvidenceCare imaging advisor_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1013","description":"Clinical decision support mechanism EvidenceCare imaging advisor_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Legion pneumo dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87541","description":"Legion pneumo dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSA0","description":"ICD-HBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXC0","description":"ICD-JBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without contrast material; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77046","description":"Magnetic resonance imaging_ breast_ without contrast material; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3d render w/intrp postproces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76377","description":"3d render w/intrp postproces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoluminal bx biliary tree","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47543","description":"Endoluminal bx biliary tree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQF0","description":"ICD-HEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD135","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leptospira antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86720","description":"Leptospira antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo_ walk boot type_ cus fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4631","description":"Afo_ walk boot type_ cus fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE255","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPD1","description":"ICD-JEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAA1","description":"ICD-CGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFC0","description":"ICD-BBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18I","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIF0","description":"ICD-OEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24A","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by abdominal or retroperitoneal inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34833","description":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by abdominal or retroperitoneal inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDC0","description":"ICD-NIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pain neg no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8731","description":"Pain neg no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC215","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCA1","description":"ICD-MBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUE1","description":"ICD-OFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD201","description":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic pancreatoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43273","description":"Endoscopic pancreatoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA53","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr pack base elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0488","description":"Pwr pack base elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA11","description":"ICD-1FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intake Activities_ Including Initial Medical Examination That Is A Complete_ Fully Documented Physical Evaluation And Initial Assessment By A Program Physician Or A Primary Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2076","description":"Intake Activities_ Including Initial Medical Examination That Is A Complete_ Fully Documented Physical Evaluation And Initial Assessment By A Program Physician Or A Primary Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDD0","description":"ICD-AHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCD0","description":"ICD-BFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2192","description":"Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQE1","description":"ICD-LDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOE0","description":"ICD-KIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAC0","description":"ICD-JIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQE1","description":"ICD-GAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUC1","description":"ICD-JCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64655","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","description":"CPT-64655","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77066","description":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBE0","description":"ICD-OEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00566","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","description":"CPT-00566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCF1","description":"ICD-BHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQE1","description":"ICD-PIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genetic counsel 15 mins","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0265","description":"Genetic counsel 15 mins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUF0","description":"ICD-MKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; with insertion of intraluminal tube or catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0654T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; with insertion of intraluminal tube or catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lyme disease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86617","description":"Lyme disease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWA1","description":"ICD-OKWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD136","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABF1","description":"ICD-AABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE125","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of toes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28280","description":"Fusion of toes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEA0","description":"ICD-IFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELB1","description":"ICD-IELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUB0","description":"ICD-EIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISA0","description":"ICD-PISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRC0","description":"ICD-KDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Patisiran_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0222","description":"Injection_ Patisiran_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIC1","description":"ICD-CAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27369","description":"Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound breast limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76642","description":"Ultrasound breast limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTB0","description":"ICD-MDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28X","description":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPB1","description":"ICD-CBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing antigen system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86911","description":"Blood typing antigen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal with reinsertion_ non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0518","description":"Removal with reinsertion_ non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin polyc mch sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5816","description":"Endo knee-shin polyc mch sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAC1","description":"ICD-CAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCD1","description":"ICD-BGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special anesthesia service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99100","description":"Special anesthesia service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Storage/year reprod tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89344","description":"Storage/year reprod tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKB1","description":"ICD-OGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB25","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYD0","description":"ICD-KGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSF0","description":"ICD-LHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJA0","description":"ICD-BAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYA0","description":"ICD-OFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNF0","description":"ICD-BDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise spinal cord ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63180","description":"Revise spinal cord ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXC0","description":"ICD-BCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCF1","description":"ICD-NGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1720","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1720","description":"CDT-D1720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5D","description":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1201","description":"HCPCS-B1201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUD0","description":"ICD-GAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82105","description":"Alpha-fetoprotein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0932T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","description":"CPT-0932T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPD1","description":"ICD-CAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBC0","description":"ICD-IBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKB0","description":"ICD-NAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Position back cush wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2613","description":"Position back cush wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML22","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGC1","description":"ICD-BFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHME1","description":"ICD-JHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33697","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUD0","description":"ICD-FFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 3","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA36","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMC0","description":"ICD-AHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0168","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","description":"HCPCS-J0168","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0680","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","description":"HCPCS-G0680","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMD0","description":"ICD-NAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWB0","description":"ICD-LGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spinal canal catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62355","description":"Remove spinal canal catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUD0","description":"ICD-BGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAA1","description":"ICD-AAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWC0","description":"ICD-PLWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEF0","description":"ICD-EHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","description":"HCPCS-M1375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKC1","description":"ICD-BFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAID1","description":"ICD-MAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRC1","description":"ICD-DCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk flex inner socket ext fra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5645","description":"Bk flex inner socket ext fra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADF0","description":"ICD-NADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYA0","description":"ICD-KCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYF0","description":"ICD-CCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteot hum xtrnl lngth dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0594T","description":"Osteot hum xtrnl lngth dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy bowel pouch/biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44386","description":"Endoscopy bowel pouch/biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDA1","description":"ICD-MLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWE1","description":"ICD-KAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJC1","description":"ICD-CIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35884","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIE1","description":"ICD-MAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWF0","description":"ICD-DGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXE1","description":"ICD-KIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPC1","description":"ICD-JGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOE1","description":"ICD-CAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVF0","description":"ICD-CEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLB1","description":"ICD-ACLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVE1","description":"ICD-GDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADE1","description":"ICD-CADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBC0","description":"ICD-NFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy prostatic imp 1-3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9739","description":"Cystoscopy prostatic imp 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Detect agnt mult dna direc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87800","description":"Detect agnt mult dna direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1004","description":"HCPCS-B1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51700","description":"Irrigation of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33852","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKA1","description":"ICD-KCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALE1","description":"ICD-NALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA55","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radio/surgical implant index","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6190","description":"Radio/surgical implant index","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUC1","description":"ICD-KDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20A","description":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB31","description":"ICD-1GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCD1","description":"ICD-JHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No postop ren fail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8576","description":"No postop ren fail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tibia & fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27709","description":"Incision of tibia & fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTE1","description":"ICD-NLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB214","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOB0","description":"ICD-HHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22A","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQD0","description":"ICD-DFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLB1","description":"ICD-GFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic Small Intestine Follow-Through Study_ Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examinatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74248","description":"Radiologic Small Intestine Follow-Through Study_ Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examinatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANF0","description":"ICD-BANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEC0","description":"ICD-AEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recd scrn hcv infec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9383","description":"Recd scrn hcv infec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8X","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of thigh muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27386","description":"Repair/graft of thigh muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAE0","description":"ICD-NGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat sesamoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28530","description":"Treat sesamoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAE0","description":"ICD-KIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUE1","description":"ICD-OJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHB0","description":"ICD-NDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAF1","description":"ICD-ACAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11404","description":"Exc tr-ext b9+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release/revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50725","description":"Release/revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Fixed Retainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8698","description":"Re-Cement Or Re-Bond Fixed Retainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRC1","description":"ICD-HIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPE1","description":"ICD-NCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMF0","description":"ICD-MLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD256","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUD0","description":"ICD-ICUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKB0","description":"ICD-JBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24D","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing care not medically possible because the patient was  discharged early due to specific medical events_ documented in the medical record_ such as the patient became hosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1147","description":"Ongoing care not medically possible because the patient was  discharged early due to specific medical events_ documented in the medical record_ such as the patient became hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"L hrt art/grft angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93459","description":"L hrt art/grft angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC260","description":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous Visible Light Hyperspectral Imaging Measurement Of Oxyhemoglobin_ Deoxyhemoglobin_ And Tissue Oxygenation_ With Interpretation And Report_ Per Extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0631T","description":"Transcutaneous Visible Light Hyperspectral Imaging Measurement Of Oxyhemoglobin_ Deoxyhemoglobin_ And Tissue Oxygenation_ With Interpretation And Report_ Per Extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81173","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEC0","description":"ICD-IFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUD0","description":"ICD-MBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRD1","description":"ICD-GHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELD1","description":"ICD-OELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of pubic bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27282","description":"Fusion of pubic bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDD0","description":"ICD-JEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00562","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","description":"CPT-00562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neg press ventilation cnp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94662","description":"Neg press ventilation cnp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Igh gene rearrang dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81262","description":"Igh gene rearrang dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0305","description":"HCPCS-A0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fndngs mammo 2pt w/in 3 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5060F","description":"Fndngs mammo 2pt w/in 3 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAF0","description":"ICD-MHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-bmez_ biosimilar_ (ziextenzo)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5120","description":"Injection_ pegfilgrastim-bmez_ biosimilar_ (ziextenzo)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTF1","description":"ICD-GCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Becaplermin gel 1%_ 0.5 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0157","description":"Becaplermin gel 1%_ 0.5 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible; with ablation of tumor(s)_ polyp(s)_ or other lesions(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6022","description":"Sigmoidoscopy_ flexible; with ablation of tumor(s)_ polyp(s)_ or other lesions(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis delta agent antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86692","description":"Hepatitis delta agent antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACA1","description":"ICD-CACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subretinal injection of a pharmacologic agent_ including vitrectomy and 1 or more retinotomies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0810T","description":"Subretinal injection of a pharmacologic agent_ including vitrectomy and 1 or more retinotomies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"In111 pentetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9548","description":"In111 pentetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCED0","description":"ICD-BCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKB0","description":"ICD-JFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wilate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7183","description":"Wilate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temple bone implant revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69717","description":"Temple bone implant revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDE1","description":"ICD-GHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28H","description":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tick-borne encephalitis virus vaccine_ inactivated; 0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90626","description":"Tick-borne encephalitis virus vaccine_ inactivated; 0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPC0","description":"ICD-GEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lympho venereum antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86729","description":"Lympho venereum antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28294","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRC1","description":"ICD-PLRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLD0","description":"ICD-ABLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-dttb_ biosimilar_ (Ontruzant)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5112","description":"Injection_ trastuzumab-dttb_ biosimilar_ (Ontruzant)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFD1","description":"ICD-NDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3mL dosage_ diluent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91300","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3mL dosage_ diluent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLD0","description":"ICD-FHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATF0","description":"ICD-CATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHE0","description":"ICD-JDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMF0","description":"ICD-NAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISD1","description":"ICD-OISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBA0","description":"ICD-MKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWA0","description":"ICD-HCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay lipoprotein pla2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83698","description":"Assay lipoprotein pla2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLC0","description":"ICD-JCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAC1","description":"ICD-ABAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB56","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFE0","description":"ICD-FHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGF1","description":"ICD-FAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance; prostate volume greater or equal to 50 mL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0867T","description":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance; prostate volume greater or equal to 50 mL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glasses air conduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5070","description":"Glasses air conduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Somatrem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2940","description":"Somatrem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE156","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFF1","description":"ICD-ODFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kne-shin exo sng axi mnl loc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5710","description":"Kne-shin exo sng axi mnl loc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOF1","description":"ICD-DGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PROTON THERAPY","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77524","description":"PROTON THERAPY","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01274","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","description":"CPT-01274","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth stone removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91851","description":"Anesth stone removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intervene hlth/behave group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96153","description":"Intervene hlth/behave group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSC1","description":"ICD-DCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTF1","description":"ICD-OLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis_ c.472G>A (rs4680) variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0032U","description":"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis_ c.472G>A (rs4680) variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQF0","description":"ICD-LBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWF0","description":"ICD-HGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69661","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infusion pump_non-prog_ perm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1891","description":"Infusion pump_non-prog_ perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACE1","description":"ICD-EACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVC0","description":"ICD-OGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antinomyces antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86602","description":"Antinomyces antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepa vaccine adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90632","description":"Hepa vaccine adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHD1","description":"ICD-NHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0803","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0803","description":"CDT-D0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens lenticular bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2215","description":"Lens lenticular bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0120U","description":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tyrosinemia type I monitoring by patient-collected blood card sample_ quantitative measurement of tyrosine_ phenylalanine_ methionine_ succinylacetone_ nitisinone_ liquid chro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0383U","description":"Tyrosinemia type I monitoring by patient-collected blood card sample_ quantitative measurement of tyrosine_ phenylalanine_ methionine_ succinylacetone_ nitisinone_ liquid chro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients on immune checkpoint inhibitor therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1180","description":"Patients on immune checkpoint inhibitor therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microdissection laser","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88380","description":"Microdissection laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8A","description":"Medium Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace vad intra w/o bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33982","description":"Replace vad intra w/o bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37242","description":"Vasc embolize/occlude artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos macroalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3062F","description":"Pos macroalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKA0","description":"ICD-NIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIA1","description":"ICD-IHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCD0","description":"ICD-MLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAE0","description":"ICD-OFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUF0","description":"ICD-CHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cognit assessed and reviewed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1494F","description":"Cognit assessed and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEE0","description":"ICD-FAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54322","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ necitumumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9295","description":"Injection_ necitumumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_  tibial/peroneal artery(ies); with intravascular lithotripsy_ and transluminal stent placement(s)_ includes angioplasty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9773","description":"Revascularization_ endovascular_ open or percutaneous_  tibial/peroneal artery(ies); with intravascular lithotripsy_ and transluminal stent placement(s)_ includes angioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4409","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","description":"HCPCS-Q4409","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Candida dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87482","description":"Candida dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIC1","description":"ICD-MGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIC0","description":"ICD-GEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQD0","description":"ICD-PDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIF0","description":"ICD-CGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIF0","description":"ICD-MBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVF0","description":"ICD-CCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1441","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","description":"HCPCS-M1441","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC115","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOD1","description":"ICD-HFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBC0","description":"ICD-AFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHB0","description":"ICD-GHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITE1","description":"ICD-KITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of porphobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84110","description":"Assay of porphobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1346","description":"Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICE1","description":"ICD-CICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQB1","description":"ICD-CFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICC0","description":"ICD-IICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHF0","description":"ICD-BIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDA0","description":"ICD-IEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko single upright pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1843","description":"Ko single upright pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem duplication_ p.D835_ p.I836_ using mononuclear cells_ reported as detection or non-detection of FLT3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0023U","description":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem duplication_ p.D835_ p.I836_ using mononuclear cells_ reported as detection or non-detection of FLT3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUA1","description":"ICD-GGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHA0","description":"ICD-FHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA256","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15C","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAC1","description":"ICD-AIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravertebral body fracture augmentation with implant (e.g._ metal_ polymer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1062","description":"Intravertebral body fracture augmentation with implant (e.g._ metal_ polymer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYE1","description":"ICD-LDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAC0","description":"ICD-NHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMA1","description":"ICD-MFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rocker bottom_ contact afo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2232","description":"Rocker bottom_ contact afo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultraviolet therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97028","description":"Ultraviolet therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMD0","description":"ICD-BGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31225","description":"Removal of upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHE1","description":"ICD-NAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEC0","description":"ICD-MCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Voice amplifier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8510","description":"Voice amplifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAA1","description":"ICD-MHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair non-electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0171","description":"Commode chair non-electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icm/ilr remote tech serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93299","description":"Icm/ilr remote tech serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHD0","description":"ICD-CAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITE0","description":"ICD-AITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE255","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iadna-dna/rna probe tq 6-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87506","description":"Iadna-dna/rna probe tq 6-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUC1","description":"ICD-ABUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESD1","description":"ICD-DESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (brixadi)_ less than or equal to 7 days of therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0577","description":"Injection_ buprenorphine extended-release (brixadi)_ less than or equal to 7 days of therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXE0","description":"ICD-JDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIE1","description":"ICD-FHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXF1","description":"ICD-NDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML25","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXE1","description":"ICD-GDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXE0","description":"ICD-KBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD125","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSA1","description":"ICD-ODSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB51","description":"High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonemerg transp mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0215","description":"Nonemerg transp mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQE0","description":"ICD-ODQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPF0","description":"ICD-BHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIF1","description":"ICD-NJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOE1","description":"ICD-GIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43499","description":"Esophagus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWD0","description":"ICD-LIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autograft Suspension_ Including Cell Processing And Application_ And All System Components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1832","description":"Autograft Suspension_ Including Cell Processing And Application_ And All System Components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMF0","description":"ICD-KHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anticoagulant mgmt initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99363","description":"Anticoagulant mgmt initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFF0","description":"ICD-BGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laiv3 vaccine intranasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90660","description":"Laiv3 vaccine intranasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8807","description":"Doc reas no us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIF1","description":"ICD-EGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHND0","description":"ICD-CHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRF1","description":"ICD-DIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resin three surfaces-anterio","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2332","description":"Resin three surfaces-anterio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal monitor w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59050","description":"Fetal monitor w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEB0","description":"ICD-NKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuromatrix nerve cuff_ cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9355","description":"Neuromatrix nerve cuff_ cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pentamidine comp unit dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7676","description":"Pentamidine comp unit dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-RUC01","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"RUC01","description":"ICD-RUC01","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tone decay hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92563","description":"Tone decay hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSC1","description":"ICD-OKSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of psa total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84153","description":"Assay of psa total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0538U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","description":"CPT-0538U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOB1","description":"ICD-HEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELE1","description":"ICD-KELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB11","description":"ICD-1LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 2.1-3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11603","description":"Exc tr-ext mal+marg 2.1-3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTE0","description":"ICD-FHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNC0","description":"ICD-NHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMC1","description":"ICD-OIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0566","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","description":"HCPCS-G0566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHD0","description":"ICD-BHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDB0","description":"ICD-EDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAE0","description":"ICD-NAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKB0","description":"ICD-NHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBE1","description":"ICD-IEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"WoundEx_ BioSkin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4163","description":"WoundEx_ BioSkin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57335","description":"Repair vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML43","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility_ and an a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1149","description":"Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility_ and an a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKD1","description":"ICD-NBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE131","description":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDE0","description":"ICD-NJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bupivicaine hydro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0020","description":"Injection_ bupivicaine hydro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9282","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","description":"HCPCS-J9282","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCE1","description":"ICD-MCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ blinatumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9039","description":"Injection_ blinatumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Not Referred_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0039","description":"Patient Not Referred_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7050","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJB0","description":"ICD-NIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATB1","description":"ICD-EATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65600","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAB0","description":"ICD-IEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERB1","description":"ICD-OERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vacc 4 dose immunsup im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90747","description":"Hepb vacc 4 dose immunsup im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITC0","description":"ICD-IITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMF1","description":"ICD-EDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWA0","description":"ICD-OAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAED1","description":"ICD-GAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBF0","description":"ICD-EFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place cath carotid/inom art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36222","description":"Place cath carotid/inom art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLD1","description":"ICD-BDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"So vest canvas/web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3675","description":"So vest canvas/web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ casimersen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1426","description":"Injection_ casimersen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACID1","description":"ICD-ACID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78320","description":"Bone imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAB1","description":"ICD-FCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthr0 w/synovectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29863","description":"Hip arthr0 w/synovectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC11","description":"ICD-3FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69650","description":"Release middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICD1","description":"ICD-FICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Misc/exper non-prescript dru","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9150","description":"Misc/exper non-prescript dru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKD1","description":"ICD-JDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous femoral-popliteal arterial revascularization_ with transcatheter placement of intravascular stent graft(s) and closure by any method_ including percutaneous or open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0505T","description":"Endovenous femoral-popliteal arterial revascularization_ with transcatheter placement of intravascular stent graft(s) and closure by any method_ including percutaneous or open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAD1","description":"ICD-CDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADC1","description":"ICD-NADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC31","description":"ICD-1FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEE0","description":"ICD-AIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNE0","description":"ICD-NHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWE0","description":"ICD-DCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXA1","description":"ICD-NDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCB0","description":"ICD-FCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVA1","description":"ICD-CHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert intrauterine device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58300","description":"Insert intrauterine device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEA1","description":"ICD-AIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYA0","description":"ICD-DFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22C","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aminophyllin 250 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0280","description":"Aminophyllin 250 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical chemistry test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84999","description":"Clinical chemistry test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sp bone algrft morsel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20930","description":"Sp bone algrft morsel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (Vas)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2137","description":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (Vas)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISB0","description":"ICD-PISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC234","description":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMB1","description":"ICD-FIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15B","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASB0","description":"ICD-LASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66635","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXE0","description":"ICD-BBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCB1","description":"ICD-NGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBD0","description":"ICD-NDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat combo w/shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1007","description":"Pwr seat combo w/shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX53","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth chest lining biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52251","description":"Anesth chest lining biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHE0","description":"ICD-CGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rna tstng hepc vir ord/docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3265F","description":"Rna tstng hepc vir ord/docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA56","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove sciatic nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64786","description":"Remove sciatic nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHB1","description":"ICD-EAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIB0","description":"ICD-KEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKC0","description":"ICD-OLKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL20","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sleeve lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32486","description":"Sleeve lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20A","description":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTA0","description":"ICD-AGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGB0","description":"ICD-BDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38520","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKB1","description":"ICD-JAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOE1","description":"ICD-OAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEA1","description":"ICD-EGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art pancreas system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1034","description":"Art pancreas system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXA0","description":"ICD-KDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc cardiac modulj pls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0409T","description":"Insj/rplc cardiac modulj pls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIF1","description":"ICD-OIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAD1","description":"ICD-GGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQB1","description":"ICD-CEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACB1","description":"ICD-FACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine nrv half segmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63185","description":"Incise spine nrv half segmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vascular graft_ synthetic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8670","description":"Vascular graft_ synthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUB1","description":"ICD-JIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacologic mgmt w/psytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90863","description":"Pharmacologic mgmt w/psytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXF1","description":"ICD-CBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67922","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE226","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE114","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ bivalent_ preservative free_ 10 mcg/0.2 mL dosa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91316","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ bivalent_ preservative free_ 10 mcg/0.2 mL dosa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVB0","description":"ICD-NCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg cong cyst malf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2402","description":"Fetal surg cong cyst malf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPB1","description":"ICD-CFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRB1","description":"ICD-LFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAF0","description":"ICD-JCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0564","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0564","description":"HCPCS-G0564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUE0","description":"ICD-IIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78432","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC02","description":"Medium Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dual layer impax membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4262","description":"Dual layer impax membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aortic aneurysm<5cm diam ct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9001F","description":"Aortic aneurysm<5cm diam ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXA0","description":"ICD-FBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty rest","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4212","description":"Gingivectomy/plasty rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUA0","description":"ICD-NAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ko elas w/ condyle pads & jo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1820","description":"Ko elas w/ condyle pads & jo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDC0","description":"ICD-EFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAF0","description":"ICD-AHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilated macular exam performed_ including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degenerat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9974","description":"Dilated macular exam performed_ including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degenerat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periodontal maint procedures","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4910","description":"Periodontal maint procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEC0","description":"ICD-EGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEC0","description":"ICD-OCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMD0","description":"ICD-CGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep b surface antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86706","description":"Hep b surface antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBE1","description":"ICD-FEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTE1","description":"ICD-JBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIB1","description":"ICD-NKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYF1","description":"ICD-OCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx gastric unresectable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9102","description":"Onc dx gastric unresectable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDA0","description":"ICD-GCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular dev_ intraop_ det ret","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1784","description":"Ocular dev_ intraop_ det ret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJC0","description":"ICD-NGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1806","description":"Injection_ esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of finger(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73140","description":"X-ray exam of finger(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87484","description":"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVC0","description":"ICD-FFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Construct bowel bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50820","description":"Construct bowel bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc xdrl/idrl lsn any lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63290","description":"Bx/exc xdrl/idrl lsn any lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDD1","description":"ICD-BHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUE0","description":"ICD-NCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFB0","description":"ICD-GIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Redo compl cardiac anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33622","description":"Redo compl cardiac anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit hydra 2 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9375","description":"Hit hydra 2 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXF0","description":"ICD-BCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap inc hernia repair recur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49656","description":"Lap inc hernia repair recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCB0","description":"ICD-IDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Approp ace/arb tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4188F","description":"Approp ace/arb tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41823","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCE1","description":"ICD-MFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES312","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHC0","description":"ICD-EFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQC1","description":"ICD-HAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUD1","description":"ICD-OGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21137","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCB0","description":"ICD-IFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVA1","description":"ICD-KBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and transluminal s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9767","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and transluminal s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLC1","description":"ICD-ICLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVF0","description":"ICD-OLVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vacc 3 dose ped/adol im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90744","description":"Hepb vacc 3 dose ped/adol im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDB0","description":"ICD-IHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit cath care noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5497","description":"Hit cath care noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX06","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47140","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy lymph node exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32674","description":"Thoracoscopy lymph node exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRD0","description":"ICD-LHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYF1","description":"ICD-DBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25150","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXB1","description":"ICD-JAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic pulpotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3220","description":"Therapeutic pulpotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTB1","description":"ICD-CBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indium in-111 auto platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9571","description":"Indium in-111 auto platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCE1","description":"ICD-FHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9484","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSF1","description":"ICD-CFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHF0","description":"ICD-MGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct thorax w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71250","description":"Ct thorax w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWB0","description":"ICD-LBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15B","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVC1","description":"ICD-BIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLA0","description":"ICD-EGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEA1","description":"ICD-OHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEA0","description":"ICD-OLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKF1","description":"ICD-KGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploratory elbow surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24000","description":"Exploratory elbow surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); laparoscopic or robotic_ from living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0666T","description":"Donor hysterectomy (including cold preservation); laparoscopic or robotic_ from living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKC0","description":"ICD-FGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVF1","description":"ICD-FHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVE1","description":"ICD-CDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0916T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","description":"CPT-0916T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us guide tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76940","description":"Us guide tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNF1","description":"ICD-OJNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMF0","description":"ICD-IEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHA0","description":"ICD-OKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMA0","description":"ICD-GBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCE1","description":"ICD-KGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRD1","description":"ICD-PFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cont intraop neuro monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0453","description":"Cont intraop neuro monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB231","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression wrap with adjustable straps_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6584","description":"Gradient compression wrap with adjustable straps_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELF0","description":"ICD-OELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21086","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD131","description":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHC0","description":"ICD-EBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATF0","description":"ICD-NATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWD0","description":"ICD-KHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL23","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methsuximide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6054","description":"Methsuximide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFF0","description":"ICD-BDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYB1","description":"ICD-KGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93620","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVD1","description":"ICD-ODVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEE1","description":"ICD-MJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASD1","description":"ICD-DASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78599","description":"Respiratory nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor wght kininogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85293","description":"Clot factor wght kininogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spinal Puncture_ Therapeutic_ For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter); With Fluoroscopic Or Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62329","description":"Spinal Puncture_ Therapeutic_ For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter); With Fluoroscopic Or Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC246","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCA0","description":"ICD-MCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUD0","description":"ICD-EBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADC1","description":"ICD-CADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDID0","description":"ICD-JDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJB1","description":"ICD-NJJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUE1","description":"ICD-EFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHD0","description":"ICD-BEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0625U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","description":"CPT-0625U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACD0","description":"ICD-FACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair nonunion hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26546","description":"Repair nonunion hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adhesive_ liquid or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4364","description":"Adhesive_ liquid or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1098T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1098T","description":"CPT-1098T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYF1","description":"ICD-GEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1829","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","description":"HCPCS-E1829","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBB0","description":"ICD-NLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar or lumbar rib pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1040","description":"Lumbar or lumbar rib pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect recur gyn mal w/lym","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58958","description":"Resect recur gyn mal w/lym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis be antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86707","description":"Hepatitis be antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUD0","description":"ICD-KEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYC1","description":"ICD-LAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA40","description":"Default_ /60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWB0","description":"ICD-CEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC21","description":"ICD-2EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray skull epidural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75872","description":"Vein x-ray skull epidural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heat & moisture exchange sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7509","description":"Heat & moisture exchange sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC06","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC02","description":"Very High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Satisfy with care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0916","description":"Satisfy with care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Common Variants (Eg_ W515A_ W515K_ W515L_ W515R)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81338","description":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Common Variants (Eg_ W515A_ W515K_ W515L_ W515R)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cranial Electrotherapy Stimulation (Ces) System_ Includes All Supplies And Accessories_ Any Type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1002","description":"Cranial Electrotherapy Stimulation (Ces) System_ Includes All Supplies And Accessories_ Any Type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYE1","description":"ICD-KIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10A","description":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPB0","description":"ICD-GBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLD0","description":"ICD-FCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligate/staple esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43405","description":"Ligate/staple esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58700","description":"Removal of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDF0","description":"ICD-IIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLE1","description":"ICD-MBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24535","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVD0","description":"ICD-JAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUE1","description":"ICD-IEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); open femoral vein approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0806T","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); open femoral vein approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDF0","description":"ICD-CEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abo rh blood typing docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3293F","description":"Abo rh blood typing docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDB0","description":"ICD-GIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intend rpt mult chr msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9669","description":"Intend rpt mult chr msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diaphragm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4266","description":"Diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61567","description":"Incision of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCF0","description":"ICD-OFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SEPT9 (Septin9) (eg_ colorectal cancer) methylation analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81327","description":"SEPT9 (Septin9) (eg_ colorectal cancer) methylation analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Local anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9215","description":"Local anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","description":"HCPCS-J9601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ankle ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27695","description":"Repair of ankle ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRE0","description":"ICD-PFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Offset knee joint heavy duty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2395","description":"Offset knee joint heavy duty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSF0","description":"ICD-LCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4422","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","description":"HCPCS-Q4422","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNC1","description":"ICD-KDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Restraints any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0710","description":"Restraints any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTA1","description":"ICD-CBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ palonosetron HCl (Avyxa)_ not therapeutically equivalent to J2469_ 25 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2468","description":"Injection_ palonosetron HCl (Avyxa)_ not therapeutically equivalent to J2469_ 25 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUC1","description":"ICD-FIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFA1","description":"ICD-OCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPA0","description":"ICD-KDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Septal defect imp sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1817","description":"Septal defect imp sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKA1","description":"ICD-GGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSF0","description":"ICD-CFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29826","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHB1","description":"ICD-KCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14451","description":"Anesth corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of oral tissue soft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7286","description":"Biopsy of oral tissue soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue Transglutaminase_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86364","description":"Tissue Transglutaminase_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-evalest ptproblem focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0170","description":"Re-evalest ptproblem focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair deformity of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28313","description":"Repair deformity of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21139","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC205","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue culture placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88235","description":"Tissue culture placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVD0","description":"ICD-BHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fit aphakia spectcl multifoc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92353","description":"Fit aphakia spectcl multifoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wellness assessment by nonph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5190","description":"Wellness assessment by nonph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epstein-barr antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86663","description":"Epstein-barr antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00529","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","description":"CPT-00529","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glycosylated hemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83036","description":"Glycosylated hemoglobin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTF0","description":"ICD-NFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98004","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","description":"CPT-98004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mitomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9280","description":"Mitomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin-based indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2710","description":"Crown resin-based indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXF1","description":"ICD-KBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech lang goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9175","description":"Speech lang goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Brexanolone_ 1Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9055","description":"Injection_ Brexanolone_ 1Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHED1","description":"ICD-FHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCB0","description":"ICD-CBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGB1","description":"ICD-KAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIA1","description":"ICD-MEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1739","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1739","description":"HCPCS-C1739","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation supply sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4397","description":"Irrigation supply sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocytotoxicity assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86806","description":"Lymphocytotoxicity assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIA0","description":"ICD-NHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Octreotide injection_ depot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2353","description":"Octreotide injection_ depot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFF0","description":"ICD-KCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAD1","description":"ICD-FGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ coagulation Factor Xa (recombinant)_ inactivated (Andexxa)_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9041","description":"Injection_ coagulation Factor Xa (recombinant)_ inactivated (Andexxa)_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lab labial veneer porcelain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2962","description":"Lab labial veneer porcelain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot inhibit prot s total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85305","description":"Clot inhibit prot s total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEF0","description":"ICD-MKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAF1","description":"ICD-OKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDE0","description":"ICD-NFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apnea monitor w recorder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0619","description":"Apnea monitor w recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic procd strg endur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0237","description":"Therapeutic procd strg endur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIA1","description":"ICD-CBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBA1","description":"ICD-EDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total hip resurfacing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2118","description":"Total hip resurfacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAB0","description":"ICD-EEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","description":"HCPCS-M1405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSC0","description":"ICD-ODSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46705","description":"Repair of anal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLC0","description":"ICD-ICLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQF0","description":"ICD-CHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGF0","description":"ICD-BIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWB1","description":"ICD-HHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNF0","description":"ICD-GBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj sc/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96372","description":"Ther/proph/diag inj sc/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDE0","description":"ICD-CDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59150","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYE1","description":"ICD-GFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","description":"HCPCS-J2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVB0","description":"ICD-CFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate oral 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8610","description":"Methotrexate oral 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Restrata_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2007","description":"Restrata_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJA1","description":"ICD-JBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3-d radiotherapy plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77295","description":"3-d radiotherapy plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVB1","description":"ICD-GHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration femoral artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35721","description":"Exploration femoral artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fosaprepitant (teva)_ not therapeutically equivalent to j1453_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1456","description":"Injection_ fosaprepitant (teva)_ not therapeutically equivalent to j1453_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tagraxofusp-erzs_ 10mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9049","description":"Injection_ tagraxofusp-erzs_ 10mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECB0","description":"ICD-BECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEB1","description":"ICD-IEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAF1","description":"ICD-AHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo new ureter/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50947","description":"Laparo new ureter/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26742","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Great toe-hand transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26551","description":"Great toe-hand transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEB0","description":"ICD-JEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3502","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dis site  tele svcs RHC/FQHC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2025","description":"Dis site  tele svcs RHC/FQHC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKA1","description":"ICD-OAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1503","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1503","description":"CDT-D1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESC1","description":"ICD-HESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27781","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cap bld skin piercing laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0620","description":"Cap bld skin piercing laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKB1","description":"ICD-KHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levalbuterol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7607","description":"Levalbuterol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBE1","description":"ICD-NCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0202","description":"HCPCS-B0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0603","description":"HCPCS-B0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29873","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWB0","description":"ICD-DGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFA0","description":"ICD-OLFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLA1","description":"ICD-CGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVD1","description":"ICD-KGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQC0","description":"ICD-LAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No cont ppi or h2ra rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4186F","description":"No cont ppi or h2ra rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUB1","description":"ICD-CCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLF0","description":"ICD-EHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1110","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLC1","description":"ICD-BDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00914","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","description":"CPT-00914","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGD0","description":"ICD-FEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1801","description":"HCPCS-B1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICD1","description":"ICD-AICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOF1","description":"ICD-LAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of knee ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27407","description":"Repair of knee ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6037","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","description":"HCPCS-L6037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKF0","description":"ICD-CHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","description":"HCPCS-J7172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methadone oral 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0109","description":"Methadone oral 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQE1","description":"ICD-PEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES225","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ evinacumab-dgnb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1305","description":"Injection_ evinacumab-dgnb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUA0","description":"ICD-FIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 15-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88262","description":"Chromosome analysis 15-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVB1","description":"ICD-OEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMD1","description":"ICD-BHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYA1","description":"ICD-GHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colpopexy_ vaginal; minimally invasive extra-peritoneal approach (sacrospinous)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9778","description":"Colpopexy_ vaginal; minimally invasive extra-peritoneal approach (sacrospinous)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJA0","description":"ICD-KFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRA0","description":"ICD-CIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEC1","description":"ICD-CGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stnd wt pwr whlchr w control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0011","description":"Stnd wt pwr whlchr w control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVE1","description":"ICD-JHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breath recording infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94772","description":"Breath recording infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDF1","description":"ICD-CIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQE0","description":"ICD-DCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt access bil tree sm bwl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47541","description":"Plmt access bil tree sm bwl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interferon alfacon-1 inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9212","description":"Interferon alfacon-1 inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18A","description":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Droperidol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1790","description":"Droperidol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDE1","description":"ICD-IHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAC0","description":"ICD-EGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEC1","description":"ICD-GBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11C","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63001","description":"Remove spine lamina 1/2 crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWF0","description":"ICD-DDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50570","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELD1","description":"ICD-KELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLA1","description":"ICD-AFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBE1","description":"ICD-KCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQC0","description":"ICD-CBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot </4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64890","description":"Nerve graft hand/foot </4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","description":"HCPCS-Q4373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4396","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","description":"HCPCS-Q4396","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB31","description":"ICD-2DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spec site no cutaneous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9430","description":"Spec site no cutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abrasion lesions add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15787","description":"Abrasion lesions add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe metatarsal bar between","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3410","description":"Shoe metatarsal bar between","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFF1","description":"ICD-KBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bat clps elec/comb vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0497","description":"Bat clps elec/comb vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB226","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXF0","description":"ICD-KDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGE1","description":"ICD-NAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQB0","description":"ICD-KDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML14","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay cyclosporine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80158","description":"Drug assay cyclosporine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cocaine or metabolite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6044","description":"Cocaine or metabolite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5299","description":"Hearing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0221","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC11","description":"ICD-1FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUC0","description":"ICD-OCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVB1","description":"ICD-JEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGC0","description":"ICD-FFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dil macula/fundus exam/w doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8397","description":"Dil macula/fundus exam/w doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt counsld on exam for moles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5005F","description":"Pt counsld on exam for moles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTB1","description":"ICD-OHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWA0","description":"ICD-KEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICB0","description":"ICD-OICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21A","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis c ab test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86803","description":"Hepatitis c ab test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEME1","description":"ICD-EEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq revasc byp graft 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92937","description":"Prq revasc byp graft 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEB1","description":"ICD-OAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHC1","description":"ICD-JIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of cleft lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10251","description":"Anesth repair of cleft lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analyze sp inf pump w/reprog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62368","description":"Analyze sp inf pump w/reprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHA0","description":"ICD-GIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMC0","description":"ICD-KBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef complet w/intact nutrient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4150","description":"Ef complet w/intact nutrient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair urethrovaginal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57311","description":"Repair urethrovaginal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of nasal valve collapse with low energy_ temperature-controlled (ie_ radiofrequency) subcutaneous/submucosal remodeling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30469","description":"Repair of nasal valve collapse with low energy_ temperature-controlled (ie_ radiofrequency) subcutaneous/submucosal remodeling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOE0","description":"ICD-CBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKE1","description":"ICD-CIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB201","description":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBB1","description":"ICD-JDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMC0","description":"ICD-MKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWB1","description":"ICD-GDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; paper_ 1-dimensional_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82487","description":"Chromatography_ qualitative; paper_ 1-dimensional_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLD1","description":"ICD-IDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurovascular pedicle flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15750","description":"Neurovascular pedicle flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUB1","description":"ICD-NBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNA1","description":"ICD-NDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Copd measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8898","description":"Copd measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEF0","description":"ICD-BHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCC0","description":"ICD-AHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45500","description":"Repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent_ chest_ including preparation andadministration of agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9791","description":"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent_ chest_ including preparation andadministration of agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFC1","description":"ICD-BGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60240","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcath closure of vsd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93581","description":"Transcath closure of vsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITE0","description":"ICD-BITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 1 std port seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0813","description":"Pwc gp 1 std port seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC41","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEF1","description":"ICD-FHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVC0","description":"ICD-OCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alveolus clsd reduc stblz te","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7771","description":"Alveolus clsd reduc stblz te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abdomen surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49999","description":"Abdomen surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCA1","description":"ICD-BHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXC0","description":"ICD-OBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01842","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","description":"CPT-01842","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFB0","description":"ICD-BEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOC0","description":"ICD-CEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC32","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0835","description":"Pwc gp2 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of adp & amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82030","description":"Assay of adp & amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBD0","description":"ICD-GCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHED0","description":"ICD-EHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAB0","description":"ICD-MCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deli/install chrg hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1600","description":"Deli/install chrg hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGF1","description":"ICD-FIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITF1","description":"ICD-KITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYD0","description":"ICD-DGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCF0","description":"ICD-JHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx nose/jaw fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21345","description":"Closed tx nose/jaw fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVD0","description":"ICD-GEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Px sup fee anti-can sub pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0512","description":"Px sup fee anti-can sub pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDF1","description":"ICD-NKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bp out of nrml limits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9274","description":"Bp out of nrml limits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt pulse gen sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4638","description":"Repl batt pulse gen sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGE0","description":"ICD-FGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXC1","description":"ICD-KFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L5-S1 inters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0195T","description":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L5-S1 inters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29040","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRC0","description":"ICD-CDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOD1","description":"ICD-ODOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAA0","description":"ICD-GBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hx injec drug use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9450","description":"Hx injec drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWB0","description":"ICD-PBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC211","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA11","description":"ICD-4CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATC1","description":"ICD-FATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD124","description":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1486","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","description":"HCPCS-M1486","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBE1","description":"ICD-FCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEA1","description":"ICD-EDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl semi/precision attach","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6091","description":"Repl semi/precision attach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJF0","description":"ICD-NEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUB0","description":"ICD-CEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34701","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nephropathy doc tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3066F","description":"Nephropathy doc tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Icar ischm mntrng prgrm eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0305T","description":"Icar ischm mntrng prgrm eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADE1","description":"ICD-JADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove penis & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54130","description":"Remove penis & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ item that has been trimmed_ bent_ molded_ assembled_ or otherwise customized to fit a specific p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3760","description":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ item that has been trimmed_ bent_ molded_ assembled_ or otherwise customized to fit a specific p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRD0","description":"ICD-LGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUC0","description":"ICD-IAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp iliorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35634","description":"Art byp iliorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine ost pch bar w lock fln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4433","description":"Urine ost pch bar w lock fln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIB0","description":"ICD-BCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0371T","description":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77499","description":"Radiation therapy management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0461","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0461","description":"CDT-D0461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBC0","description":"ICD-MIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWA0","description":"ICD-PAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy w/biopsy(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52204","description":"Cystoscopy w/biopsy(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOB0","description":"ICD-GGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1362","description":"Patients who died during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Open_ Performed At The Time Of Other Sternotomy Or Thoracotomy Procedure(S)_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33268","description":"Exclusion Of Left Atrial Appendage_ Open_ Performed At The Time Of Other Sternotomy Or Thoracotomy Procedure(S)_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLA0","description":"ICD-BBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg urin trac obstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2401","description":"Fetal surg urin trac obstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUA0","description":"ICD-BDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colon ca scrn; barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0120","description":"Colon ca scrn; barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQD1","description":"ICD-DAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYA1","description":"ICD-KCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXE1","description":"ICD-KEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen quant zonisamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80203","description":"Drug screen quant zonisamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUA0","description":"ICD-KHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFF0","description":"ICD-CBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERA1","description":"ICD-KERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled carbon dioxide test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94770","description":"Exhaled carbon dioxide test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIF1","description":"ICD-IDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVD0","description":"ICD-GCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENA0","description":"ICD-CENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQC0","description":"ICD-PIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATE1","description":"ICD-IATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAE1","description":"ICD-FIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFB1","description":"ICD-GBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILE0","description":"ICD-GILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAB0","description":"ICD-KIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDD0","description":"ICD-OHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tympanometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92567","description":"Tympanometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9918","description":"Functional status not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; second physician or other qualifie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0821T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; second physician or other qualifie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Community Transition Svcs (House Hold Suppl)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7332","description":"Community Transition Svcs (House Hold Suppl)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pelv & thor control gluteal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2650","description":"Pelv & thor control gluteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc with wrong event","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8912","description":"Pt doc with wrong event","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ATXN1 (ataxin 1) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81178","description":"ATXN1 (ataxin 1) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10B","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYD0","description":"ICD-OIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLF0","description":"ICD-MBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuroeltrd stim post tibial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64566","description":"Neuroeltrd stim post tibial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA21","description":"High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise excess skin fat pad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15838","description":"Excise excess skin fat pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cellular therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0075","description":"Cellular therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENE1","description":"ICD-FENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIF1","description":"ICD-MHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINE0","description":"ICD-JINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUF0","description":"ICD-JHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC07","description":"High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJC0","description":"ICD-FCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLB1","description":"ICD-KDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBD1","description":"ICD-MGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins)_ endovascular_ including all imaging and radiological supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36909","description":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins)_ endovascular_ including all imaging and radiological supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOC1","description":"ICD-PDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECB1","description":"ICD-IECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHD1","description":"ICD-GCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8A","description":"Low Rehab_ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPA0","description":"ICD-OJPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWF1","description":"ICD-KCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinal female jug-type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0326","description":"Urinal female jug-type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAF0","description":"ICD-JHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0639U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0639U","description":"CPT-0639U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIA1","description":"ICD-BCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANB1","description":"ICD-CANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And Mai","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95716","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And Mai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC215","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABB1","description":"ICD-BABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRA1","description":"ICD-PGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd trach dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87490","description":"Chylmd trach dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress forearm 1 space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25020","description":"Decompress forearm 1 space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68525","description":"Biopsy of tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMD1","description":"ICD-IAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDD0","description":"ICD-BHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTA0","description":"ICD-GFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOD0","description":"ICD-KFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of external ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69105","description":"Biopsy of external ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSB1","description":"ICD-GDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXD0","description":"ICD-BEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52320","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUC0","description":"ICD-KBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDF1","description":"ICD-MIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEF1","description":"ICD-OEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARF1","description":"ICD-PARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iv inj ra drug dx study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78808","description":"Iv inj ra drug dx study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2188","description":"Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFB0","description":"ICD-BFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28A","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 1 std port cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0814","description":"Pwc gp 1 std port cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Precision attachment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6950","description":"Precision attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKA1","description":"ICD-JAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYF0","description":"ICD-OIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGA0","description":"ICD-OFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mirror coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2761","description":"Mirror coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Free skin flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15757","description":"Free skin flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15A","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOB1","description":"ICD-PHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDE0","description":"ICD-JGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSB0","description":"ICD-HHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thromboemb risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1180F","description":"Thromboemb risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTC0","description":"ICD-JBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth heart surg w/arrest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56351","description":"Anesth heart surg w/arrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLF1","description":"ICD-JGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACA0","description":"ICD-FACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMF0","description":"ICD-OKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDA0","description":"ICD-MBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frozen cell preparation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88241","description":"Frozen cell preparation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"So cap design w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3671","description":"So cap design w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analyze spine infus pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62367","description":"Analyze spine infus pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endocrinology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4004","description":"Endocrinology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIC0","description":"ICD-BAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCF1","description":"ICD-JHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLC1","description":"ICD-BFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduce bowel obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44050","description":"Reduce bowel obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHC0","description":"ICD-KEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection ferric pyrophosphate citrate solution 0.1 mg iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9976","description":"Injection ferric pyrophosphate citrate solution 0.1 mg iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ surgical wound pathogens_ 34 microorganisms and identification of 21 associated antibiotic-resistance genes_ multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0370U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ surgical wound pathogens_ 34 microorganisms and identification of 21 associated antibiotic-resistance genes_ multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26992","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist/elbow bowden cable mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6580","description":"Wrist/elbow bowden cable mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERB1","description":"ICD-LERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB240","description":"Reduced Physical Function _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scalp cooling_ mechanical; placement of device_ monitoring_ and removal of device (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0663T","description":"Scalp cooling_ mechanical; placement of device_ monitoring_ and removal of device (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC205","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL13","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7530","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQA0","description":"ICD-KCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1001","description":"HCPCS-C1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cell cryopreserve/storage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88240","description":"Cell cryopreserve/storage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTD1","description":"ICD-FCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct orbit/forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21172","description":"Reconstruct orbit/forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHB1","description":"ICD-KFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD)_ leukocyte enzyme activity_ whole blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0257U","description":"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD)_ leukocyte enzyme activity_ whole blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFME0","description":"ICD-CFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Audiometry air only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0208T","description":"Audiometry air only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surface mechanomyography (sMMG) with concurrent application of inertial measurement unit (IMU) sensors for measurement of multi-joint range of motion_ posture_ gait_ and muscl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0778T","description":"Surface mechanomyography (sMMG) with concurrent application of inertial measurement unit (IMU) sensors for measurement of multi-joint range of motion_ posture_ gait_ and muscl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAB0","description":"ICD-NAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4649","description":"Surgical supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUD1","description":"ICD-OHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01682","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01682","description":"CPT-01682","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYC0","description":"ICD-DBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA156","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE110","description":"Special Care High _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHE0","description":"ICD-IBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0151A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBD1","description":"ICD-KEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J8502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","description":"HCPCS-J8502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; first 30 minutes of patient face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0368T","description":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; first 30 minutes of patient face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIC1","description":"ICD-EDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSB0","description":"ICD-GDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neg press wound tx </=50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97605","description":"Neg press wound tx </=50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9741","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18D","description":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOC1","description":"ICD-KGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"RHD&RHCE GNTYP RHD1-10&RHCE5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0198U","description":"RHD&RHCE GNTYP RHD1-10&RHCE5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTB1","description":"ICD-NJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin suppression panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80432","description":"Insulin suppression panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55868","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","description":"CPT-55868","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRF0","description":"ICD-DBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95721","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELF1","description":"ICD-NELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0628U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","description":"CPT-0628U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA251","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove middle ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69676","description":"Remove middle ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multiaxial ankle w dorsiflex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5968","description":"Multiaxial ankle w dorsiflex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHA1","description":"ICD-JFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ven blood coll snf/hha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0471","description":"Ven blood coll snf/hha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCE1","description":"ICD-ADCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELD0","description":"ICD-CELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD150","description":"Reduced Physical Function _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFD0","description":"ICD-JFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conform band s w >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6447","description":"Conform band s w >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAA1","description":"ICD-BDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKB0","description":"ICD-GBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDC1","description":"ICD-KIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intraoral procedures_ including biopsy; not otherwise specif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0125U","description":"Anesthesia for intraoral procedures_ including biopsy; not otherwise specif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKA0","description":"ICD-FAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54230","description":"Prepare penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKE0","description":"ICD-OFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCF0","description":"ICD-GDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth testis suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93051","description":"Anesth testis suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla ii typing 1 loc hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81382","description":"Hla ii typing 1 loc hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYE0","description":"ICD-GHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA42","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQE1","description":"ICD-KIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antepartum manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59412","description":"Antepartum manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSA1","description":"ICD-LGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETD0","description":"ICD-JETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYB1","description":"ICD-HDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75658","description":"Artery x-rays arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXC1","description":"ICD-BDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQA0","description":"ICD-LFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRB1","description":"ICD-DGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health Care Practitioners Rendering Treatment In Place (Tip)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2021","description":"Health Care Practitioners Rendering Treatment In Place (Tip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce shoulder bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23491","description":"Reinforce shoulder bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61566","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWC0","description":"ICD-DGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMF0","description":"ICD-BCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDA1","description":"ICD-EHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJC0","description":"ICD-ODJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUD0","description":"ICD-ODUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0981T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","description":"CPT-0981T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory bp monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93784","description":"Ambulatory bp monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA01","description":"Low Rehab_ ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education_ include microprocessor_ all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0738","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education_ include microprocessor_ all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOC1","description":"ICD-DBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL55","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQF0","description":"ICD-LFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLND0","description":"ICD-NLND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12C","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIF1","description":"ICD-KIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert cervical dilator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59200","description":"Insert cervical dilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental suture wound to 5 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7911","description":"Dental suture wound to 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD121","description":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10B","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBC1","description":"ICD-NCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNF0","description":"ICD-OJNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOF0","description":"ICD-PHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21077","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFE1","description":"ICD-BFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITE1","description":"ICD-NITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BTK (Bruton_s tyrosine kinase) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ C481S_ C481R_ C481F)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81233","description":"BTK (Bruton_s tyrosine kinase) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ C481S_ C481R_ C481F)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18X","description":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXA1","description":"ICD-NFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYB1","description":"ICD-CCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAF0","description":"ICD-MDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQE0","description":"ICD-OBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGB1","description":"ICD-ODGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBD0","description":"ICD-IDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67311","description":"Revise eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low pecarn ped head trauma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9593","description":"Low pecarn ped head trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQB0","description":"ICD-PKQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGA0","description":"ICD-JIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Add joint upper ext orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3956","description":"Add joint upper ext orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem oct rta dev setup&educaj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0604T","description":"Rem oct rta dev setup&educaj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIE0","description":"ICD-KIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIE0","description":"ICD-MGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tooth transplantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7272","description":"Tooth transplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01522","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","description":"CPT-01522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCD0","description":"ICD-MDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML36","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITF0","description":"ICD-OITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVB1","description":"ICD-GCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQA1","description":"ICD-DDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; initial single probe stain p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0851T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; initial single probe stain p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYF1","description":"ICD-KBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0525U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","description":"CPT-0525U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANF0","description":"ICD-NANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68115","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEC0","description":"ICD-OFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANA0","description":"ICD-BANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKC0","description":"ICD-NKKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixed adjust armrest pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0020","description":"Fixed adjust armrest pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANF0","description":"ICD-CANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHD1","description":"ICD-OEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBC1","description":"ICD-KIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood osmolality","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83930","description":"Assay of blood osmolality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWC1","description":"ICD-PJWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9696","description":"Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOE1","description":"ICD-GGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLD0","description":"ICD-ODLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Head control nonproportional","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2329","description":"Head control nonproportional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIB1","description":"ICD-FIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXB1","description":"ICD-KGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOD0","description":"ICD-KDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBF1","description":"ICD-BEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHID1","description":"ICD-AHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVD1","description":"ICD-FHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVB1","description":"ICD-NDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHA0","description":"ICD-IAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown full base metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6791","description":"Crown full base metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEB0","description":"ICD-AAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery_ procedure or test with analysis_ review and report_ leadle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0390T","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery_ procedure or test with analysis_ review and report_ leadle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47362","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Personalized_ anterior and lateral interbody cage (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1831","description":"Personalized_ anterior and lateral interbody cage (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQA0","description":"ICD-CCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Device evaluation and interrogation of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ including reprogramming and visual training_ when performed_ wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0473T","description":"Device evaluation and interrogation of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ including reprogramming and visual training_ when performed_ wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whole blood for transfusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9010","description":"Whole blood for transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTF0","description":"ICD-JGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOE1","description":"ICD-DDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No surg proc w/in 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8628","description":"No surg proc w/in 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had a transplant prior to initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1262","description":"Patients who had a transplant prior to initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl&rplcmt ss impl dfb pg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0614T","description":"Rmvl&rplcmt ss impl dfb pg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGA0","description":"ICD-GIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam establish patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92012","description":"Eye exam establish patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESC0","description":"ICD-OESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABA1","description":"ICD-JABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray spleen/liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75810","description":"Vein x-ray spleen/liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGF1","description":"ICD-NLGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGID0","description":"ICD-IGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDC1","description":"ICD-EDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADD1","description":"ICD-IADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFC1","description":"ICD-CGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain flow imaging only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78610","description":"Brain flow imaging only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0703","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0703","description":"CDT-D0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB03","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNE0","description":"ICD-NCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKA1","description":"ICD-KFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Procenta_ per 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4244","description":"Procenta_ per 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUB1","description":"ICD-IBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroguide for spine inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77003","description":"Fluoroguide for spine inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oseltamivir phosphate 75mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9019","description":"Oseltamivir phosphate 75mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of folic acid serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82746","description":"Assay of folic acid serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt biliary drainage cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47534","description":"Plmt biliary drainage cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWD1","description":"ICD-KDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63086","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0913T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","description":"CPT-0913T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBED0","description":"ICD-OBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43247","description":"Egd remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"intravenous moderate (conscious) sedation/analgesia each subsequent 15 minute increment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9243","description":"intravenous moderate (conscious) sedation/analgesia each subsequent 15 minute increment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEF1","description":"ICD-BHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75726","description":"Artery x-rays abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMD0","description":"ICD-FHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain chest lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21502","description":"Drain chest lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKB1","description":"ICD-KGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18I","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cervical collar molded to pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0170","description":"Cervical collar molded to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGA1","description":"ICD-BHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcath mtral vlve repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0345T","description":"Transcath mtral vlve repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVD0","description":"ICD-BFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMF0","description":"ICD-KAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE220","description":"Reduced Physical Function _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC225","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of insulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83527","description":"Assay of insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL35","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESB0","description":"ICD-PESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand with single or double upright(s)_ includes microproce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8701","description":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand with single or double upright(s)_ includes microproce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Str markers specimen anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81265","description":"Str markers specimen anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Canakinumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0638","description":"Canakinumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of anterior segment aqueous drainage device_ with creation of intraocular reservoir_ internal approach_ into the supraciliary space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0474T","description":"Insertion of anterior segment aqueous drainage device_ with creation of intraocular reservoir_ internal approach_ into the supraciliary space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTD1","description":"ICD-ABTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKB1","description":"ICD-KBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGF1","description":"ICD-GCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX45","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75827","description":"Vein x-ray chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9726","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTC1","description":"ICD-MDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ic inf pbw 2501-5000 g subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99480","description":"Ic inf pbw 2501-5000 g subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXD0","description":"ICD-OAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANA1","description":"ICD-OANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD106","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNC0","description":"ICD-FFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAC1","description":"ICD-OEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFD1","description":"ICD-FIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFA0","description":"ICD-OCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRA1","description":"ICD-GDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening propoxyphene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80367","description":"Drug screening propoxyphene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIC1","description":"ICD-MHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO knee intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9727","description":"Patient unable to complete the FOTO knee intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFME0","description":"ICD-NFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFE1","description":"ICD-CCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Basic life support mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0380","description":"Basic life support mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMD1","description":"ICD-EGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILE1","description":"ICD-GILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon extent unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9089","description":"Onc dx colon extent unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01260","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","description":"CPT-01260","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release spinal cord lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63200","description":"Release spinal cord lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALF0","description":"ICD-OALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUB0","description":"ICD-AAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMB1","description":"ICD-CEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIE1","description":"ICD-JEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10D","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYF1","description":"ICD-DCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0451T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVF0","description":"ICD-NJVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55712","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","description":"CPT-55712","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRB1","description":"ICD-LIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFD1","description":"ICD-GCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Soft tissue graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4278","description":"Soft tissue graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multi-durometer symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5661","description":"Multi-durometer symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIME1","description":"ICD-KIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELF0","description":"ICD-CELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXE1","description":"ICD-GGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region fracture at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1038","description":"Patients with a diagnosis of lumbar spine region fracture at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic ftwear ladies oxf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3215","description":"Orthopedic ftwear ladies oxf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARA0","description":"ICD-OARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFE1","description":"ICD-OEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ige","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82785","description":"Assay of ige","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24515","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0750","description":"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUC0","description":"ICD-KAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUF0","description":"ICD-EAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63600","description":"Remove spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28H","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVC0","description":"ICD-ODVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIC1","description":"ICD-IBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUE1","description":"ICD-KDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHE1","description":"ICD-CBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUC0","description":"ICD-MIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUC0","description":"ICD-JIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBD0","description":"ICD-AFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27330","description":"Biopsy knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13D","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWA1","description":"ICD-PAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBE0","description":"ICD-JHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDF1","description":"ICD-OHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHF1","description":"ICD-JIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit day life activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99509","description":"Home visit day life activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUA1","description":"ICD-FEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAC1","description":"ICD-FEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Full mouth x-ray of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70320","description":"Full mouth x-ray of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-evaluation of physical therapy established plan of care_ requiring these components: An examination including a review of history and use of standardized tests and measures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97164","description":"Re-evaluation of physical therapy established plan of care_ requiring these components: An examination including a review of history and use of standardized tests and measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEE0","description":"ICD-OHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAF0","description":"ICD-MFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m pentetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9539","description":"Tc99m pentetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMF1","description":"ICD-IBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVD1","description":"ICD-CBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEF0","description":"ICD-JHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28192","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB106","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct urethra stage 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53425","description":"Reconstruct urethra stage 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for ureter x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50684","description":"Injection for ureter x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of procainamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80190","description":"Assay of procainamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYF0","description":"ICD-PBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Polatuzumab Vedotin-Piiq_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9309","description":"Injection_ Polatuzumab Vedotin-Piiq_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (genetic bleeding disorders)_ genomic sequence analysis of 51 genes_ blood_ buccal swab_ or amniotic fluid_ comprehensive (Versiti™ Comprehensive Bleeding Disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0272U","description":"Hematology (genetic bleeding disorders)_ genomic sequence analysis of 51 genes_ blood_ buccal swab_ or amniotic fluid_ comprehensive (Versiti™ Comprehensive Bleeding Disorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35111","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYA0","description":"ICD-DEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDE0","description":"ICD-EBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93615","description":"Esophageal recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd varices ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43244","description":"Egd varices ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYA0","description":"ICD-GBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/family 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90837","description":"Psytx pt&/family 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of implanted vestibular device_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0727T","description":"Removal and replacement of implanted vestibular device_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ gene expression profiling by real-time RT-PCR of 7 gene pathways (ER_ AR_ PI3K_ MAPK_ HH_ TGFB_ Notch)_ formalin-fixed paraffin-embedded (FFPE)_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0262U","description":"Oncology (solid tumor)_ gene expression profiling by real-time RT-PCR of 7 gene pathways (ER_ AR_ PI3K_ MAPK_ HH_ TGFB_ Notch)_ formalin-fixed paraffin-embedded (FFPE)_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sho insert w arch toe filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5000","description":"Sho insert w arch toe filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEC1","description":"ICD-JBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66987","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulm funct tst plethysmograp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94726","description":"Pulm funct tst plethysmograp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLF1","description":"ICD-ICLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVC0","description":"ICD-KGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWF1","description":"ICD-KIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYA0","description":"ICD-KHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCA1","description":"ICD-EGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGC1","description":"ICD-NDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Renal function panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80069","description":"Renal function panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGF0","description":"ICD-BHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40820","description":"Treatment of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Path consult intraop addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88332","description":"Path consult intraop addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXA0","description":"ICD-JDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0142A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PLCG2 (phospholipase C gamma 2) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ R665W_ S707F_ L845F)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81320","description":"PLCG2 (phospholipase C gamma 2) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ R665W_ S707F_ L845F)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTC0","description":"ICD-MKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL26","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHA1","description":"ICD-ABHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWB1","description":"ICD-OGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of thigh muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27385","description":"Repair of thigh muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69662","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of procainamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80192","description":"Assay of procainamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUE0","description":"ICD-GCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt reas no pneumococcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8866","description":"Doc pt reas no pneumococcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath fl nongyn smears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88104","description":"Cytopath fl nongyn smears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLC1","description":"ICD-CHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1033T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1033T","description":"CPT-1033T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVC0","description":"ICD-GFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB160","description":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETB1","description":"ICD-CETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSE1","description":"ICD-GCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJC0","description":"ICD-FBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICA1","description":"ICD-IICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14D","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDD1","description":"ICD-OEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBB0","description":"ICD-CDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB11","description":"ICD-4JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL26","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYB0","description":"ICD-KCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBD1","description":"ICD-FGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXF0","description":"ICD-CHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supplies for home delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8415","description":"Supplies for home delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tongue and neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41135","description":"Tongue and neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGF1","description":"ICD-JFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove intrauterine device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58301","description":"Remove intrauterine device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDF0","description":"ICD-BDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEC1","description":"ICD-MJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBC0","description":"ICD-CGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33688","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAC1","description":"ICD-KHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hd inj >24h/gcs >15/no res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9596","description":"Hd inj >24h/gcs >15/no res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfusion service fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36460","description":"Transfusion service fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTA0","description":"ICD-BDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWF1","description":"ICD-PIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVE1","description":"ICD-FCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment plan development","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1007","description":"Treatment plan development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28008","description":"Incision of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTE1","description":"ICD-BDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECE0","description":"ICD-EECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital bed var ht w/ mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0255","description":"Hospital bed var ht w/ mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and/or with contrast material(s); unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77058","description":"Magnetic resonance imaging_ breast_ without and/or with contrast material(s); unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVE0","description":"ICD-GFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKE1","description":"ICD-FIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASB1","description":"ICD-LASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIID1","description":"ICD-GIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9131","description":"Onc dx brst unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient_s current functional status when there is a documented change;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97172","description":"Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient_s current functional status when there is a documented change;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTD1","description":"ICD-FHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","description":"HCPCS-Q4401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBB0","description":"ICD-OLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of biotinidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82261","description":"Assay of biotinidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQA1","description":"ICD-OIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHD0","description":"ICD-AIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermacyte Amniotic Membrane Allograft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4248","description":"Dermacyte Amniotic Membrane Allograft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBF0","description":"ICD-AFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exam feces for meat fibers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89160","description":"Exam feces for meat fibers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECA0","description":"ICD-OECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSD0","description":"ICD-OFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA230","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97001","description":"Pt evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSE1","description":"ICD-LGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWE0","description":"ICD-KBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWA0","description":"ICD-HFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oxford Knee Score (OKS) patient reported outcome tool within three months preoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1047","description":"Functional status was measured by the Oxford Knee Score (OKS) patient reported outcome tool within three months preoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBE1","description":"ICD-BCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srs linear based","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77372","description":"Srs linear based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81364","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILC1","description":"ICD-OILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB21","description":"ICD-1JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPE0","description":"ICD-CGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4419","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","description":"HCPCS-Q4419","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12D","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVB0","description":"ICD-BAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJD1","description":"ICD-KFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAD1","description":"ICD-ACAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYA1","description":"ICD-KEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (autosomal dominant congenital thrombocytopenia)_ genomic sequence analysis of 14 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Autosomal Dominant Thromboc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0269U","description":"Hematology (autosomal dominant congenital thrombocytopenia)_ genomic sequence analysis of 14 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Autosomal Dominant Thromboc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOF1","description":"ICD-PIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inlay repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2981","description":"Inlay repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Voltage-Gated Calcium Channel Antibody_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86596","description":"Voltage-Gated Calcium Channel Antibody_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15C","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of salivary gland","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7981","description":"Excision of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44121","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRB1","description":"ICD-OBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXB1","description":"ICD-NFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB241","description":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNB0","description":"ICD-JBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Init eval for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1119F","description":"Init eval for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKB0","description":"ICD-NEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGD1","description":"ICD-NDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAD0","description":"ICD-NIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVA0","description":"ICD-OHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0516U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","description":"CPT-0516U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSA1","description":"ICD-KCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISE1","description":"ICD-HISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCC0","description":"ICD-EDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIE1","description":"ICD-KFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMF0","description":"ICD-MBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8007","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8007","description":"HCPCS-C8007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCF0","description":"ICD-IFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDC1","description":"ICD-CGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINA1","description":"ICD-CINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSD1","description":"ICD-KDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEB1","description":"ICD-MEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thromboplastin time partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85730","description":"Thromboplastin time partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKC1","description":"ICD-JAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIE1","description":"ICD-KIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLF0","description":"ICD-NCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQC1","description":"ICD-GFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYB1","description":"ICD-GDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHA1","description":"ICD-KCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other manual wheelchair/base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0009","description":"Other manual wheelchair/base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQE0","description":"ICD-HFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQF1","description":"ICD-LHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB210","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDB0","description":"ICD-FBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKC0","description":"ICD-GGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXA1","description":"ICD-JFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corneal hysteresis deter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92145","description":"Corneal hysteresis deter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOD1","description":"ICD-OLOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUC0","description":"ICD-IBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programming Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Iterative Adjustment Of The Implantable Device To Te","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0575T","description":"Programming Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Iterative Adjustment Of The Implantable Device To Te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQA0","description":"ICD-GFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKE1","description":"ICD-CHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pjp proph ordered cd4 low","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9223","description":"Pjp proph ordered cd4 low","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVD0","description":"ICD-NAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMB1","description":"ICD-NEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFC0","description":"ICD-JAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYB1","description":"ICD-OCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20C","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60270","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJE0","description":"ICD-JHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHA1","description":"ICD-EAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGC1","description":"ICD-CBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51820","description":"Revision of urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31287","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGB0","description":"ICD-OJGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLD0","description":"ICD-AHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rt heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93530","description":"Rt heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIA1","description":"ICD-AIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCD0","description":"ICD-JCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUA0","description":"ICD-OGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACD0","description":"ICD-EACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDB0","description":"ICD-BHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96933","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endocrine nuclear procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78099","description":"Endocrine nuclear procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of arm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24310","description":"Revision of arm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair lead pace-defib dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33220","description":"Repair lead pace-defib dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLA0","description":"ICD-MLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCA1","description":"ICD-OKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJC0","description":"ICD-OIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBB1","description":"ICD-GDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIB1","description":"ICD-JIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQC0","description":"ICD-LEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Serial tonometry exam(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92100","description":"Serial tonometry exam(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Puraply_ puraply antimic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9349","description":"Puraply_ puraply antimic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00174","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","description":"CPT-00174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHE0","description":"ICD-EGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pathologists/dermatopathologists providing a second opinion on a biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9784","description":"Pathologists/dermatopathologists providing a second opinion on a biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHA0","description":"ICD-AHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5615","description":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTD0","description":"ICD-CCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg all night recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95827","description":"Eeg all night recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heat lamp without stand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0200","description":"Heat lamp without stand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYC0","description":"ICD-LIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of foot at ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27889","description":"Amputation of foot at ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOA0","description":"ICD-OAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATD0","description":"ICD-OATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESC0","description":"ICD-LESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECE0","description":"ICD-NECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCE1","description":"ICD-BDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXE1","description":"ICD-BEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33426","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of chest tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32551","description":"Insertion of chest tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc foot/toe tum dep 1.5cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28041","description":"Exc foot/toe tum dep 1.5cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACE1","description":"ICD-BACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid exam both ears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92591","description":"Hearing aid exam both ears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLE0","description":"ICD-FDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFME0","description":"ICD-MFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHC1","description":"ICD-FHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRE1","description":"ICD-CBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRA0","description":"ICD-OIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUE0","description":"ICD-AEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXD1","description":"ICD-JFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1357","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRF0","description":"ICD-CCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemolysin acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85475","description":"Hemolysin acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVB0","description":"ICD-KHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ureteral embolization/occl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50705","description":"Ureteral embolization/occl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth penis nodes removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93651","description":"Anesth penis nodes removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRD1","description":"ICD-CHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMB1","description":"ICD-CAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXA1","description":"ICD-FEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lactoferrin fecal (quant)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83631","description":"Lactoferrin fecal (quant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ preF_ subunit_ bivalent_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90678","description":"Respiratory syncytial virus vaccine_ preF_ subunit_ bivalent_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33231","description":"Insrt pulse gen w/mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aortorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35560","description":"Art byp grft aortorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99403","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHE0","description":"ICD-MFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDB1","description":"ICD-ODDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSD0","description":"ICD-OLSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUF1","description":"ICD-NDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Online e/m by phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99444","description":"Online e/m by phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELE1","description":"ICD-OELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRE1","description":"ICD-GDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of impacted wax md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0268","description":"Removal of impacted wax md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer); genomic sequence analysis panel_ must incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81432","description":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer); genomic sequence analysis panel_ must incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSC0","description":"ICD-CFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of tacrolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80197","description":"Assay of tacrolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ oritavancin (Kimyrsa)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2406","description":"Injection_ oritavancin (Kimyrsa)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Evicore_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1001","description":"Clinical Decision Support Mechanism Evicore_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAD1","description":"ICD-KHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tocilizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3262","description":"Tocilizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical boot each junior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3211","description":"Surgical boot each junior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2004","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2004","description":"CDT-D2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sodium thiosulfate_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0208","description":"Injection_ sodium thiosulfate_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFA0","description":"ICD-OGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1101T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1101T","description":"CPT-1101T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB217","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBA0","description":"ICD-IFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Followup eval of foot pt lop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0246","description":"Followup eval of foot pt lop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vena cava filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1880","description":"Vena cava filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoabdominal graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33877","description":"Thoracoabdominal graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5273","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTC0","description":"ICD-FHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSD1","description":"ICD-DHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML53","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC241","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBF0","description":"ICD-MCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone graft time of implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6104","description":"Bone graft time of implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCB0","description":"ICD-MCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICE1","description":"ICD-GICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYF1","description":"ICD-OJYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myelography neck spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72240","description":"Myelography neck spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIE1","description":"ICD-NGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMC1","description":"ICD-KIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHD0","description":"ICD-NJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB21","description":"ICD-4KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2B","description":"High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC206","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58974","description":"Transfer of embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBE0","description":"ICD-OJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHD1","description":"ICD-MLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC31","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient-specific_ assistive_ rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient_s tumor-specific cancer marker information obtained fr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0794T","description":"Patient-specific_ assistive_ rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient_s tumor-specific cancer marker information obtained fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext antenna phren nerve stim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8696","description":"Ext antenna phren nerve stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adapt/ext_ pacing/neuro lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1883","description":"Adapt/ext_ pacing/neuro lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise temple bone implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69718","description":"Revise temple bone implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDF0","description":"ICD-ADDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0211","description":"Injection_ sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEF1","description":"ICD-MGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCE1","description":"ICD-CDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXB1","description":"ICD-JIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCE0","description":"ICD-MKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strep b dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87653","description":"Strep b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDB0","description":"ICD-EIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFA1","description":"ICD-FDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99201","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc compl inf antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9301","description":"Doc compl inf antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15945","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9038","description":"Rbc irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sinus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31299","description":"Sinus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables_ patient lift_ and adjustabl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0501","description":"Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables_ patient lift_ and adjustabl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQF0","description":"ICD-DFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPB1","description":"ICD-JDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent prenatal care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0502F","description":"Subsequent prenatal care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKC0","description":"ICD-FHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEA1","description":"ICD-GEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low risk for retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3072F","description":"Low risk for retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attendance at delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99464","description":"Attendance at delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMB0","description":"ICD-CBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASB0","description":"ICD-CASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46748","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLC1","description":"ICD-NFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC214","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCE0","description":"ICD-GDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm ped fbrglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4012","description":"Cast sup sht arm ped fbrglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cervix repair bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57556","description":"Remove cervix repair bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA205","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKD1","description":"ICD-OAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVF0","description":"ICD-NGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23C","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26715","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home sleep test/type 4 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0400","description":"Home sleep test/type 4 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDC0","description":"ICD-FFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstr w/lat flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19361","description":"Breast reconstr w/lat flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen one/mult class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80303","description":"Drug screen one/mult class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPB1","description":"ICD-OCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug delivery system >=50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4305","description":"Drug delivery system >=50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21076","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMD1","description":"ICD-KAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAD0","description":"ICD-GIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2A","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23D","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anastrozole 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0170","description":"Anastrozole 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTD1","description":"ICD-BCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPD0","description":"ICD-FGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFC1","description":"ICD-JCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood glucose level test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0412","description":"Blood glucose level test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Z7610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Z7610","description":"HCPCS-Z7610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJA1","description":"ICD-KIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor intestine/artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44721","description":"Prep donor intestine/artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61514","description":"Removal of brain abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services utilized by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9694","description":"Hospice services utilized by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Misoprostol_ oral_ 200 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0191","description":"Misoprostol_ oral_ 200 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWD0","description":"ICD-OIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1150","description":"Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy inject material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52327","description":"Cystoscopy inject material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx spine process fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22305","description":"Closed tx spine process fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPE1","description":"ICD-BIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPA1","description":"ICD-KFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSD0","description":"ICD-DBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEB1","description":"ICD-JFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCD0","description":"ICD-JDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBID1","description":"ICD-GBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRF0","description":"ICD-HIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0173A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect arm/elbow tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24077","description":"Resect arm/elbow tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEF0","description":"ICD-KFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXB1","description":"ICD-KAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCD0","description":"ICD-ECCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res Copd/As Bill Sid-Bnef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9681","description":"Onsite Ac C Tx Nsg Fac Res Copd/As Bill Sid-Bnef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPE0","description":"ICD-BGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62325","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLE0","description":"ICD-NCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shunt accessory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4740","description":"Shunt accessory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBE0","description":"ICD-BCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sincalide (maia) not therapeutically equivalent to j2805_ 5 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2806","description":"Injection_ sincalide (maia) not therapeutically equivalent to j2805_ 5 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attach ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65140","description":"Attach ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEB1","description":"ICD-NEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77280","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cranial remolding orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1040","description":"Cranial remolding orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0B","description":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resin retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6549","description":"Resin retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTB0","description":"ICD-KBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSE1","description":"ICD-PDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOA1","description":"ICD-OFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJA1","description":"ICD-FGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLF1","description":"ICD-ADLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis for chromosomal abnormalities_ copy number variants_ duplications/deletions_ inversions_ unb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0469U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis for chromosomal abnormalities_ copy number variants_ duplications/deletions_ inversions_ unb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRA0","description":"ICD-KIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19368","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB205","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLF1","description":"ICD-KHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFC1","description":"ICD-KHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with di","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7560","description":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not receive cervical cytology or an HPV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9807","description":"Patients who did not receive cervical cytology or an HPV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of chest wall respiratory sensor electrode or electrode array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0468T","description":"Removal of chest wall respiratory sensor electrode or electrode array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24495","description":"Decompression of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78832","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPE1","description":"ICD-GIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB256","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGC1","description":"ICD-FHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl leath cuff kafo-afo cal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4110","description":"Repl leath cuff kafo-afo cal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWB0","description":"ICD-GAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","description":"HCPCS-J3373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEB1","description":"ICD-CCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBE0","description":"ICD-IGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNE0","description":"ICD-GGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAE1","description":"ICD-GFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKD0","description":"ICD-KDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNC0","description":"ICD-JBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBC1","description":"ICD-GIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJD0","description":"ICD-GEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMA1","description":"ICD-CFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMA1","description":"ICD-ECMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8012","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8012","description":"HCPCS-C8012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLB1","description":"ICD-BFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens pmma spherical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2500","description":"Contact lens pmma spherical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or ot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0734T","description":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or ot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction Of Mixture Of Saline And Air For Sonosalpingography To Confirm Occlusion Of Fallopian Tubes_ Transcervical Approach_ Including Transvaginal Ultrasound And Pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0568T","description":"Introduction Of Mixture Of Saline And Air For Sonosalpingography To Confirm Occlusion Of Fallopian Tubes_ Transcervical Approach_ Including Transvaginal Ultrasound And Pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bevacizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9035","description":"Bevacizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILB0","description":"ICD-KILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy vag lesions simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57061","description":"Destroy vag lesions simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB21","description":"ICD-3KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52310","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1704","description":"HCPCS-B1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonprim loc anat bx site tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3250F","description":"Nonprim loc anat bx site tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/irrigate tear ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68840","description":"Explore/irrigate tear ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATA0","description":"ICD-BATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNA0","description":"ICD-CDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise palsy hand tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25316","description":"Revise palsy hand tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial preventive exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0402","description":"Initial preventive exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRC0","description":"ICD-OBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOC1","description":"ICD-CDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIC1","description":"ICD-GAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUF1","description":"ICD-OIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73590","description":"X-ray exam of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5155","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","description":"HCPCS-Q5155","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28A","description":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cygnus Matrix_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4199","description":"Cygnus Matrix_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFF1","description":"ICD-OEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDF0","description":"ICD-EIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIC0","description":"ICD-JCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBD1","description":"ICD-MHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXA1","description":"ICD-BAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFD1","description":"ICD-BIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBA0","description":"ICD-GGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision hyperplastic tissue","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7970","description":"Excision hyperplastic tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trnscth renal symp denrv bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0339T","description":"Trnscth renal symp denrv bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC11","description":"ICD-1JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Penile venous occlusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37790","description":"Penile venous occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35471","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRE0","description":"ICD-GHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQA0","description":"ICD-OHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKF1","description":"ICD-KIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cocaine hydrochloride nasal solution for topical administration_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9046","description":"Cocaine hydrochloride nasal solution for topical administration_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"removal of non-resorbable barrier","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4286","description":"removal of non-resorbable barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEA1","description":"ICD-NCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQC0","description":"ICD-HIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADE0","description":"ICD-CADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Face-To-Face Hh Nsg Vst Rhc/Fqhc Area Shtg Hha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0490","description":"Face-To-Face Hh Nsg Vst Rhc/Fqhc Area Shtg Hha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1702","description":"HCPCS-B1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIE1","description":"ICD-OHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mdd moderate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3089F","description":"Mdd moderate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95979","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTB0","description":"ICD-MHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medical food oral 100% nutr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9433","description":"Medical food oral 100% nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUA0","description":"ICD-AAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lincomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2010","description":"Lincomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTA1","description":"ICD-NBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIA1","description":"ICD-GDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 2 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64491","description":"Inj paravert f jnt c/t 2 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18X","description":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC06","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHB1","description":"ICD-IDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIC0","description":"ICD-FHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWA1","description":"ICD-DEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECF0","description":"ICD-KECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB134","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDC1","description":"ICD-FGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0481U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","description":"CPT-0481U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asthma measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8645","description":"Asthma measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAID0","description":"ICD-KAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWD1","description":"ICD-PHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychoed svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2027","description":"Psychoed svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHC1","description":"ICD-CFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHB0","description":"ICD-MBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; subcutaneous electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0458T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; subcutaneous electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24115","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB21","description":"ICD-1FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peroneal straps pair pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0980","description":"Peroneal straps pair pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETA0","description":"ICD-BETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28730","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43632","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGB1","description":"ICD-KDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrial Shunt Or Placebo Control_ Including Right Heart Catheterization_ Trans-Esophag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9758","description":"Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrial Shunt Or Placebo Control_ Including Right Heart Catheterization_ Trans-Esophag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic sock multi ply bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8420","description":"Prosthetic sock multi ply bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteoarthritis assessed (OA) Includes assessment of all the following compo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0109U","description":"Osteoarthritis assessed (OA) Includes assessment of all the following compo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPC0","description":"ICD-KIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIE1","description":"ICD-NHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBD1","description":"ICD-EIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27395","description":"Lengthening of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; by instrument chemistry analyzers (eg_ utilizing immunoassay [eg_ EIA_ ELISA_ EMIT_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80307","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; by instrument chemistry analyzers (eg_ utilizing immunoassay [eg_ EIA_ ELISA_ EMIT_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermal filler inj px/suppl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9800","description":"Dermal filler inj px/suppl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUE1","description":"ICD-CHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYA0","description":"ICD-OIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA151","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryo-Cord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4237","description":"Cryo-Cord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluid pressure muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20950","description":"Fluid pressure muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc med rsn no stat tx/presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9667","description":"Doc med rsn no stat tx/presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMA0","description":"ICD-AGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDF0","description":"ICD-KHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt info into recall system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7010F","description":"Pt info into recall system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina tissue part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57107","description":"Remove vagina tissue part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILB1","description":"ICD-AILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Benzodiazepines 13 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80347","description":"Benzodiazepines 13 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41110","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGME1","description":"ICD-IGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rho d immune globulin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2790","description":"Rho d immune globulin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Throat muscle surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43030","description":"Throat muscle surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBC0","description":"ICD-NJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBD1","description":"ICD-IDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18D","description":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQB0","description":"ICD-HHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLF0","description":"ICD-BGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPA1","description":"ICD-NKPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBF0","description":"ICD-NEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multi-axial knee/shin system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5840","description":"Multi-axial knee/shin system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"R-T Spctrl Alys Prst8 Tiss Fluorescenc Spctrscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0443T","description":"R-T Spctrl Alys Prst8 Tiss Fluorescenc Spctrscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRA0","description":"ICD-DIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPB0","description":"ICD-FHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammo bx proven malig docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3350F","description":"Mammo bx proven malig docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOA0","description":"ICD-PJOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOF0","description":"ICD-PFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRE1","description":"ICD-OGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable ext urethral dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4360","description":"Disposable ext urethral dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral counseling for diabetes prevention_ in-person_ group_ 60 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9886","description":"Behavioral counseling for diabetes prevention_ in-person_ group_ 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBME1","description":"ICD-EBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFME0","description":"ICD-GFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAF1","description":"ICD-FEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICE0","description":"ICD-EICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYE1","description":"ICD-HFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mlh1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81288","description":"Mlh1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peg interferon alfa-2a/180","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0145","description":"Peg interferon alfa-2a/180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMA1","description":"ICD-MEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOB1","description":"ICD-KFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kyphectomy 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22819","description":"Kyphectomy 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1504","description":"HCPCS-C1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Progenamatrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4222","description":"Progenamatrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKF0","description":"ICD-CIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Underarm springassist crutch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0117","description":"Underarm springassist crutch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply rem fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20660","description":"Apply rem fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCD1","description":"ICD-ACCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKC1","description":"ICD-CDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOC0","description":"ICD-KIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUE1","description":"ICD-MGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTC1","description":"ICD-BFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAD0","description":"ICD-ADAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLA1","description":"ICD-NKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQB1","description":"ICD-LIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech audiometry complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92556","description":"Speech audiometry complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPD0","description":"ICD-BGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPA0","description":"ICD-KAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiofq trsmtr for implt neu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8683","description":"Radiofq trsmtr for implt neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHF1","description":"ICD-AAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIB1","description":"ICD-BBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKD0","description":"ICD-JFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27605","description":"Incision of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove inner ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69970","description":"Remove inner ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHF1","description":"ICD-NIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJA1","description":"ICD-BHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","description":"CPT-64474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise hernia & sperm veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55540","description":"Revise hernia & sperm veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8G","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vc lesion w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31545","description":"Remove vc lesion w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heel leather reinforced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3440","description":"Heel leather reinforced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOE1","description":"ICD-OJOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSB1","description":"ICD-CCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA33","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOC1","description":"ICD-PEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGD0","description":"ICD-BCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFB1","description":"ICD-JBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0901","description":"HCPCS-B0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft brachial-brchl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35525","description":"Art byp grft brachial-brchl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTB0","description":"ICD-CBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPB0","description":"ICD-CAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSE1","description":"ICD-OKSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB240","description":"Special Care Low _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of heel bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28300","description":"Incision of heel bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx platelet plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0232T","description":"Njx platelet plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1904","description":"HCPCS-B1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFA1","description":"ICD-BBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reposition intraocular lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66825","description":"Reposition intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39010","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTF0","description":"ICD-FDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mtms by pharm addl 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99607","description":"Mtms by pharm addl 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Overdenture partial mandib","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5866","description":"Overdenture partial mandib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDE0","description":"ICD-OKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRA0","description":"ICD-PLRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abdominal pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1270","description":"Abdominal pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDME1","description":"ICD-EDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHA1","description":"ICD-FHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug_ generic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5000","description":"Prescription drug_ generic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLE0","description":"ICD-MCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQB0","description":"ICD-PHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0105","description":"HCPCS-A0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWD0","description":"ICD-KFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMA1","description":"ICD-OLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKE1","description":"ICD-BBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kanamycin sulfate 75 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1850","description":"Kanamycin sulfate 75 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUE0","description":"ICD-KFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21A","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","description":"HCPCS-J3374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acupunct w/o stimul 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97810","description":"Acupunct w/o stimul 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLE0","description":"ICD-EGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33814","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair nasal septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30630","description":"Repair nasal septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation physics consult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77370","description":"Radiation physics consult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD130","description":"Reduced Physical Function _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXB1","description":"ICD-KEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ONC MRNA 5 genes alg risk recr urothelial cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013M","description":"ONC MRNA 5 genes alg risk recr urothelial cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27652","description":"Repair/graft achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUC1","description":"ICD-MEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41115","description":"Excision of tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee cap medial or lateral p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2800","description":"Knee cap medial or lateral p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDC1","description":"ICD-CBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML56","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33694","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCC0","description":"ICD-JFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVF1","description":"ICD-OLVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablation of malignant prostate tissue by magnetic field induction_ including all intraprocedural_ transperineal needle/catheter placement for nanoparticle installation and int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0739T","description":"Ablation of malignant prostate tissue by magnetic field induction_ including all intraprocedural_ transperineal needle/catheter placement for nanoparticle installation and int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXD0","description":"ICD-GIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iv pole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0776","description":"Iv pole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo cholecystoenterostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47570","description":"Laparo cholecystoenterostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHF0","description":"ICD-BDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPE0","description":"ICD-KBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVD0","description":"ICD-NBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVA1","description":"ICD-JAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWC0","description":"ICD-PIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc car modulj vnt elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0411T","description":"Insj/rplc car modulj vnt elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75801","description":"Lymph vessel x-ray arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen tent excl croup/ped t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0455","description":"Oxygen tent excl croup/ped t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24930","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTB1","description":"ICD-NCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65260","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAC0","description":"ICD-BBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28050","description":"Biopsy of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afamelanotide implant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7352","description":"Afamelanotide implant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCF1","description":"ICD-IFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise & treat bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51030","description":"Incise & treat bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting_ isolation and preparation of harvested cells_ i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0717T","description":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting_ isolation and preparation of harvested cells_ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thigh length surg stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4495","description":"Thigh length surg stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDC1","description":"ICD-CIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNF1","description":"ICD-OHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACB0","description":"ICD-IACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCB1","description":"ICD-BCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplant forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25310","description":"Transplant forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIC0","description":"ICD-NFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spec rpt no doc class histo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9425","description":"Spec rpt no doc class histo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28024","description":"Exploration of toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sacral nerve stim test lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4290","description":"Sacral nerve stim test lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1252","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of figure eight","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29049","description":"Application of figure eight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKE0","description":"ICD-NHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQC1","description":"ICD-KIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJD0","description":"ICD-NHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair oviduct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58750","description":"Repair oviduct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCE0","description":"ICD-NLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBB0","description":"ICD-BHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAE0","description":"ICD-GBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tcd emboli detect w/inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93893","description":"Tcd emboli detect w/inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score knee >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8647","description":"Fun stat score knee >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTB1","description":"ICD-CCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNB1","description":"ICD-KCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6518","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","description":"HCPCS-A6518","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5A","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychophysiological therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90875","description":"Psychophysiological therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii fc fusion recomb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7205","description":"Factor viii fc fusion recomb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTE1","description":"ICD-MJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES313","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCC1","description":"ICD-FHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; screening and interpretation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0832T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; screening and interpretation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATF1","description":"ICD-AATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRB0","description":"ICD-KBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKD0","description":"ICD-CHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGB1","description":"ICD-FDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQF0","description":"ICD-ODQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJE1","description":"ICD-OJJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0303U","description":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ amiodarone hydrochloride (nexterone)_ 30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0283","description":"Injection_ amiodarone hydrochloride (nexterone)_ 30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHD0","description":"ICD-MKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECE1","description":"ICD-OECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKA1","description":"ICD-NGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21C","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIA0","description":"ICD-KBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUA1","description":"ICD-GIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWE1","description":"ICD-LEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bivalirudin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0583","description":"Bivalirudin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRE0","description":"ICD-HHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA13","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUE0","description":"ICD-MJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJE0","description":"ICD-GFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1804","description":"HCPCS-A1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHD1","description":"ICD-FGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAB1","description":"ICD-FEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCB1","description":"ICD-OGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Andrology (infertility)_ sperm-capacitation assessment of ganglioside GM1 distribution patterns_ fluorescence microscopy_ fresh/ frozen specimen_ reported as % of capacitated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0255U","description":"Andrology (infertility)_ sperm-capacitation assessment of ganglioside GM1 distribution patterns_ fluorescence microscopy_ fresh/ frozen specimen_ reported as % of capacitated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9174","description":"HCPCS-C9174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31267","description":"Endoscopy maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWC0","description":"ICD-HAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMC0","description":"ICD-NHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGA0","description":"ICD-JDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01380","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","description":"CPT-01380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risperidone_ (Uzedy)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9158","description":"Injection_ risperidone_ (Uzedy)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver_ including craniectomy or craniotomy_ when performed_ with direct or inductive coupling_ with co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61889","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver_ including craniectomy or craniotomy_ when performed_ with direct or inductive coupling_ with co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYB0","description":"ICD-KBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of oxalate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83945","description":"Assay of oxalate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITE1","description":"ICD-OITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWC0","description":"ICD-DBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFF0","description":"ICD-GEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWC0","description":"ICD-LGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQF0","description":"ICD-KIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYE1","description":"ICD-KDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder abduction joint pai","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6640","description":"Shoulder abduction joint pai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60540","description":"Explore adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAF0","description":"ICD-BAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES113","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGE0","description":"ICD-FHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA245","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOF1","description":"ICD-LBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWF0","description":"ICD-LEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0585U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","description":"CPT-0585U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-cov surg proc_clin trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0293","description":"Non-cov surg proc_clin trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYB1","description":"ICD-HHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYF0","description":"ICD-PGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALA1","description":"ICD-CALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ propofol_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2704","description":"Inj_ propofol_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLC0","description":"ICD-GBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4545","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","description":"HCPCS-A4545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSF1","description":"ICD-HFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytp urne 3-5 probes ea spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88120","description":"Cytp urne 3-5 probes ea spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom shape cover ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5705","description":"Custom shape cover ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heterophile antibody absrbj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86310","description":"Heterophile antibody absrbj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWE0","description":"ICD-LBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEA1","description":"ICD-MKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAB1","description":"ICD-CGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pms2 known familial variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81318","description":"Pms2 known familial variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBE0","description":"ICD-OKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETA0","description":"ICD-EETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scleral lens liquid bandage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0515","description":"Scleral lens liquid bandage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58152","description":"Total hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKE1","description":"ICD-KAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX43","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug delivery system <=50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4306","description":"Drug delivery system <=50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open wedge/bx lung nodule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32097","description":"Open wedge/bx lung nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45385","description":"Colonoscopy w/lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIA1","description":"ICD-CCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHB1","description":"ICD-BBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No hist type doc on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9284","description":"No hist type doc on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEC0","description":"ICD-EAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVE1","description":"ICD-NEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53275","description":"Repair of urethra defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVE0","description":"ICD-GAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treprostinil_ non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7686","description":"Treprostinil_ non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; characterization of alleles (eg_ expanded size or me","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81204","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; characterization of alleles (eg_ expanded size or me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digoxin thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4220F","description":"Digoxin thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHF1","description":"ICD-MHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBB1","description":"ICD-NDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQA1","description":"ICD-PLQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKC1","description":"ICD-OAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPB1","description":"ICD-BCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl zinc air battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8621","description":"Repl zinc air battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOA1","description":"ICD-GBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXF1","description":"ICD-NEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMF1","description":"ICD-IFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1267","description":"Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPB1","description":"ICD-FBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAED0","description":"ICD-IAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBD0","description":"ICD-FFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8G","description":"High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric electric hook","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7045","description":"Pediatric electric hook","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Msh6 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81298","description":"Msh6 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPC0","description":"ICD-BIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25101","description":"Explore/treat wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluorine-18 fluorodeoxygluco","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8085","description":"Fluorine-18 fluorodeoxygluco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFF1","description":"ICD-CIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mod compres band w>=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6451","description":"Mod compres band w>=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJB0","description":"ICD-BCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHB1","description":"ICD-OKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35879","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37248","description":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCC1","description":"ICD-JGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treponema pallidum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86780","description":"Treponema pallidum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient enrolled in hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9858","description":"Patient enrolled in hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5213","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost clsd pouch w att st barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4387","description":"Ost clsd pouch w att st barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ertapenem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1335","description":"Ertapenem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAF1","description":"ICD-OAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscop w/vc inj + scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31571","description":"Laryngoscop w/vc inj + scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKF0","description":"ICD-GGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair nerve/shorten bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64876","description":"Repair nerve/shorten bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-53865","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","description":"CPT-53865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCA0","description":"ICD-FBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14D","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGB1","description":"ICD-CAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1238","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHE0","description":"ICD-MAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD112","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mecp2 gene dup/delet variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81304","description":"Mecp2 gene dup/delet variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPD1","description":"ICD-BEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHA0","description":"ICD-JBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Botulinum antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90287","description":"Botulinum antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv vacc pandemic adjuvt im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90667","description":"Iiv vacc pandemic adjuvt im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carecoordination prenatal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1002","description":"Carecoordination prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGA1","description":"ICD-BEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cosyntropin cortrosyn inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0834","description":"Cosyntropin cortrosyn inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4352","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","description":"HCPCS-Q4352","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWE1","description":"ICD-KCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44378","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTD1","description":"ICD-ODTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comp comm supp svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2015","description":"Comp comm supp svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB21","description":"ICD-3FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal contract stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59020","description":"Fetal contract stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA101","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFE0","description":"ICD-FAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMD1","description":"ICD-FBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCB1","description":"ICD-ADCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54110","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMB0","description":"ICD-FIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24498","description":"Reinforce humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMD0","description":"ICD-ABMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARA1","description":"ICD-DARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKB0","description":"ICD-NFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+ cell >=15% (hiv)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3498F","description":"Cd4+ cell >=15% (hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB44","description":"Very High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHB0","description":"ICD-CGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of midfoot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28264","description":"Release of midfoot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIND1","description":"ICD-BIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIF1","description":"ICD-FDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD160","description":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKF1","description":"ICD-CDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFC1","description":"ICD-GCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHD1","description":"ICD-ABHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Papaverin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2440","description":"Papaverin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ic lbw inf < 1500 gm subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99478","description":"Ic lbw inf < 1500 gm subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMF1","description":"ICD-NLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBB1","description":"ICD-OCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy roof of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42100","description":"Biopsy roof of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJC1","description":"ICD-BIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alginate drsg wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6199","description":"Alginate drsg wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDB0","description":"ICD-ECDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3B","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVD1","description":"ICD-OLVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Impl/redo electrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43881","description":"Impl/redo electrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient exhibits 2 or more risk factors for postoperative vomiting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9954","description":"Patient exhibits 2 or more risk factors for postoperative vomiting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11A","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bupivacaine (posimir)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9144","description":"Injection_ bupivacaine (posimir)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBC0","description":"ICD-EHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNE0","description":"ICD-BBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNE1","description":"ICD-JFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lanadelumab-flyo_ 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician_ not for use when drug is self-administered)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0593","description":"Injection_ lanadelumab-flyo_ 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician_ not for use when drug is self-administered)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45317","description":"Proctosigmoidoscopy bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFF1","description":"ICD-BFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFC1","description":"ICD-BDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close nephrovisceral fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50525","description":"Close nephrovisceral fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0424T","description":"Insj/rplc nstim apnea compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB150","description":"Special Care High _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ non-coat/cov w/o del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1877","description":"Stent_ non-coat/cov w/o del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lengthen radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25393","description":"Lengthen radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heavyduty walker no wheels","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0148","description":"Heavyduty walker no wheels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Sublocade)_ less than or equal to 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9991","description":"Injection_ buprenorphine extended-release (Sublocade)_ less than or equal to 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUE0","description":"ICD-MDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66840","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11750","description":"Removal of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deoxycortisol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82634","description":"Deoxycortisol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47350","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEE1","description":"ICD-CGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQD1","description":"ICD-DFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDB1","description":"ICD-NGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITD0","description":"ICD-BITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVA1","description":"ICD-KGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2216","description":"Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparo ablate liver tumor rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47370","description":"Laparo ablate liver tumor rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSD1","description":"ICD-HDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPE1","description":"ICD-NAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBA1","description":"ICD-IEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCF0","description":"ICD-OKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy DNA sequencing comparative analysis_ fetal DNA from products of conception_ reported as normal (euploidy)_ monosomy_ trisomy_ or partial deletion/duplication_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0341U","description":"Fetal aneuploidy DNA sequencing comparative analysis_ fetal DNA from products of conception_ reported as normal (euploidy)_ monosomy_ trisomy_ or partial deletion/duplication_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24C","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUB1","description":"ICD-GHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who have had a hysterectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9774","description":"Patients who have had a hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMD0","description":"ICD-EHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCD1","description":"ICD-ADCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93316","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOB0","description":"ICD-CDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL33","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11B","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDF0","description":"ICD-KCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1094T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1094T","description":"CPT-1094T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBE0","description":"ICD-AEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection Fluocinolone Acetonide Intravitreal Implant_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9450","description":"Injection Fluocinolone Acetonide Intravitreal Implant_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKID1","description":"ICD-OKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOE0","description":"ICD-CGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUF1","description":"ICD-CIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYF1","description":"ICD-LEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHD0","description":"ICD-NKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69620","description":"Repair of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMA1","description":"ICD-OHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tympanostomy (Requiring Insertion Of Ventilating Tube)_ Using An Automated Tube Delivery System_ Iontophoresis Local Anesthesia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0583T","description":"Tympanostomy (Requiring Insertion Of Ventilating Tube)_ Using An Automated Tube Delivery System_ Iontophoresis Local Anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laiv vacc pandemic intranasl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90664","description":"Laiv vacc pandemic intranasl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGF0","description":"ICD-CBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX11","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace skull plate/flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62143","description":"Replace skull plate/flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62305","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHD0","description":"ICD-EGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0556","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","description":"HCPCS-G0556","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on nose and accessory sinuses; biopsy_ soft tissu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0124U","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy_ soft tissu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who have a diagnosis of rhabdomyolysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9780","description":"Patients who have a diagnosis of rhabdomyolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are identified as having an intolerance or allergy to beta-blocker therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9800","description":"Patients who are identified as having an intolerance or allergy to beta-blocker therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDD1","description":"ICD-JBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB251","description":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraop cyst eval trac inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9606","description":"Intraop cyst eval trac inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAC0","description":"ICD-ABAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBC1","description":"ICD-ABBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICB1","description":"ICD-CICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Physical Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4025","description":"Physical Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDB0","description":"ICD-NHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10C","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHB1","description":"ICD-MCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA02","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJE0","description":"ICD-GBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67101","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bamlanivimab_ 700 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0239","description":"Bamlanivimab_ 700 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA11","description":"ICD-1EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20B","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tretinoin topical 5 g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0117","description":"Tretinoin topical 5 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87449","description":"IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abduct control hip semi-flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1630","description":"Abduct control hip semi-flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDF0","description":"ICD-FCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTC1","description":"ICD-OBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGF0","description":"ICD-GHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRC1","description":"ICD-PBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDB1","description":"ICD-BCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation_ including dissection and removal of surrounding soft tissues and preparat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0668T","description":"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation_ including dissection and removal of surrounding soft tissues and preparat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Covid-19 vaccine admin inside a patient_s home; reported only once per individual home per date of service when only covid-19 vaccine admin is performed at the patients home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0201","description":"Covid-19 vaccine admin inside a patient_s home; reported only once per individual home per date of service when only covid-19 vaccine admin is performed at the patients home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/2.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2208","description":"Lens sphcy bifocal 4.25-7/2.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRA1","description":"ICD-PHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDE0","description":"ICD-CBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"removal of implant body not requiring bone removal or flap elevation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6105","description":"removal of implant body not requiring bone removal or flap elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGC0","description":"ICD-BFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13B","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCND1","description":"ICD-FCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","description":"HCPCS-J7174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUD0","description":"ICD-GBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNB0","description":"ICD-NFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHE0","description":"ICD-JAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53200","description":"Biopsy of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDE0","description":"ICD-KGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEF0","description":"ICD-NGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFF0","description":"ICD-BBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBD1","description":"ICD-ICBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB116","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFF1","description":"ICD-NJFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDA1","description":"ICD-FIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48150","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj iris prosth w/rmvl&insj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0617T","description":"Insj iris prosth w/rmvl&insj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilated macular exam was not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9977","description":"Dilated macular exam was not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX40","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHA0","description":"ICD-GDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJC0","description":"ICD-FFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRA0","description":"ICD-OHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIC0","description":"ICD-EFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HER2-targeted therapies administered during the initial course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9828","description":"HER2-targeted therapies administered during the initial course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer water collec devic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7012","description":"Nebulizer water collec devic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMA0","description":"ICD-OHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIE1","description":"ICD-NFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFF0","description":"ICD-OJFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMF1","description":"ICD-KIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERE1","description":"ICD-OERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering zoster vaccine (e.g._ prior anaphylaxis due to the zoster vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1175","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g._ prior anaphylaxis due to the zoster vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAF0","description":"ICD-EBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVB1","description":"ICD-JAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ Trichomonas vaginalis_ Mycoplasma genitalium_ multiplex amplified probe techni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0402U","description":"Infectious agent (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ Trichomonas vaginalis_ Mycoplasma genitalium_ multiplex amplified probe techni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUA1","description":"ICD-CDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove sling repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57287","description":"Revise/remove sling repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEB1","description":"ICD-NJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSB0","description":"ICD-DCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWF1","description":"ICD-DDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRA0","description":"ICD-LIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANF0","description":"ICD-GANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRF1","description":"ICD-LIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC10","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLF0","description":"ICD-JFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95978","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELD1","description":"ICD-CELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHB0","description":"ICD-OAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTF1","description":"ICD-FFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWA1","description":"ICD-GDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWD1","description":"ICD-PJWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKND1","description":"ICD-OKND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrist disarticul switch ctrl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6920","description":"Wrist disarticul switch ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost skn barrier sld ext wear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4385","description":"Ost skn barrier sld ext wear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"K flow/funct image multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78709","description":"K flow/funct image multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUF1","description":"ICD-IAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOA1","description":"ICD-DDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self-mgmt educ/train 5-8 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98962","description":"Self-mgmt educ/train 5-8 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMB0","description":"ICD-MGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPA1","description":"ICD-CFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/w resect addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32667","description":"Thoracoscopy w/w resect addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKC1","description":"ICD-BDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXF1","description":"ICD-KAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAE1","description":"ICD-JIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61531","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPA0","description":"ICD-CHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68440","description":"Incise tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERD1","description":"ICD-OERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1397","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","description":"HCPCS-M1397","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFA0","description":"ICD-BDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWE0","description":"ICD-HGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEB0","description":"ICD-MBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQD1","description":"ICD-CDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJF1","description":"ICD-JCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped power wheelchair nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1239","description":"Ped power wheelchair nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non cutaneous loc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9295","description":"Non cutaneous loc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBC0","description":"ICD-NBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAE0","description":"ICD-FHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRD0","description":"ICD-KBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Follow-up surgery of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66250","description":"Follow-up surgery of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUC0","description":"ICD-CHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRE1","description":"ICD-PFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPE0","description":"ICD-JHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62287","description":"Percutaneous diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBA1","description":"ICD-NLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9801","description":"Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMB1","description":"ICD-GIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC16","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spec sit not prim tumor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8723","description":"Spec sit not prim tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Free jejunum flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43496","description":"Free jejunum flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLA1","description":"ICD-GDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHC1","description":"ICD-ODHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVC0","description":"ICD-GEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOC1","description":"ICD-OEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGA1","description":"ICD-ODGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIE0","description":"ICD-MBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYB1","description":"ICD-KAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0978T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","description":"CPT-0978T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYB1","description":"ICD-LGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAB1","description":"ICD-MLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPA0","description":"ICD-NGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVB1","description":"ICD-ODVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25520","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB22","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD131","description":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVC0","description":"ICD-OKVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKE0","description":"ICD-JIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJE1","description":"ICD-FCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPF1","description":"ICD-NJPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Testosterone pellet 75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0189","description":"Testosterone pellet 75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYD1","description":"ICD-OKYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Punch biopsy of skin (including simple closure_ when performed); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11104","description":"Punch biopsy of skin (including simple closure_ when performed); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","description":"HCPCS-Q4375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc ext unknwn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9070","description":"Onc dx sclc/nsclc ext unknwn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABF1","description":"ICD-CABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTE1","description":"ICD-ICTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGD0","description":"ICD-FBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18B","description":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4041","description":"Cast sup lng leg splnt plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSC0","description":"ICD-OJSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEF1","description":"ICD-NHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seat lift for pt furn-electr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0628","description":"Seat lift for pt furn-electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKA1","description":"ICD-CDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC07","description":"Very High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVD1","description":"ICD-NJVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDE1","description":"ICD-FBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIA1","description":"ICD-FIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery bifurcation (eg_ aneurysm_ pseudoaneurysm_ arteriovenous malformation_ trauma_ dissection) using bifurcated endograft from the common iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0254T","description":"Endovascular repair of iliac artery bifurcation (eg_ aneurysm_ pseudoaneurysm_ arteriovenous malformation_ trauma_ dissection) using bifurcated endograft from the common iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE150","description":"Special Care Low _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tdap vaccine 7 yrs/> im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90715","description":"Tdap vaccine 7 yrs/> im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0C","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sperm identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89257","description":"Sperm identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leg surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27599","description":"Leg surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52450","description":"Incision of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEND0","description":"ICD-OEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKF1","description":"ICD-NHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99231","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCA1","description":"ICD-MDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUF0","description":"ICD-FCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trifoc prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0508","description":"Trifoc prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vinblastine sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9360","description":"Vinblastine sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1249","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCC0","description":"ICD-GDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEA1","description":"ICD-IBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable nebulizer prefill","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7008","description":"Disposable nebulizer prefill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBD1","description":"ICD-KIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPB1","description":"ICD-GGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dem severity classified mild","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1490F","description":"Dem severity classified mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITA0","description":"ICD-KITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVD1","description":"ICD-FIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPC0","description":"ICD-JAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bath/shower chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0240","description":"Bath/shower chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEE1","description":"ICD-EBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantation_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside of the mastoid and resulting in removal of greater","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69729","description":"Implantation_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside of the mastoid and resulting in removal of greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVD0","description":"ICD-JHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27508","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam filled caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2387","description":"Foam filled caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient  compression arm sleeve_ custom_ heavy weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6577","description":"Gradient  compression arm sleeve_ custom_ heavy weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDID1","description":"ICD-NDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYB0","description":"ICD-PBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degree","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9772","description":"Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFB1","description":"ICD-OBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc of tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9276","description":"Doc of tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLE0","description":"ICD-JFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3304","description":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFB1","description":"ICD-CGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy pyeloplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50544","description":"Laparoscopy pyeloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOA1","description":"ICD-KGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive testis surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54535","description":"Extensive testis surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMB0","description":"ICD-AGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDC0","description":"ICD-NBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAE0","description":"ICD-CGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRB0","description":"ICD-OIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTE1","description":"ICD-NCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21A","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59151","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-84394","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","description":"CPT-84394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42410","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx combined","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21387","description":"Opn tx orbit fx combined","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c wdth 24-27 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2341","description":"W/c wdth 24-27 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95717","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYB1","description":"ICD-DFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDC1","description":"ICD-IFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE212","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fistulization of sclera for glaucoma_ through ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0123T","description":"Fistulization of sclera for glaucoma_ through ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBE0","description":"ICD-MKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent leadless pacemaker_ right ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33275","description":"Transcatheter removal of permanent leadless pacemaker_ right ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61210","description":"Pierce skull implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNE1","description":"ICD-NKNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWD0","description":"ICD-GCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51800","description":"Revision of bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBE1","description":"ICD-KEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelets leukoreduced irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9033","description":"Platelets leukoreduced irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFC1","description":"ICD-OJFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice/home hlth_ place nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5009","description":"Hospice/home hlth_ place nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATC1","description":"ICD-NATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-3/> piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21143","description":"Lefort i-3/> piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Init pm e/m new pat 1-4 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99382","description":"Init pm e/m new pat 1-4 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXD0","description":"ICD-BBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJF0","description":"ICD-JEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX10","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCA0","description":"ICD-CDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBD0","description":"ICD-JHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69550","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYC1","description":"ICD-GEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19125","description":"Excision breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASC0","description":"ICD-LASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8D","description":"High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Individual_ Initial Assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0591T","description":"Health And Well-Being Coaching Face-To-Face; Individual_ Initial Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cranial surg nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21051","description":"Anesth cranial surg nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIE1","description":"ICD-IHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of gdh enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82965","description":"Assay of gdh enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC21","description":"ICD-1CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNC0","description":"ICD-FDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hc pro phone call 11-20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98967","description":"Hc pro phone call 11-20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvf assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3020F","description":"Lvf assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAA1","description":"ICD-OBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJE0","description":"ICD-NDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEB0","description":"ICD-MJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HER2/neu positive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9830","description":"HER2/neu positive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXA0","description":"ICD-JFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8F","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gingival irrigation per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4921","description":"Gingival irrigation per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKE1","description":"ICD-JFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fecal microbiota_ live - jslm_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1440","description":"Fecal microbiota_ live - jslm_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screw retained plate","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7292","description":"Screw retained plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAB1","description":"ICD-CHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"LU GNOTYP BCAM EXON 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0196U","description":"LU GNOTYP BCAM EXON 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29836","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/o coronary artery stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4562F","description":"Pt w/o coronary artery stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCND1","description":"ICD-NCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWA1","description":"ICD-PEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLC0","description":"ICD-JFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIE0","description":"ICD-MJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA20","description":"Low Rehab_ ADL Index 0-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXD1","description":"ICD-OAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAA0","description":"ICD-BIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYA0","description":"ICD-GEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obstructive sleep apnea mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8900","description":"Obstructive sleep apnea mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54430","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL42","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGC1","description":"ICD-OHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy shoulder tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23065","description":"Biopsy shoulder tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg1a-b or 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9114","description":"Onc dx ovarian stg1a-b or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC221","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILE0","description":"ICD-FILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ckd meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8495","description":"Ckd meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cst bse mtl inlay 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6604","description":"Cst bse mtl inlay 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWC1","description":"ICD-OLWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESC1","description":"ICD-PESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immediate mandibular partial denture - flexible base (including any clasps_ rests and teeth)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5228","description":"Immediate mandibular partial denture - flexible base (including any clasps_ rests and teeth)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A8006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","description":"HCPCS-A8006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWA1","description":"ICD-DDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHB1","description":"ICD-FFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32671","description":"Thoracoscopy pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TPMT (thiopurine S-methyltransferase) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81335","description":"TPMT (thiopurine S-methyltransferase) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFB1","description":"ICD-OKFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEA1","description":"ICD-CAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31294","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWC1","description":"ICD-OHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDC0","description":"ICD-JGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSA1","description":"ICD-OCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPF1","description":"ICD-JCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKC1","description":"ICD-NHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES214","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electron microscopy diagnost","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0481","description":"Electron microscopy diagnost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMC0","description":"ICD-JAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUB0","description":"ICD-CHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXF1","description":"ICD-NBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein five","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33514","description":"Cabg vein five","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8I","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWD0","description":"ICD-OJWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALC0","description":"ICD-OALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJB0","description":"ICD-GHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKF1","description":"ICD-GGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB112","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWF1","description":"ICD-PHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUD1","description":"ICD-ABUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAD1","description":"ICD-AHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23D","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peng benzathine/procaine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0558","description":"Peng benzathine/procaine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Melanomaajcc stage 0 or ia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3322F","description":"Melanomaajcc stage 0 or ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHA0","description":"ICD-KHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain appendix abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44900","description":"Drain appendix abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBD1","description":"ICD-NHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMF1","description":"ICD-ICMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEID0","description":"ICD-JEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"C motor evoked lwr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95929","description":"C motor evoked lwr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bilirubin total transcut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88720","description":"Bilirubin total transcut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC11","description":"ICD-1IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0406T","description":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elevat legrst up hangr brack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0047","description":"Elevat legrst up hangr brack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJD0","description":"ICD-KFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQA0","description":"ICD-OKQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCC0","description":"ICD-ECCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUF0","description":"ICD-NJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9700","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc forearm tum deep < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25076","description":"Exc forearm tum deep < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKC0","description":"ICD-JIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagomyotomy abdominal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43330","description":"Esophagomyotomy abdominal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 2nd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36246","description":"Ins cath abd/l-ext art 2nd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNF0","description":"ICD-GHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of nail fold toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11765","description":"Excision of nail fold toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opioids & opiate analogs 3/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80363","description":"Opioids & opiate analogs 3/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMA0","description":"ICD-BDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart revascularize (tmr)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33140","description":"Heart revascularize (tmr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAC1","description":"ICD-BGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTA0","description":"ICD-FFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mibm but no dx of breast ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8946","description":"Mibm but no dx of breast ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKE1","description":"ICD-GEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSD1","description":"ICD-GCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sialidase enzyme assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87905","description":"Sialidase enzyme assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUC1","description":"ICD-MFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0305","description":"HCPCS-C0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ torso/shoulder_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6569","description":"Gradient compression garment_ torso/shoulder_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFE0","description":"ICD-GCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62320","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00220","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","description":"CPT-00220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAA0","description":"ICD-CGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0804","description":"HCPCS-A0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSC0","description":"ICD-PGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX33","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery for vulva lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56440","description":"Surgery for vulva lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNE0","description":"ICD-BGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1504","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1504","description":"CDT-D1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJC0","description":"ICD-CHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRC0","description":"ICD-LHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGB0","description":"ICD-CDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDID1","description":"ICD-KDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Srs spinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63620","description":"Srs spinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHA1","description":"ICD-IEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp ilio-celiac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35632","description":"Art byp ilio-celiac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBB0","description":"ICD-MIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJE1","description":"ICD-JIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21C","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1484","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","description":"HCPCS-M1484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKB1","description":"ICD-BIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18B","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUC0","description":"ICD-BDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interv hlth/behav fam w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96154","description":"Interv hlth/behav fam w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPA0","description":"ICD-KGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYF1","description":"ICD-KDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTB1","description":"ICD-IDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDB1","description":"ICD-OHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIA0","description":"ICD-ODIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHE1","description":"ICD-GCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWE0","description":"ICD-OBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBC0","description":"ICD-KCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUD0","description":"ICD-EIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESE0","description":"ICD-KESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood viscosity examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85810","description":"Blood viscosity examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA16","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC121","description":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Varicella zoster ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87290","description":"Varicella zoster ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMD0","description":"ICD-AHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0838T","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOC0","description":"ICD-HIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVB0","description":"ICD-KDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65130","description":"Insert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"EpiFix or Epicord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4131","description":"EpiFix or Epicord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBB0","description":"ICD-BEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKD0","description":"ICD-NBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKE0","description":"ICD-FDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGE1","description":"ICD-CHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYF1","description":"ICD-KIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recd f/u w/in 7d disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9405","description":"Recd f/u w/in 7d disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow_ report of clinically s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0331U","description":"Oncology (hematolymphoid neoplasia)_ optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow_ report of clinically s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAD1","description":"ICD-FIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWF0","description":"ICD-DCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMB1","description":"ICD-AHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (genetic thrombosis)_ genomic sequence analysis of 12 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Thrombosis Panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0278U","description":"Hematology (genetic thrombosis)_ genomic sequence analysis of 12 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Thrombosis Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRC1","description":"ICD-CFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental gold foil one surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2410","description":"Dental gold foil one surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMD1","description":"ICD-BGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunotherapy 2/> injections","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95125","description":"Immunotherapy 2/> injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMF1","description":"ICD-KAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBB1","description":"ICD-EFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing paternity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86910","description":"Blood typing paternity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL46","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC213","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext line w easy lock connect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4673","description":"Ext line w easy lock connect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22844","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVA0","description":"ICD-CFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93619","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKD0","description":"ICD-OGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAB0","description":"ICD-OIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCC0","description":"ICD-OFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKB0","description":"ICD-KHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAE1","description":"ICD-FCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPF1","description":"ICD-OLPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo below knee alignable sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5910","description":"Endo below knee alignable sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBA0","description":"ICD-JDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spun microhematocrit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85013","description":"Spun microhematocrit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heavy metal screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83015","description":"Heavy metal screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change of gastrostomy tube_ percutaneous_ without imaging or endoscopic guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43760","description":"Change of gastrostomy tube_ percutaneous_ without imaging or endoscopic guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55600","description":"Incise sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYB0","description":"ICD-HIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNC1","description":"ICD-NJNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA36","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDA0","description":"ICD-FEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed var ht w/o rail w/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0292","description":"Hosp bed var ht w/o rail w/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA254","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD250","description":"Special Care High _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVA1","description":"ICD-CAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCB1","description":"ICD-MCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUF0","description":"ICD-MLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29365","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEB0","description":"ICD-FDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sperm isolation complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89261","description":"Sperm isolation complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKD0","description":"ICD-BBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKE0","description":"ICD-ODKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11B","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert ant segment drain int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0376T","description":"Insert ant segment drain int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt disch home day #2 evar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8826","description":"Pt disch home day #2 evar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath ren art 1st bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36252","description":"Ins cath ren art 1st bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDD0","description":"ICD-JDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27882","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ring flange plas/leather mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1110","description":"Ring flange plas/leather mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKE0","description":"ICD-JDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Death_ permanent nursing home resident or receiving hospice or palliative care any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9433","description":"Death_ permanent nursing home resident or receiving hospice or palliative care any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAB1","description":"ICD-JEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPC1","description":"ICD-JHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESF0","description":"ICD-OESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9957","description":"Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc count of ct in 12mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9321","description":"Doc count of ct in 12mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of glucosidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82963","description":"Assay of glucosidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cetirizine hydrochloride_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9057","description":"Injection_ cetirizine hydrochloride_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAE0","description":"ICD-CFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATE1","description":"ICD-KATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAB1","description":"ICD-NHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Palifermin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2425","description":"Palifermin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC25","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAA1","description":"ICD-CBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sys bp > or = 140","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8753","description":"Sys bp > or = 140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert major vessel graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33335","description":"Insert major vessel graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESF0","description":"ICD-LESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"DI GNOTYP SLC4A1 EXON 19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0183U","description":"DI GNOTYP SLC4A1 EXON 19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHA1","description":"ICD-BDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9246","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9246","description":"CDT-D9246","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB236","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90624","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","description":"CPT-90624","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99174","description":"Ocular instrumnt screen bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ganciclovir sodium (exela) not therapeutically equivalent to j1570_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1574","description":"Injection_ ganciclovir sodium (exela) not therapeutically equivalent to j1570_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWA0","description":"ICD-HEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCF0","description":"ICD-ECCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUD0","description":"ICD-FIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE220","description":"Clinically Complex _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPF1","description":"ICD-CAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig med check","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8430","description":"Pt inelig med check","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovas non-cardiac abl cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1888","description":"Endovas non-cardiac abl cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDE1","description":"ICD-JEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB21","description":"ICD-3AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Free/remove chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32320","description":"Free/remove chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERF1","description":"ICD-LERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUA1","description":"ICD-MKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80402","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No eval activity clin symp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3119F","description":"No eval activity clin symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40650","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with noninvasive interface (e.g._ mask)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0461","description":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with noninvasive interface (e.g._ mask)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24D","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23D","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trnslum dil eye canal w/stnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66175","description":"Trnslum dil eye canal w/stnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDB1","description":"ICD-ABDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJA0","description":"ICD-OHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYE0","description":"ICD-PBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Asparaginase_ Recombinant_ (Rylaze)_ 0.1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9021","description":"Injection_ Asparaginase_ Recombinant_ (Rylaze)_ 0.1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; implantable monitor only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0532T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; implantable monitor only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMF0","description":"ICD-OLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emergency Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4003","description":"Emergency Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMA0","description":"ICD-BFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pessary rubber_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4561","description":"Pessary rubber_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10D","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXB1","description":"ICD-BHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB156","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGE1","description":"ICD-NCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cannula nasal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4615","description":"Cannula nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUB1","description":"ICD-IEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDE1","description":"ICD-KBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEA1","description":"ICD-JGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVF1","description":"ICD-NFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB160","description":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB260","description":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD)_ with concurrent vertebral fracture assessment_ utilizing data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0743T","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD)_ with concurrent vertebral fracture assessment_ utilizing data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUD1","description":"ICD-JGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/replace knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27486","description":"Revise/replace knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long arm ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4008","description":"Cast sup long arm ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPB0","description":"ICD-NIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMD0","description":"ICD-ODMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMF1","description":"ICD-CAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70332","description":"X-ray exam of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDND0","description":"ICD-CDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00145","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","description":"CPT-00145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTE0","description":"ICD-KBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI angio chest w or w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71555","description":"MRI angio chest w or w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37246","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evacuation Of Meibomian Glands_ Using Heat Delivered Through Wearable_ Open-Eye Eyelid Treatment Devices And Manual Gland Expression_ Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0563T","description":"Evacuation Of Meibomian Glands_ Using Heat Delivered Through Wearable_ Open-Eye Eyelid Treatment Devices And Manual Gland Expression_ Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0540U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","description":"CPT-0540U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIID1","description":"ICD-KIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIF0","description":"ICD-GEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise lip or cheek fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40819","description":"Excise lip or cheek fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFA0","description":"ICD-JCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCC0","description":"ICD-IHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVC0","description":"ICD-GAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ and transluminal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9765","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ and transluminal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB31","description":"Very High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection into vocal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31513","description":"Injection into vocal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore parathyroid glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60505","description":"Explore parathyroid glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKC1","description":"ICD-OGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDD0","description":"ICD-AFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with thepower source and control electronics unit_ controlled by hardw","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0491","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with thepower source and control electronics unit_ controlled by hardw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1086T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1086T","description":"CPT-1086T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFE0","description":"ICD-KFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBA1","description":"ICD-ICBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRE0","description":"ICD-OCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMB0","description":"ICD-FDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of upper eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15822","description":"Revision of upper eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec knee-shin swing only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5857","description":"Elec knee-shin swing only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYF0","description":"ICD-LAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL11","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat kneecap fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27520","description":"Treat kneecap fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00404","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","description":"CPT-00404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYC1","description":"ICD-GDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92986","description":"Revision of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAA0","description":"ICD-OGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4356","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","description":"HCPCS-Q4356","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virus antibody nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86790","description":"Virus antibody nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial valve addl insert","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31651","description":"Bronchial valve addl insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77263","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTE0","description":"ICD-ECTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip bone les super","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27065","description":"Remove hip bone les super","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHB1","description":"ICD-GAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPB1","description":"ICD-NHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25545","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOE0","description":"ICD-OJOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGA1","description":"ICD-JCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCB1","description":"ICD-MKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin reuse pen 1.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5560","description":"Insulin reuse pen 1.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEF1","description":"ICD-CCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABA1","description":"ICD-AABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tdap or td or 1tet/dipth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9416","description":"Tdap or td or 1tet/dipth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18X","description":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICE0","description":"ICD-IICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUC0","description":"ICD-KGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg_ expanded size and methylation status)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81172","description":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg_ expanded size and methylation status)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAC0","description":"ICD-GBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB201","description":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBD0","description":"ICD-IBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLB0","description":"ICD-OHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16377","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16377","description":"CPT-16377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62327","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBA1","description":"ICD-OIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWC1","description":"ICD-LCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYB0","description":"ICD-DBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immntx 4 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95133","description":"Immntx 4 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26437","description":"Realignment of tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tooth pin retention","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2951","description":"Tooth pin retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6069","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 1)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1713","description":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 1)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMD1","description":"ICD-EEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stoma plug or seal_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5081","description":"Stoma plug or seal_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; With Mediastinal Lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21603","description":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; With Mediastinal Lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDA1","description":"ICD-EGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWF1","description":"ICD-CFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLC0","description":"ICD-NFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVF1","description":"ICD-GBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAC1","description":"ICD-MLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXB0","description":"ICD-FIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","description":"CPT-00930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Derm-Maxx_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4238","description":"Derm-Maxx_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qty act card prev mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9677","description":"Qty act card prev mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5143","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","description":"HCPCS-Q5143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ not otherwise specified_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9075","description":"Injection_ cyclophosphamide_ not otherwise specified_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; set-up and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99453","description":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; set-up and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01440","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","description":"CPT-01440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHB0","description":"ICD-KAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAB1","description":"ICD-FGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNE0","description":"ICD-KFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65235","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUA1","description":"ICD-IAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA11","description":"ICD-1HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEB0","description":"ICD-GDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Audiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0062","description":"Audiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sgd digitized pre-rec <=8min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2500","description":"Sgd digitized pre-rec <=8min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKC1","description":"ICD-BEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE230","description":"Special Care High _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTF0","description":"ICD-EGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSE0","description":"ICD-PGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracardiac ecg (ice)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93662","description":"Intracardiac ecg (ice)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1214","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart symp image plnr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0331T","description":"Heart symp image plnr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other pt/ot current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8990","description":"Other pt/ot current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not rcvng esa thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4172F","description":"Pt not rcvng esa thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARB0","description":"ICD-PARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remis 6m w/6mos phq-9 <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9573","description":"Remis 6m w/6mos phq-9 <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEC1","description":"ICD-KCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49600","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBC1","description":"ICD-IEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEF0","description":"ICD-MIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKB0","description":"ICD-FBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Specialty care transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0434","description":"Specialty care transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"T cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86359","description":"T cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiof trsmtr implt scrl neu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8684","description":"Radiof trsmtr implt scrl neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNB0","description":"ICD-OLNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHC1","description":"ICD-NLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mycobacteric identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87118","description":"Mycobacteric identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antibody detection nos if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87299","description":"Antibody detection nos if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPD1","description":"ICD-OGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOA0","description":"ICD-HDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Appro rad ds dvcs techs docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6040F","description":"Appro rad ds dvcs techs docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81541","description":"Oncology (prostate)_ mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ polycentric_ pneumatic swing_ and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5841","description":"Addition_ endoskeletal knee-shin system_ polycentric_ pneumatic swing_ and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise cerv artific disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22861","description":"Revise cerv artific disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCED1","description":"ICD-KCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXA1","description":"ICD-KIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKC0","description":"ICD-CAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c wdth 20-23 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2340","description":"W/c wdth 20-23 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plastic mold recipro hip & c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2627","description":"Plastic mold recipro hip & c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVC0","description":"ICD-CHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon metas evid dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9087","description":"Onc dx colon metas evid dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUF0","description":"ICD-JDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUD0","description":"ICD-KIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Camisole post-mast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8460","description":"Camisole post-mast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERC1","description":"ICD-HERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGC1","description":"ICD-GFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPE1","description":"ICD-NHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of burn scab initi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16035","description":"Incision of burn scab initi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42890","description":"Partial removal of pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAE0","description":"ICD-ODAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEB0","description":"ICD-CAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGD0","description":"ICD-CCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAF0","description":"ICD-JBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMF1","description":"ICD-IIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20694","description":"Remove bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8F","description":"Medium Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22A","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVA0","description":"ICD-FEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14C","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ talquetamab-tgvs_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3055","description":"Injection_ talquetamab-tgvs_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96202","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psych disorders assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3700F","description":"Psych disorders assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRF0","description":"ICD-GBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Not medically necessary svc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9986","description":"Not medically necessary svc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAE1","description":"ICD-JAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWB0","description":"ICD-PJWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s) of sclerosant for spider veins (telangiectasia)_ limb or trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36468","description":"Injection(s) of sclerosant for spider veins (telangiectasia)_ limb or trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGB0","description":"ICD-KBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOF0","description":"ICD-HBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUF0","description":"ICD-FEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove thyroid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60200","description":"Remove thyroid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMF0","description":"ICD-JFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA21","description":"ICD-1AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIF1","description":"ICD-AGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYF1","description":"ICD-CIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALC0","description":"ICD-MALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy & revise urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52270","description":"Cystoscopy & revise urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIF1","description":"ICD-OJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITD1","description":"ICD-AITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; First Level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0629T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; First Level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External transmitter_ cgm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9277","description":"External transmitter_ cgm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing patient serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86904","description":"Blood typing patient serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mast radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19305","description":"Mast radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA225","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMA1","description":"ICD-EEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mandibular part denture flex","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5226","description":"Mandibular part denture flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orbital prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8042","description":"Orbital prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ cell-free DNA (cfDNA)_ methylation-based quantitative PCR assay (SEPTIN9_ IKZF1_ BCAT1_ Septin9-2_ VAV3_ BCAN)_ plasma_ reported as presence or a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0453U","description":"Oncology (colorectal cancer)_ cell-free DNA (cfDNA)_ methylation-based quantitative PCR assay (SEPTIN9_ IKZF1_ BCAT1_ Septin9-2_ VAV3_ BCAN)_ plasma_ reported as presence or a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens extended wear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2513","description":"Contact lens extended wear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFD1","description":"ICD-JHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC11","description":"ICD-4BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01990","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","description":"CPT-01990","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYF1","description":"ICD-OGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUD0","description":"ICD-KFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJA0","description":"ICD-BEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC33","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adj skin pro/pos cus<22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2624","description":"Adj skin pro/pos cus<22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGC0","description":"ICD-CFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alginate dressing <=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6196","description":"Alginate dressing <=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMC1","description":"ICD-GAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEF0","description":"ICD-AGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRB0","description":"ICD-CHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11307","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMD1","description":"ICD-KDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess negative docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3341F","description":"Mammo assess negative docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHND1","description":"ICD-JHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDA1","description":"ICD-AHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAB0","description":"ICD-NEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61880","description":"Revise/remove neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGED1","description":"ICD-OGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDA0","description":"ICD-OEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43840","description":"Repair of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIA1","description":"ICD-ODIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFE0","description":"ICD-OBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; hemicortical intercalary_ partial (ie_ hemicylindrical) (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20933","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; hemicortical intercalary_ partial (ie_ hemicylindrical) (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAF1","description":"ICD-JFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt asked/cnsld aed effects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6070F","description":"Pt asked/cnsld aed effects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interventional Radiology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4012","description":"Interventional Radiology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGC1","description":"ICD-GCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD211","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEF1","description":"ICD-EIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHF0","description":"ICD-MHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inter active grp psych parti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0411","description":"Inter active grp psych parti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam drg > 48 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6214","description":"Foam drg > 48 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plan caremng angnl symptdocd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0557F","description":"Plan caremng angnl symptdocd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMB1","description":"ICD-OIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBD1","description":"ICD-MCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open/perq place stent same","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37238","description":"Open/perq place stent same","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther hrvst onl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0265T","description":"Im b1 mrw cel ther hrvst onl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC26","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYB0","description":"ICD-PGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIME0","description":"ICD-IIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPA0","description":"ICD-BGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22B","description":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close bronchial fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32815","description":"Close bronchial fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Symptoms improved/consist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1450F","description":"Symptoms improved/consist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOB0","description":"ICD-LGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ringers lactate infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7120","description":"Ringers lactate infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDC0","description":"ICD-GHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGD1","description":"ICD-KDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flutter device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8185","description":"Flutter device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBC0","description":"ICD-JBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29885","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLB1","description":"ICD-OGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMF0","description":"ICD-AFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D6180","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6180","description":"CDT-D6180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGA0","description":"ICD-JFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMA0","description":"ICD-ADMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOD0","description":"ICD-CDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC254","description":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fit spectacles compound lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92355","description":"Fit spectacles compound lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Level of activity assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1003F","description":"Level of activity assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDME0","description":"ICD-NDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36557","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy vulva lesions sim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56501","description":"Destroy vulva lesions sim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLC1","description":"ICD-CBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERE1","description":"ICD-HERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPA0","description":"ICD-JIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1498","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","description":"HCPCS-M1498","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine process addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172T","description":"Lumbar spine process addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX23","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No transfercare chklist used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0584F","description":"No transfercare chklist used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diphtheria toxoid_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90719","description":"Diphtheria toxoid_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ antihemophilic factor (recombinant)_ (Esperoct)_ glycopegylated-exei_ per IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7204","description":"Injection_ Factor VIII_ antihemophilic factor (recombinant)_ (Esperoct)_ glycopegylated-exei_ per IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYD1","description":"ICD-DHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0207","description":"Traumatic brain injury with Motor <22.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37297","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","description":"CPT-37297","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pain management (opioid-use disorder) genotyping panel_ 16 common variants (ie_ ABCB1_ COMT_ DAT1_ DBH_ DOR_ DRD1_ DRD2_ DRD4_ GABA_ GAL_ HTR2A_ HTTLPR_ MTHFR_ MUOR_ OPRK1_ OP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0078U","description":"Pain management (opioid-use disorder) genotyping panel_ 16 common variants (ie_ ABCB1_ COMT_ DAT1_ DBH_ DOR_ DRD1_ DRD2_ DRD4_ GABA_ GAL_ HTR2A_ HTTLPR_ MTHFR_ MUOR_ OPRK1_ OP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 2.6-5.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12013","description":"Rpr f/e/e/n/l/m 2.6-5.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA11","description":"ICD-3IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76390","description":"Mr spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDE1","description":"ICD-MKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBF0","description":"ICD-ADBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso full corset","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0976","description":"Lso full corset","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOF0","description":"ICD-HFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLA1","description":"ICD-JGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBC0","description":"ICD-AHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAA1","description":"ICD-OJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOC1","description":"ICD-KBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal focal laser ablation of malignant prostate tissue_ including transrectal imaging guidance_ with MR-fused images or other enhanced ultrasound imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0655T","description":"Transperineal focal laser ablation of malignant prostate tissue_ including transrectal imaging guidance_ with MR-fused images or other enhanced ultrasound imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthro acetabuloplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29915","description":"Hip arthro acetabuloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYE0","description":"ICD-DEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVC1","description":"ICD-FIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46746","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMF1","description":"ICD-GAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4A","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOB1","description":"ICD-LGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0092A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHF1","description":"ICD-MKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo poly hip_ pneu/hyd/rot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5961","description":"Endo poly hip_ pneu/hyd/rot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTD1","description":"ICD-NHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of lower jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21244","description":"Reconstruction of lower jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGF0","description":"ICD-BEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXB1","description":"ICD-BAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLD0","description":"ICD-IFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRF1","description":"ICD-PHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLE1","description":"ICD-IGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immed man part denture resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5222","description":"Immed man part denture resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLB1","description":"ICD-GBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1488","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","description":"HCPCS-M1488","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQE0","description":"ICD-GAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Formoterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7640","description":"Formoterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA41","description":"Medium Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61684","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQF1","description":"ICD-LDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0868T","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12B","description":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31293","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD217","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0537U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","description":"CPT-0537U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unclassified drugs or biolog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9399","description":"Unclassified drugs or biolog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nitrogen n-13 ammonia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9526","description":"Nitrogen n-13 ammonia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation without programming of implanted phrenic nerve stimulator system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93153","description":"Interrogation without programming of implanted phrenic nerve stimulator system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGB1","description":"ICD-OBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray for pancreas endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74329","description":"X-ray for pancreas endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBE0","description":"ICD-CGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLC1","description":"ICD-AHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADF1","description":"ICD-IADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trac stand free stand extrem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0880","description":"Trac stand free stand extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Buprenorphine oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0571","description":"Buprenorphine oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTE0","description":"ICD-CCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOD0","description":"ICD-LBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE225","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJME1","description":"ICD-NJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe styled positioning dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3160","description":"Shoe styled positioning dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1198","description":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18D","description":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4B","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spinal lamina add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63048","description":"Remove spinal lamina add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWB1","description":"ICD-GGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPC0","description":"ICD-NGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGC0","description":"ICD-BIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1454","description":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECF0","description":"ICD-GECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCD1","description":"ICD-NJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOE1","description":"ICD-DAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3A","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALA0","description":"ICD-OALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL12","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWD0","description":"ICD-KDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBF0","description":"ICD-OHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHF1","description":"ICD-CIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive at least one well-child visit with PCP during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9965","description":"Patient did not receive at least one well-child visit with PCP during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJD1","description":"ICD-GGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB113","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJB0","description":"ICD-GBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Distal/proximal wedge proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4274","description":"Distal/proximal wedge proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSC1","description":"ICD-HDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILF0","description":"ICD-OILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"20+ cc syringe only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4213","description":"20+ cc syringe only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMB1","description":"ICD-NDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 4 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3390F","description":"Ajcc cln cncr stage 4 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYA1","description":"ICD-DAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFE1","description":"ICD-NHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31577","description":"Remove foreign body larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPC1","description":"ICD-CDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown full cast base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2791","description":"Crown full cast base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66852","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMA0","description":"ICD-OLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bebtelovimab_ 175 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0222","description":"Injection_ bebtelovimab_ 175 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90380","description":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXA0","description":"ICD-KEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49593","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB36","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0463","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","description":"HCPCS-J0463","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20610","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCD1","description":"ICD-AGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt no elig for bp assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8784","description":"Pt no elig for bp assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNB1","description":"ICD-ODNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nelarabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9261","description":"Nelarabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suction lipectomy upr extrem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15878","description":"Suction lipectomy upr extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLE0","description":"ICD-MLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMA1","description":"ICD-AIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDC0","description":"ICD-BDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt tobacco screen rcvd tlk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4004F","description":"Pt tobacco screen rcvd tlk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of salivary cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42409","description":"Drainage of salivary cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDE0","description":"ICD-EDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESF0","description":"ICD-PESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pancreas surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48999","description":"Pancreas surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1336","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB146","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-elec oscillatory pep dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0484","description":"Non-elec oscillatory pep dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc fe+ stores b/4 epo thx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3160F","description":"Doc fe+ stores b/4 epo thx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of arm nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64713","description":"Revision of arm nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQC1","description":"ICD-GDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTC1","description":"ICD-MGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGA0","description":"ICD-KIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLC1","description":"ICD-KBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4035","description":"Thoracic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay quant nos nonab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83520","description":"Immunoassay quant nos nonab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0245","description":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33411","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFF1","description":"ICD-JGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76018","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","description":"CPT-76018","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4296","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","description":"HCPCS-A4296","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX25","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB120","description":"Clinically Complex _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11A","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28X","description":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human papillomavirus (HPV)_ oropharyngeal swab_ 14 high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ and 68)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0429U","description":"Human papillomavirus (HPV)_ oropharyngeal swab_ 14 high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ and 68)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOC1","description":"ICD-LCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33953","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28450","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26358","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPB0","description":"ICD-GGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0651","description":"Injection_ levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKF1","description":"ICD-NCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01742","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","description":"CPT-01742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00620","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","description":"CPT-00620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHD1","description":"ICD-MFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screeningmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0202","description":"Screeningmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interferon beta-1b / .25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1830","description":"Interferon beta-1b / .25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEE1","description":"ICD-AAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stoma absorptive cover","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5083","description":"Stoma absorptive cover","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ disp_ binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5263","description":"Hearing aid_ disp_ binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29807","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXC1","description":"ICD-FFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deb bone add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11047","description":"Deb bone add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNE0","description":"ICD-OHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adapter_ single-use (i.e._ disposable)_ for attaching ultrasound system to upper gastrointestinal endoscope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1606","description":"Adapter_ single-use (i.e._ disposable)_ for attaching ultrasound system to upper gastrointestinal endoscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application lower leg splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29515","description":"Application lower leg splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIF1","description":"ICD-FBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complex cystometrogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51726","description":"Complex cystometrogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVF0","description":"ICD-KHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDF1","description":"ICD-JEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Uvl pnl 2 sq ft or less","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0691","description":"Uvl pnl 2 sq ft or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMA0","description":"ICD-ECMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy remove segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32669","description":"Thoracoscopy remove segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFA0","description":"ICD-KFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHA1","description":"ICD-OCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNB1","description":"ICD-NCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ high complexity_ requiring these components: A medical history and physical activity profile_ with 3 or more comorbidities that affect physical a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97171","description":"Athletic training evaluation_ high complexity_ requiring these components: A medical history and physical activity profile_ with 3 or more comorbidities that affect physical a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBED1","description":"ICD-CBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC245","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64640","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt dchg home post op day 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9601","description":"Pt dchg home post op day 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKB0","description":"ICD-NDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28G","description":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supplies For Maintenance Of Insulin Infusion Pump With Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing_ Per Week","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4226","description":"Supplies For Maintenance Of Insulin Infusion Pump With Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing_ Per Week","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWB0","description":"ICD-CCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adenoma(s) or colorectal cancer not detected during screening colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9935","description":"Adenoma(s) or colorectal cancer not detected during screening colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGF0","description":"ICD-NEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12B","description":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNA0","description":"ICD-BCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc neck les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21552","description":"Exc neck les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB56","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fracture frame free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0930","description":"Fracture frame free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"guided tissue regeneration - non-resorbable barrier_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6107","description":"guided tissue regeneration - non-resorbable barrier_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBA0","description":"ICD-BHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47760","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYE1","description":"ICD-CHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Main/clean max prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5993","description":"Main/clean max prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEC1","description":"ICD-CHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood ph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82800","description":"Blood ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (cardiovascular disease)_ analysis of 4 proteins (NT-proBNP_ osteopontin_ tissue inhibitor of metalloproteinase-1 [TIMP-1]_ and kidney injury molecule-1 [KIM-1])_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0309U","description":"Cardiology (cardiovascular disease)_ analysis of 4 proteins (NT-proBNP_ osteopontin_ tissue inhibitor of metalloproteinase-1 [TIMP-1]_ and kidney injury molecule-1 [KIM-1])_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPC0","description":"ICD-OGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25695","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematopoietic nuclear tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79403","description":"Hematopoietic nuclear tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dispensing fee bicros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5240","description":"Dispensing fee bicros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMA0","description":"ICD-ODMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Audiometry air & bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92553","description":"Audiometry air & bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB17","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESA1","description":"ICD-KESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABB0","description":"ICD-OABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDA1","description":"ICD-CDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":">85y no hx colo ca/rsn scope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9659","description":">85y no hx colo ca/rsn scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTD1","description":"ICD-GFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSF0","description":"ICD-CBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEC1","description":"ICD-FDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24A","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70557","description":"MRI brain w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not have the retina attached after 6 months following only one surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9377","description":"Patient did not have the retina attached after 6 months following only one surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHD0","description":"ICD-MJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDF1","description":"ICD-IIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incis w/discectomy thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22222","description":"Incis w/discectomy thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQD0","description":"ICD-PHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19294","description":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJD1","description":"ICD-BFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTB0","description":"ICD-FCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rig fram pelvic pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0468","description":"Tlso rig fram pelvic pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Facial moulage complete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5912","description":"Facial moulage complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27442","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1749","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","description":"HCPCS-J1749","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 4 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0869","description":"Pwc gp 4 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of sirolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80195","description":"Assay of sirolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECE0","description":"ICD-OECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBC1","description":"ICD-IHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAD1","description":"ICD-NLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluocinolone acetonide implt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7311","description":"Fluocinolone acetonide implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKA1","description":"ICD-KIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGND1","description":"ICD-KGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGC1","description":"ICD-BEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGA0","description":"ICD-KFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE246","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21123","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair & adjust spectacles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92370","description":"Repair & adjust spectacles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCE0","description":"ICD-FCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Max ultrasound image capture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0386","description":"Max ultrasound image capture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q8h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9502","description":"Hit antibiotic q8h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0008","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNC0","description":"ICD-JDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJED0","description":"ICD-NJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65710","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFE0","description":"ICD-KCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRC0","description":"ICD-CIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteopath manj 5-6 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98927","description":"Osteopath manj 5-6 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEE1","description":"ICD-KEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTC1","description":"ICD-IFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQB0","description":"ICD-PJQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWD1","description":"ICD-PKWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRB0","description":"ICD-OCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDF0","description":"ICD-KGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCF1","description":"ICD-OGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt falls assess-docd le1/yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1101F","description":"Pt falls assess-docd le1/yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9946","description":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHF0","description":"ICD-BGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQD1","description":"ICD-PGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMB0","description":"ICD-CAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCB0","description":"ICD-GGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBC0","description":"ICD-KDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJB0","description":"ICD-KIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGE0","description":"ICD-CDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat combo w/o shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1006","description":"Pwr seat combo w/o shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occlusal guard - soft appliance_ full arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9945","description":"Occlusal guard - soft appliance_ full arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMB0","description":"ICD-KIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCA0","description":"ICD-OGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA250","description":"Reduced Physical Function _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERA1","description":"ICD-GERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Als iv drug therapy supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0394","description":"Als iv drug therapy supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8E","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHF1","description":"ICD-AHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVD0","description":"ICD-CIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADD0","description":"ICD-EADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Retinal polarization scan_ ocular screening with on-site automated results_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0469T","description":"Retinal polarization scan_ ocular screening with on-site automated results_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43361","description":"Gastrointestinal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert balloon device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33973","description":"Insert balloon device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01967","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","description":"CPT-01967","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB241","description":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEA0","description":"ICD-JGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOD1","description":"ICD-HGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMB1","description":"ICD-GGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLB1","description":"ICD-BHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albumin (human)_ 25%_ 50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9047","description":"Albumin (human)_ 25%_ 50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0238","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","description":"HCPCS-Q0238","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal shunt placement w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59076","description":"Fetal shunt placement w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Htlv-ii antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86688","description":"Htlv-ii antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODME1","description":"ICD-ODME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAE1","description":"ICD-JHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACA1","description":"ICD-OACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient progr_ neurostim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1787","description":"Patient progr_ neurostim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGD1","description":"ICD-BIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Term dev_ passive hand mitt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6703","description":"Term dev_ passive hand mitt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKB1","description":"ICD-FEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66761","description":"Revision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHF0","description":"ICD-MKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVD0","description":"ICD-KEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMC0","description":"ICD-FIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Abnormal Native Connecti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93594","description":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Abnormal Native Connecti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hernia repair w/mesh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49568","description":"Hernia repair w/mesh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDB1","description":"ICD-AGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDA0","description":"ICD-CDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA214","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intra-atrial pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93610","description":"Intra-atrial pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcysteine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0132","description":"Acetylcysteine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Ramucirumab_ 5 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9025","description":"Injection_ Ramucirumab_ 5 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXD0","description":"ICD-KGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prq coronary mech thrombect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92973","description":"Prq coronary mech thrombect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAME0","description":"ICD-IAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILA0","description":"ICD-KILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDF1","description":"ICD-ADDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99437","description":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLA1","description":"ICD-CHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glucagon hydrochloride/1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1610","description":"Glucagon hydrochloride/1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIID1","description":"ICD-OIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFF0","description":"ICD-BEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVC1","description":"ICD-BBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXF0","description":"ICD-BHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJA0","description":"ICD-CGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01758","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","description":"CPT-01758","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQC0","description":"ICD-OIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAD0","description":"ICD-JCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMC0","description":"ICD-EIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUA1","description":"ICD-GCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTF0","description":"ICD-IFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOF1","description":"ICD-PJOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg monitoring/videorecord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95951","description":"Eeg monitoring/videorecord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic decompression of spinal cord_ nerve root(s)_ including laminotomy_ partial facetectomy_ foraminotomy_ discectomy and/or excision of herniated intervertebral disc_ 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62380","description":"Endoscopic decompression of spinal cord_ nerve root(s)_ including laminotomy_ partial facetectomy_ foraminotomy_ discectomy and/or excision of herniated intervertebral disc_ 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGA0","description":"ICD-KGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARD0","description":"ICD-DARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infrared ht sys replcmnt pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4639","description":"Infrared ht sys replcmnt pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOF0","description":"ICD-PKOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBA1","description":"ICD-NHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGC1","description":"ICD-KIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWD0","description":"ICD-DHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11606","description":"Exc tr-ext mal+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBC1","description":"ICD-KCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA11","description":"ICD-2EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTB0","description":"ICD-GGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjust ankle ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1815","description":"Adjust ankle ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ single dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90480","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ single dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKD0","description":"ICD-GFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBND0","description":"ICD-CBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ATXN3 (ataxin 3) (eg_ spinocerebellar ataxia_ Machado-Joseph disease) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81180","description":"ATXN3 (ataxin 3) (eg_ spinocerebellar ataxia_ Machado-Joseph disease) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surg dx exam anorectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45990","description":"Surg dx exam anorectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cefazolin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0690","description":"Cefazolin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive preoperative assessment performed for cataract surgery with i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0122U","description":"Comprehensive preoperative assessment performed for cataract surgery with i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ crotalidae immune F(ab_)2 (equine)_ 120 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0841","description":"Injection_ crotalidae immune F(ab_)2 (equine)_ 120 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0687U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687U","description":"CPT-0687U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cl mult vsd w/rem pul band","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33677","description":"Cl mult vsd w/rem pul band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLB1","description":"ICD-GHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAC0","description":"ICD-AFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAE1","description":"ICD-MIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 xhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0840","description":"Pwc gp2 xhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adrenal cortex & medulla img","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78075","description":"Adrenal cortex & medulla img","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJC0","description":"ICD-KDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIB1","description":"ICD-ECIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; placement_ manipulation of transducer_ and image acquisition only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76988","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; placement_ manipulation of transducer_ and image acquisition only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cst hgh nble mtl inlay 2 srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6602","description":"Cst hgh nble mtl inlay 2 srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mdd severe w/psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3091F","description":"Mdd severe w/psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQD1","description":"ICD-KEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLE0","description":"ICD-KBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Sandwich","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1761","description":"Home Delivered Meals-Sandwich","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skeletal muscle relaxant 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80369","description":"Skeletal muscle relaxant 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRD0","description":"ICD-GBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth kidney stone destruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87351","description":"Anesth kidney stone destruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSB0","description":"ICD-DDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCA0","description":"ICD-NDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt has docd immun to hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3515F","description":"Pt has docd immun to hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ includes titer(s)_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0224U","description":"Antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ includes titer(s)_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAC0","description":"ICD-AGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31290","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensv oral eval prob focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0160","description":"Extensv oral eval prob focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped crit care transport addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99467","description":"Ped crit care transport addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPE1","description":"ICD-BHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFB1","description":"ICD-FCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWC1","description":"ICD-KAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA114","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Liver surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47399","description":"Liver surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of thyroid (t3 or t4)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84479","description":"Assay of thyroid (t3 or t4)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASF1","description":"ICD-GASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2B","description":"Very High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTF1","description":"ICD-MKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMC1","description":"ICD-FAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJME1","description":"ICD-MJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQA1","description":"ICD-KDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC140","description":"Special Care High _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6609","description":"Gradient compression bandaging supply_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immune admin oral/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90473","description":"Immune admin oral/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for tear sac x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68850","description":"Injection for tear sac x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSE1","description":"ICD-HGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablation_ Benign Thyroid Nodule(S)_ Percutaneous_ Laser_ Including Imaging Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0673T","description":"Ablation_ Benign Thyroid Nodule(S)_ Percutaneous_ Laser_ Including Imaging Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHE0","description":"ICD-JCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop app non-wgt bear dsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5460","description":"Postop app non-wgt bear dsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14C","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNC1","description":"ICD-BCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKD1","description":"ICD-FBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJD1","description":"ICD-CAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak 4 bar link w/fric swing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5611","description":"Ak 4 bar link w/fric swing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc of pain comfort 48hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9250","description":"Doc of pain comfort 48hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEA1","description":"ICD-KBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiograph neck w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70549","description":"Mr angiograph neck w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITD0","description":"ICD-CITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWF1","description":"ICD-LEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYE1","description":"ICD-DAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECF1","description":"ICD-OECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISC0","description":"ICD-CISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDD1","description":"ICD-NHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWF1","description":"ICD-KFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTD0","description":"ICD-IFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens pmma color vision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2503","description":"Cntct lens pmma color vision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0201","description":"HCPCS-C0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC24","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTB0","description":"ICD-FHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cranio/maxillofacial surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21299","description":"Cranio/maxillofacial surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fda approved prescription drug_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0799","description":"Fda approved prescription drug_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8C","description":"Medium Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bed pan fracture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0276","description":"Bed pan fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGE1","description":"ICD-BAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE140","description":"Clinically Complex _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hypothermia ill neonate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99184","description":"Hypothermia ill neonate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Slings","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4565","description":"Slings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDED0","description":"ICD-MDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUB0","description":"ICD-KHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL23","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPD0","description":"ICD-GHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 3 or more views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74021","description":"Radiologic examination_ abdomen; 3 or more views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOF1","description":"ICD-CCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Herpes simplex 2 ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87273","description":"Herpes simplex 2 ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abl1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81170","description":"Abl1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block lumbar/thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64520","description":"N block lumbar/thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEF1","description":"ICD-CDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPB0","description":"ICD-BBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOC0","description":"ICD-KHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJA1","description":"ICD-JCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ polyvalent_ for children under 5 years_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90669","description":"Pneumococcal conjugate vaccine_ polyvalent_ for children under 5 years_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC31","description":"ICD-3IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Throat surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42999","description":"Throat surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional outcome assessment not documented as being performed_ documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8540","description":"Functional outcome assessment not documented as being performed_ documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVB0","description":"ICD-BFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESB1","description":"ICD-DESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCA0","description":"ICD-CCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBID1","description":"ICD-MBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDA1","description":"ICD-GBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCA1","description":"ICD-NCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPB1","description":"ICD-BAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMB0","description":"ICD-NDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thigh/wght bear high roll cu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2550","description":"Thigh/wght bear high roll cu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration/repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45563","description":"Exploration/repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXF1","description":"ICD-JEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJC1","description":"ICD-CEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5B","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ anifrolumab-fnia_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0491","description":"Injection_ anifrolumab-fnia_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYA0","description":"ICD-LEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0073A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1273","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQA0","description":"ICD-OBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1203","description":"HCPCS-A1203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICF1","description":"ICD-NICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJD0","description":"ICD-OEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUA0","description":"ICD-GCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10120","description":"Remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHE0","description":"ICD-BCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVF1","description":"ICD-GDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6065","description":"Implant supported crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIED0","description":"ICD-NIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA05","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tooth root removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7250","description":"Tooth root removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUA1","description":"ICD-OCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFA1","description":"ICD-FEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICC1","description":"ICD-MICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKB0","description":"ICD-NBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPE1","description":"ICD-NJPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ doxercalciferol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1270","description":"Injection_ doxercalciferol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Salivary surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42699","description":"Salivary surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABA0","description":"ICD-GABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMD1","description":"ICD-OGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAF1","description":"ICD-IFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sprvsd xrcz back pn >12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4242F","description":"Sprvsd xrcz back pn >12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC31","description":"ICD-3FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPC0","description":"ICD-JCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXF0","description":"ICD-CIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC114","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Admin hepatitis b vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0010","description":"Admin hepatitis b vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECD0","description":"ICD-CECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUC1","description":"ICD-NGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSB0","description":"ICD-CHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28I","description":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJF0","description":"ICD-GHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJD1","description":"ICD-CBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVD1","description":"ICD-NGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score hip >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8651","description":"Fun stat score hip >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ctlso a-p-l control w/ inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0710","description":"Ctlso a-p-l control w/ inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLE0","description":"ICD-BFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDF1","description":"ICD-FGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL56","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAE0","description":"ICD-GIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54344","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0860","description":"Pwc gp3 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTA1","description":"ICD-NJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24B","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC21","description":"ICD-3IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01190","description":"CPT-01190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFC1","description":"ICD-OIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiologic study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93624","description":"Electrophysiologic study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67340","description":"Revise eye muscle add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDED1","description":"ICD-GDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62281","description":"Treat spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace pump_ alt press pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0182","description":"Replace pump_ alt press pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOC0","description":"ICD-LGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0551","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","description":"HCPCS-G0551","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWD1","description":"ICD-HIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulpal therapy posterior pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3240","description":"Pulpal therapy posterior pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKF0","description":"ICD-KEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0604U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","description":"CPT-0604U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Otolaryngology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4022","description":"Otolaryngology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXD1","description":"ICD-CIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA130","description":"Reduced Physical Function _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAA0","description":"ICD-EAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEC1","description":"ICD-IHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HER2/neu negative or undocumented/unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9825","description":"HER2/neu negative or undocumented/unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFE0","description":"ICD-KGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43651","description":"Laparoscopy vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUB0","description":"ICD-IIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIA1","description":"ICD-IIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13131","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45005","description":"Drainage of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOE0","description":"ICD-DFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient is currently on a daily aspirin or other antiplatelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9793","description":"Patient is currently on a daily aspirin or other antiplatelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFF0","description":"ICD-KEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVB0","description":"ICD-BIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37267","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","description":"CPT-37267","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/long tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34805","description":"Endovas aaa repr w/long tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPB1","description":"ICD-CAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCA0","description":"ICD-JCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36620","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt ref pulm fx test/peakflow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3758F","description":"Pt ref pulm fx test/peakflow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohols biomarkers 3/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80322","description":"Alcohols biomarkers 3/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX33","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBE1","description":"ICD-MDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepagam b im injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1571","description":"Hepagam b im injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - premolar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3472","description":"Surgical repair of root resorption - premolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85420","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gauze <= 16 sq in water/sal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6228","description":"Gauze <= 16 sq in water/sal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apnea monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0618","description":"Apnea monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autologous blood process","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86890","description":"Autologous blood process","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTD1","description":"ICD-JFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA112","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMA0","description":"ICD-BGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0805","description":"HCPCS-B0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWE1","description":"ICD-KIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAD0","description":"ICD-JEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOF1","description":"ICD-LCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVC0","description":"ICD-GGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay free hydroxyproline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83500","description":"Assay free hydroxyproline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score neck/ts < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8672","description":"Fun stat score neck/ts < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0804","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0804","description":"CDT-D0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4210","description":"Gingivectomy/plasty per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total disc arthroplasty (artificial disc)_ anterior approach_ including discectomy to prepare interspace (other than for decompression); second interspace_ lumbar (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22860","description":"Total disc arthroplasty (artificial disc)_ anterior approach_ including discectomy to prepare interspace (other than for decompression); second interspace_ lumbar (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; capable of being read by direct optical observation only (eg_ utilizing immunoassay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80305","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; capable of being read by direct optical observation only (eg_ utilizing immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAA0","description":"ICD-AIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB214","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE134","description":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBA1","description":"ICD-NCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE104","description":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25560","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENE0","description":"ICD-GENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXF1","description":"ICD-FHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tymp memb motion examd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2035F","description":"Tymp memb motion examd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ ep_ 19 or few elect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1730","description":"Cath_ ep_ 19 or few elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ micafungin in sodium (Baxter)_ not therapeutically equivalent to J2248_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2246","description":"Injection_ micafungin in sodium (Baxter)_ not therapeutically equivalent to J2248_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infusion pump_ programmable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1772","description":"Infusion pump_ programmable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Histotripsy (ie_ non-thermal ablation via acoustic energy delivery) of malignant renal tissue_ including imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0888T","description":"Histotripsy (ie_ non-thermal ablation via acoustic energy delivery) of malignant renal tissue_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFC1","description":"ICD-GBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC154","description":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iris Prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1839","description":"Iris Prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis_ copy number variants_ and micros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81463","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis_ copy number variants_ and micros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0106","description":"HCPCS-C0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC14","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Estradiol; Free_ Direct Measurement (Eg_ Equilibrium Dialysis)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82681","description":"Estradiol; Free_ Direct Measurement (Eg_ Equilibrium Dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWB1","description":"ICD-KHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0435","description":"Oral hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECC0","description":"ICD-IECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALD1","description":"ICD-NALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSA0","description":"ICD-CDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46940","description":"Treatment of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0477U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","description":"CPT-0477U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUB1","description":"ICD-CFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision constricting tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26596","description":"Excision constricting tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNB1","description":"ICD-KFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABE0","description":"ICD-NABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICE1","description":"ICD-EICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7568","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7568","description":"HCPCS-C7568","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA11","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIF0","description":"ICD-JIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of gonadotropin (fsh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83001","description":"Assay of gonadotropin (fsh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIC1","description":"ICD-CDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligate/divide/excise vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37785","description":"Ligate/divide/excise vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHF1","description":"ICD-MBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL05","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oasis wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4102","description":"Oasis wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEC1","description":"ICD-EDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sps knee device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1811","description":"Sps knee device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSB1","description":"ICD-KFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKF0","description":"ICD-NLKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD146","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD250","description":"Clinically Complex _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq device breast ea imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19282","description":"Perq device breast ea imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D6196","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6196","description":"CDT-D6196","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEB1","description":"ICD-NKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risankizumab-rzaa_ intravenous_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2327","description":"Injection_ risankizumab-rzaa_ intravenous_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emer rspns sys serv permonth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5161","description":"Emer rspns sys serv permonth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Beta amyloid_ AB40 and AB42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ ratio_ plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0346U","description":"Beta amyloid_ AB40 and AB42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ ratio_ plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair sternum/nuss w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21743","description":"Repair sternum/nuss w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC134","description":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPD0","description":"ICD-KFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERD1","description":"ICD-GERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFF0","description":"ICD-OEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ibandronate sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1740","description":"Ibandronate sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQB0","description":"ICD-HEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tb test cell immun measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86480","description":"Tb test cell immun measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14D","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBC0","description":"ICD-BBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test one fiber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95872","description":"Muscle test one fiber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vaginal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57415","description":"Remove vaginal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins lt atrl press monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0293T","description":"Ins lt atrl press monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHF0","description":"ICD-OFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCC0","description":"ICD-BFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBB0","description":"ICD-MCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENF0","description":"ICD-JENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIB0","description":"ICD-JBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE206","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVF0","description":"ICD-FIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17261","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAE1","description":"ICD-CBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBA0","description":"ICD-EBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE255","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trastuzumab not administered within 12 months of diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9837","description":"Trastuzumab not administered within 12 months of diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSE1","description":"ICD-PCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0202","description":"HCPCS-A0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUB1","description":"ICD-OHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSE0","description":"ICD-OCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLF0","description":"ICD-GBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCA0","description":"ICD-JGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXD1","description":"ICD-KGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEE1","description":"ICD-EGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTF1","description":"ICD-FHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 0.5 cm<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11400","description":"Exc tr-ext b9+marg 0.5 cm<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDF0","description":"ICD-CGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOC0","description":"ICD-PEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dtap-ipv vaccine 4-6 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90696","description":"Dtap-ipv vaccine 4-6 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise epiphyseal bar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20150","description":"Excise epiphyseal bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99239","description":"Hospital discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenervation of abductor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2340","description":"Chemodenervation of abductor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPE0","description":"ICD-OAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUE1","description":"ICD-ECUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCB0","description":"ICD-OJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2031","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","description":"HCPCS-A2031","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Analysis of saliva sample","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0418","description":"Analysis of saliva sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj benztropine mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0515","description":"Inj benztropine mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8H","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRD1","description":"ICD-OGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIED1","description":"ICD-JIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical exposure prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55860","description":"Surgical exposure prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anes medscpy&thorscpy 1 lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52951","description":"Anes medscpy&thorscpy 1 lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mucus trap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8210","description":"Mucus trap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENB0","description":"ICD-NENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFA0","description":"ICD-NJFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUF1","description":"ICD-NBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYA0","description":"ICD-LIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23465","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72190","description":"X-ray exam of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot </4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64895","description":"Nerve graft hand/foot </4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8I","description":"Low Rehab_ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPC1","description":"ICD-GGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYD1","description":"ICD-PKYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKD0","description":"ICD-OFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBC1","description":"ICD-CBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Each Additional 30 Minutes Of Counseling In A Week Of Medication Assisted Treatment_ (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2080","description":"Each Additional 30 Minutes Of Counseling In A Week Of Medication Assisted Treatment_ (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDME1","description":"ICD-FDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA35","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2082","description":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGB1","description":"ICD-NGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of breast implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19328","description":"Removal of breast implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHF1","description":"ICD-CEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-77437","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","description":"CPT-77437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30150","description":"Partial removal of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos back post/lat wdth <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2615","description":"Pos back post/lat wdth <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPC0","description":"ICD-NLPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"von Willebrand factor (VWF)_ type 2B_ platelet-binding evaluation_ radioimmunoassay_ plasma (Versiti™ VWD Type 2B Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0283U","description":"von Willebrand factor (VWF)_ type 2B_ platelet-binding evaluation_ radioimmunoassay_ plasma (Versiti™ VWD Type 2B Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA53","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVF0","description":"ICD-OCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair Accessory_ Dynamic Positioning Hardware For Back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2398","description":"Wheelchair Accessory_ Dynamic Positioning Hardware For Back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUD1","description":"ICD-KAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0018","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWB0","description":"ICD-LIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBE1","description":"ICD-NBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tetanus toxoid adsorbed_ for intramuscular or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90703","description":"Tetanus toxoid adsorbed_ for intramuscular or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58951","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC217","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1822","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","description":"HCPCS-E1822","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":">85y scope othr rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9661","description":">85y scope othr rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJA1","description":"ICD-KAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDE0","description":"ICD-CIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ diclofenac sodium_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1130","description":"Injection_ diclofenac sodium_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPA1","description":"ICD-BBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject l ventr/atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93565","description":"Inject l ventr/atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 7.6-12.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12054","description":"Intmd rpr face/mm 7.6-12.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCD0","description":"ICD-CBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES134","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD140","description":"Special Care Low _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Most recent assess vol mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8955","description":"Most recent assess vol mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frenulotomy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54164","description":"Frenulotomy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQA1","description":"ICD-HGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLB0","description":"ICD-ABLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRF0","description":"ICD-GDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11308","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAF0","description":"ICD-ICAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supports brokerage_ self-directed_ waiver; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2051","description":"Supports brokerage_ self-directed_ waiver; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDE1","description":"ICD-NIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATD1","description":"ICD-KATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMD0","description":"ICD-ACMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIE1","description":"ICD-MJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flutamide 125 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0175","description":"Flutamide 125 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGE0","description":"ICD-CEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC146","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIC1","description":"ICD-MAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES216","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical prostatectomy_ simple subtotal (including control of postoperative bleeding_ vasectomy_ meatotomy_ urethral calibration and/or dilation_ and internal ure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55867","description":"Laparoscopy_ surgical prostatectomy_ simple subtotal (including control of postoperative bleeding_ vasectomy_ meatotomy_ urethral calibration and/or dilation_ and internal ure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTE1","description":"ICD-NFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHA1","description":"ICD-FCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEB0","description":"ICD-MCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUF1","description":"ICD-AFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle transfers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23397","description":"Muscle transfers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMA0","description":"ICD-AFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL35","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHC0","description":"ICD-FEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93225","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKB0","description":"ICD-FCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHB0","description":"ICD-KDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prp i/hern init block >5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49507","description":"Prp i/hern init block >5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nondisposable nebulizer set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7005","description":"Nondisposable nebulizer set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQD0","description":"ICD-GFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cesarean delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59510","description":"Cesarean delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTC1","description":"ICD-MCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBB1","description":"ICD-OGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKE0","description":"ICD-NEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRD1","description":"ICD-KIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE155","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anes spine transthor w/vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62659","description":"Anes spine transthor w/vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88162","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPB1","description":"ICD-KBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","description":"HCPCS-Q4389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRF0","description":"ICD-LBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of major peripheral nerve neuroma_ except sciatic_ with implantation of nerve end into bone or muscle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7551","description":"Excision of major peripheral nerve neuroma_ except sciatic_ with implantation of nerve end into bone or muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20C","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJF1","description":"ICD-BDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMF1","description":"ICD-OIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVC0","description":"ICD-BEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOB1","description":"ICD-CHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGID0","description":"ICD-KGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCME0","description":"ICD-MCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALE0","description":"ICD-BALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95984","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetically controlled capsule endoscopy_ esophagus through stomach_ including intraprocedural positioning of capsule_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0651T","description":"Magnetically controlled capsule endoscopy_ esophagus through stomach_ including intraprocedural positioning of capsule_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trapeze bar attached to bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0910","description":"Trapeze bar attached to bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYA0","description":"ICD-DDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Max sterile barriers flwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6030F","description":"Max sterile barriers flwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCF1","description":"ICD-FDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLA0","description":"ICD-FGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUE0","description":"ICD-AGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILB1","description":"ICD-CILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALE1","description":"ICD-MALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVF0","description":"ICD-CFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVE1","description":"ICD-JIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDB0","description":"ICD-CGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGC1","description":"ICD-NBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVE1","description":"ICD-KAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILB0","description":"ICD-JILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXE1","description":"ICD-CDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58660","description":"Laparoscopy lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ binaural_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5249","description":"Hearing aid_ binaural_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLA1","description":"ICD-JDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI orbt/fac/nck w/o &w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70543","description":"MRI orbt/fac/nck w/o &w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure of split wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12020","description":"Closure of split wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLC0","description":"ICD-FDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJA0","description":"ICD-FDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMC1","description":"ICD-NIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artacent cord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4216","description":"Artacent cord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEC0","description":"ICD-NFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNA1","description":"ICD-NHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTC0","description":"ICD-MJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"INTRAORIFICE BARRIER","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3911","description":"INTRAORIFICE BARRIER","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBD1","description":"ICD-ABBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ncntc r-t fluor wnd img 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0598T","description":"Ncntc r-t fluor wnd img 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHF1","description":"ICD-EEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIF1","description":"ICD-CIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPA1","description":"ICD-CAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41018","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73080","description":"X-ray exam of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQF0","description":"ICD-PFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3B","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLF1","description":"ICD-CCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX44","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBE0","description":"ICD-NBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC41","description":"High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58540","description":"Revision of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-77436","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","description":"CPT-77436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay other fluid chlorides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82438","description":"Assay other fluid chlorides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLA0","description":"ICD-KGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel pad & depress for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3480","description":"Shoe heel pad & depress for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPA1","description":"ICD-GBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXF1","description":"ICD-FFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATC0","description":"ICD-OATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGND1","description":"ICD-OGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDME0","description":"ICD-BDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decoronation or submergence of an erupted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3921","description":"Decoronation or submergence of an erupted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDE0","description":"ICD-MLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFED1","description":"ICD-FFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRF1","description":"ICD-GCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27335","description":"Remove knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmic biometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92136","description":"Ophthalmic biometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEF1","description":"ICD-GDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX13","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC11","description":"ICD-1GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAF1","description":"ICD-IIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No med visit in 24mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9246","description":"No med visit in 24mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEE0","description":"ICD-NDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thorac cont lat support upri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2680","description":"Thorac cont lat support upri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonrandomized_ nonblinded procedure for NYHA Class II_ III_ IV heart failure; transcatheter implantation of interatrial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9760","description":"Nonrandomized_ nonblinded procedure for NYHA Class II_ III_ IV heart failure; transcatheter implantation of interatrial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immntx 3 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95132","description":"Immntx 3 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal biliary drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47537","description":"Removal biliary drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE135","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antibiot rxd/given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4120F","description":"Antibiot rxd/given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped size pull-on lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4532","description":"Ped size pull-on lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQA1","description":"ICD-LIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHE1","description":"ICD-ECHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJD1","description":"ICD-BEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMF0","description":"ICD-OGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap esophagomyotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2079","description":"Lap esophagomyotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"FMRI brain by tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70554","description":"FMRI brain by tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMB1","description":"ICD-FBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC214","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGB1","description":"ICD-NCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjv thxpyrxd/rcvd colon ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4180F","description":"Adjv thxpyrxd/rcvd colon ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51525","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMF0","description":"ICD-MAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVA1","description":"ICD-BBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flu immunize no admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8484","description":"Flu immunize no admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXB0","description":"ICD-ODXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLD1","description":"ICD-NBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSE1","description":"ICD-OFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIF1","description":"ICD-BHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDA1","description":"ICD-MJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSD1","description":"ICD-CGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWE0","description":"ICD-LDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ JAK2 mutation_ DNA_ PCR amplification of exons 12-14 and sequence analysis_ blood or bone marrow_ report of JAK2 mutation not detected or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0017U","description":"Oncology (hematolymphoid neoplasia)_ JAK2 mutation_ DNA_ PCR amplification of exons 12-14 and sequence analysis_ blood or bone marrow_ report of JAK2 mutation not detected or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHC0","description":"ICD-IFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNB1","description":"ICD-GGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33414","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5257","description":"Hearing aid_ digit_ mon_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of calcium deposits","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23000","description":"Removal of calcium deposits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit stoma care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99505","description":"Home visit stoma care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBA0","description":"ICD-NIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFC0","description":"ICD-FBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL10","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0235","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","description":"HCPCS-M0235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clean & inspect rem dent man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9933","description":"Clean & inspect rem dent man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2A","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABC0","description":"ICD-KABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98976","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for bone marrow_ smear interpretation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0855T","description":"Digitization of glass microscope slides for bone marrow_ smear interpretation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAB0","description":"ICD-KDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLC1","description":"ICD-MDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIC1","description":"ICD-FHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral surgery procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7999","description":"Oral surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5170","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5170","description":"HCPCS-Q5170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Employment Benefits Counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1740","description":"Employment Benefits Counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC131","description":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLA1","description":"ICD-CCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular Repair Of Iliac Artery_ Not Associated With Placement Of An Aorto-Iliac Artery Endograft At The Same Session_ By Deployment Of An Iliac Branched Endograft_ Includ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34718","description":"Endovascular Repair Of Iliac Artery_ Not Associated With Placement Of An Aorto-Iliac Artery Endograft At The Same Session_ By Deployment Of An Iliac Branched Endograft_ Includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDD0","description":"ICD-CDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Transluminal Angioplasty Of Native Or Recurrent Coarctation Of The Aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33897","description":"Percutaneous Transluminal Angioplasty Of Native Or Recurrent Coarctation Of The Aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBD1","description":"ICD-OIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult foster care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5140","description":"Adult foster care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRF1","description":"ICD-OGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWC1","description":"ICD-LEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress fingers/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26035","description":"Decompress fingers/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35112","description":"Repair artery rupture spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I131 iodide sol_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9529","description":"I131 iodide sol_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGB0","description":"ICD-BBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36200","description":"Place catheter in aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTE0","description":"ICD-OHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repeat control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30906","description":"Repeat control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYA1","description":"ICD-HAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6539","description":"Gc stocking waistlngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPA1","description":"ICD-OIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQB1","description":"ICD-OAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD117","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGED0","description":"ICD-BGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24545","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of troponin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84512","description":"Assay of troponin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHC0","description":"ICD-FIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCC0","description":"ICD-JDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB110","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGB1","description":"ICD-KHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1012T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","description":"CPT-1012T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJE0","description":"ICD-CIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD225","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMC0","description":"ICD-NDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGME0","description":"ICD-GGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ercp remove duct calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43264","description":"Ercp remove duct calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Straight knee joint heavy du","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2385","description":"Straight knee joint heavy du","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTB1","description":"ICD-GDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair leg fascia defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27656","description":"Repair leg fascia defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13C","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Con tissue w dble ped graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4276","description":"Con tissue w dble ped graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5940","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5940","description":"CDT-D5940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAB1","description":"ICD-EHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUA0","description":"ICD-AIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHA1","description":"ICD-FEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSA0","description":"ICD-GCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0842T","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microcapillary tube sealant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4652","description":"Microcapillary tube sealant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flotufolastat f 18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9608","description":"Flotufolastat f 18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ leadless pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0391T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ leadless pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45051","description":"Anesth surgery of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality cognitive behavioral therapy device (cbt)_ including pre-programmed therapy software","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1905","description":"Virtual reality cognitive behavioral therapy device (cbt)_ including pre-programmed therapy software","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYF1","description":"ICD-HFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; removal_ each balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0550T","description":"Transperineal periurethral balloon continence device; removal_ each balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay blood carbon dioxide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82374","description":"Assay blood carbon dioxide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cult skin graft t/a/l +%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15152","description":"Cult skin graft t/a/l +%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUF1","description":"ICD-EGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWC0","description":"ICD-HBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood gases any combination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82803","description":"Blood gases any combination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain w/ noble met","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2752","description":"Crown porcelain w/ noble met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNB1","description":"ICD-GBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFD0","description":"ICD-GFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYB1","description":"ICD-HIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYD0","description":"ICD-LAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJE0","description":"ICD-CGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein access cutdown > 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36425","description":"Vein access cutdown > 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 50-100","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88248","description":"Chromosome analysis 50-100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB155","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy adrenalectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60650","description":"Laparoscopy adrenalectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCD1","description":"ICD-NFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDE1","description":"ICD-BFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis b dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87517","description":"Hepatitis b dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB105","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUB1","description":"ICD-KIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c medial thigh support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0957","description":"W/c medial thigh support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEE0","description":"ICD-BBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEE1","description":"ICD-BHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilation and curettage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58120","description":"Dilation and curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJA1","description":"ICD-JHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLD0","description":"ICD-MHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELD0","description":"ICD-OELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 0 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3382F","description":"Ajcc cln cncr stage 0 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67973","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOA1","description":"ICD-OAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTE0","description":"ICD-IHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28475","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt/caregiver counsel safety","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6090F","description":"Pt/caregiver counsel safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31645","description":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKD0","description":"ICD-FGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQE1","description":"ICD-OBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEB0","description":"ICD-CBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx multi myeloma stage i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9128","description":"Onc dx multi myeloma stage i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSC1","description":"ICD-ODSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61580","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFE1","description":"ICD-CHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial brush biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31717","description":"Bronchial brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTA1","description":"ICD-AHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0871","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0871","description":"HCPCS-J0871","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWF1","description":"ICD-LCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10A","description":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARC0","description":"ICD-KARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCE0","description":"ICD-CGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10B","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABB0","description":"ICD-EABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27510","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject suprvlv aortography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93567","description":"Inject suprvlv aortography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKD1","description":"ICD-CHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBB1","description":"ICD-CCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1102","description":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78266","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHE1","description":"ICD-AAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNC0","description":"ICD-OJNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin reuse pen 3 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5561","description":"Insulin reuse pen 3 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYE1","description":"ICD-CDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESD0","description":"ICD-LESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUF1","description":"ICD-IBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTB0","description":"ICD-OCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDF0","description":"ICD-GIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC145","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit immunotherapy diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9338","description":"Hit immunotherapy diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc rect tum transanal full","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45172","description":"Exc rect tum transanal full","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAD0","description":"ICD-JIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemorrhoidectomy_ Internal_ By Transanal Hemorrhoidal Dearterialization_ 2 Or More Hemorrhoid Columns/Groups_ Including Ultrasound Guidance_ With Mucopexy_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46948","description":"Hemorrhoidectomy_ Internal_ By Transanal Hemorrhoidal Dearterialization_ 2 Or More Hemorrhoid Columns/Groups_ Including Ultrasound Guidance_ With Mucopexy_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEB0","description":"ICD-AIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Not Crossing Major Side Branches","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33895","description":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Not Crossing Major Side Branches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDC0","description":"ICD-NGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWD1","description":"ICD-PIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB110","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLA0","description":"ICD-GHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9307","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9307","description":"HCPCS-C9307","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMC1","description":"ICD-KFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENB0","description":"ICD-JENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML06","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18I","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOF1","description":"ICD-GFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNB0","description":"ICD-BGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKC1","description":"ICD-OLKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRC0","description":"ICD-PFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8B","description":"Very High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Podiatry Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4028","description":"Podiatry Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flexible keel foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5972","description":"Flexible keel foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0740T","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy irrigation bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4398","description":"Ostomy irrigation bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC31","description":"ICD-1IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOA0","description":"ICD-PFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX15","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1303","description":"HCPCS-B1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional Status Was Not Measured By The Oxford Knee Score (Oks) At One Year (9 To 15 Months) Postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1141","description":"Functional Status Was Not Measured By The Oxford Knee Score (Oks) At One Year (9 To 15 Months) Postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGE0","description":"ICD-OGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1814","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","description":"HCPCS-E1814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQA0","description":"ICD-PIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMC0","description":"ICD-IIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pmkr_ other than sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2621","description":"Pmkr_ other than sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPC0","description":"ICD-JHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX03","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Community-acquired bacterial pneumonia assessment (includes all of the foll","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0118U","description":"Community-acquired bacterial pneumonia assessment (includes all of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert nasal septal button","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30220","description":"Insert nasal septal button","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJE1","description":"ICD-BCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDC1","description":"ICD-IIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fern test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0114","description":"Fern test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydroxyzine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3410","description":"Hydroxyzine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00539","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","description":"CPT-00539","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10B","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML26","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00326","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","description":"CPT-00326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0630U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","description":"CPT-0630U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPC0","description":"ICD-CCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biovance 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4154","description":"Biovance 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE116","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1202","description":"HCPCS-A1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glycine receptor alpha1 IgG_ serum or cerebrospinal fluid (CSF)_ live cell-binding assay (LCBA)_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0431U","description":"Glycine receptor alpha1 IgG_ serum or cerebrospinal fluid (CSF)_ live cell-binding assay (LCBA)_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSE0","description":"ICD-CFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00520","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","description":"CPT-00520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Porcelain/ceramic inlay 2srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6600","description":"Porcelain/ceramic inlay 2srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVE0","description":"ICD-KBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1501","description":"HCPCS-C1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX43","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thorax stereo rad targetw/tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32701","description":"Thorax stereo rad targetw/tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALB0","description":"ICD-MALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMA0","description":"ICD-MDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUE1","description":"ICD-CDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAE1","description":"ICD-ACAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4420","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","description":"HCPCS-Q4420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJD0","description":"ICD-CIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHD1","description":"ICD-GBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMB1","description":"ICD-KBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAF1","description":"ICD-CDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEC1","description":"ICD-BFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBA1","description":"ICD-FEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUB1","description":"ICD-AFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVA1","description":"ICD-GCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKD0","description":"ICD-FHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21435","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNE0","description":"ICD-OLNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADD0","description":"ICD-KADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBF0","description":"ICD-ODBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19364","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRC1","description":"ICD-HDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_ fine needle aspirate of thyroid nodule_ algorithmic analysis reported as a categorical result (Posi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0026U","description":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_ fine needle aspirate of thyroid nodule_ algorithmic analysis reported as a categorical result (Posi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neisseria meningitidis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86741","description":"Neisseria meningitidis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVB0","description":"ICD-KAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epstein-barr capsid vca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86665","description":"Epstein-barr capsid vca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDB1","description":"ICD-EDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ paliperidone palmitate extended release (invega hafyera_ or invega trinza)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2427","description":"Injection_ paliperidone palmitate extended release (invega hafyera_ or invega trinza)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMB1","description":"ICD-MAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4418","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","description":"HCPCS-Q4418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPF0","description":"ICD-CGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYD0","description":"ICD-LHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13A","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC21","description":"ICD-1HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNC1","description":"ICD-BGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording_ data scanning_ with raw electronic signal transfer of data and storage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0476T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording_ data scanning_ with raw electronic signal transfer of data and storage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26700","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEB1","description":"ICD-KFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEB1","description":"ICD-BCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35450","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGC1","description":"ICD-JGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPC1","description":"ICD-OKPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21B","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ak/knee disartic pelvic join","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5696","description":"Ak/knee disartic pelvic join","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPB0","description":"ICD-GFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALD1","description":"ICD-MALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTA1","description":"ICD-JHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBF1","description":"ICD-GGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63702","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay prostate phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84066","description":"Assay prostate phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANB0","description":"ICD-CANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAB0","description":"ICD-MAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUD0","description":"ICD-JAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLC0","description":"ICD-BDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDB1","description":"ICD-FBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBA1","description":"ICD-OKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0841","description":"Pwc gp2 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc face tum deep 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21014","description":"Exc face tum deep 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAF1","description":"ICD-FBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7354","description":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMF1","description":"ICD-KEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group mnt 2 or more 30 mins","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0271","description":"Group mnt 2 or more 30 mins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBE0","description":"ICD-FBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDE1","description":"ICD-IFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0533","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","description":"HCPCS-G0533","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mntr io press 24hrs/> uni/bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0329T","description":"Mntr io press 24hrs/> uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25927","description":"Amputation of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITB1","description":"ICD-FITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMC0","description":"ICD-NAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4395","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","description":"HCPCS-Q4395","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4D","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVB1","description":"ICD-NLVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVA1","description":"ICD-CCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHE0","description":"ICD-MBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB20","description":"Low Rehab_ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove uterus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59100","description":"Remove uterus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28405","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRF0","description":"ICD-OIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMB1","description":"ICD-IHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr angio upr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73225","description":"Mr angio upr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVC0","description":"ICD-NEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep c ab test confirm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86804","description":"Hep c ab test confirm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQD0","description":"ICD-HCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLF1","description":"ICD-MJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0107","description":"Stroke with Motor >26.15 & Motor <30.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC230","description":"Special Care Low _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML31","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Washed red blood cells unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9022","description":"Washed red blood cells unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dias bp > or = 90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8755","description":"Dias bp > or = 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADB1","description":"ICD-CADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTD0","description":"ICD-CDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect mediastinal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39220","description":"Resect mediastinal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYE1","description":"ICD-HBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Advncd care plan 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99497","description":"Advncd care plan 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0504","description":"HCPCS-A0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPC1","description":"ICD-KDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJC0","description":"ICD-CGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELD0","description":"ICD-EELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst stg1-2b hr_nopro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9071","description":"Onc dx brst stg1-2b hr_nopro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoglobulin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86023","description":"Immunoglobulin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICD1","description":"ICD-GICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCA1","description":"ICD-CGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOD1","description":"ICD-OJOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm ear level receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5284","description":"Ald fm/dm ear level receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRE1","description":"ICD-OJRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOB0","description":"ICD-CFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair throat wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42900","description":"Repair throat wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLB1","description":"ICD-MGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 hd sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0859","description":"Pwc gp3 hd sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTE1","description":"ICD-CGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYF1","description":"ICD-OAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEB1","description":"ICD-AIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMB0","description":"ICD-NAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHD0","description":"ICD-KFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEA0","description":"ICD-NDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21138","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSE0","description":"ICD-PDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTE1","description":"ICD-CDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection torsemide 10 mg/ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3265","description":"Injection torsemide 10 mg/ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilat macular exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2021F","description":"Dilat macular exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPD0","description":"ICD-JFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc surv no stroke after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9261","description":"Doc surv no stroke after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGND0","description":"ICD-NGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLF0","description":"ICD-MGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNC1","description":"ICD-CCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67820","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEF1","description":"ICD-FEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHA1","description":"ICD-CEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNF1","description":"ICD-OKNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair accessory_ foot box_ any type_ includes attachment and mounting hardware_ each foot.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0954","description":"Wheelchair accessory_ foot box_ any type_ includes attachment and mounting hardware_ each foot.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVF1","description":"ICD-NCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTD0","description":"ICD-IHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDB1","description":"ICD-GEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIA1","description":"ICD-FEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Soft liner for complete or partial removable denture - indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5765","description":"Soft liner for complete or partial removable denture - indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHF1","description":"ICD-IGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPB0","description":"ICD-CGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glucagon tolerance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82946","description":"Glucagon tolerance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSE1","description":"ICD-DHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIF1","description":"ICD-BEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (fresenius kabi) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0134","description":"Injection_ acetaminophen (fresenius kabi) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDC0","description":"ICD-GCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWF1","description":"ICD-DBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJF1","description":"ICD-GDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2133","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28D","description":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKB0","description":"ICD-OBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9878","description":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy internal hemorrhoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46930","description":"Destroy internal hemorrhoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGID1","description":"ICD-FGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTB0","description":"ICD-OJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3D","description":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQC1","description":"ICD-PCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drill skull for implantation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61107","description":"Drill skull for implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSA0","description":"ICD-PCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIB0","description":"ICD-CBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"H&p for surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0260","description":"H&p for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTE0","description":"ICD-MCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAED0","description":"ICD-AAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam pelvic limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76857","description":"Us exam pelvic limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAA1","description":"ICD-NDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99337","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ lyophilized_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9319","description":"Injection_ romidepsin_ lyophilized_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRE0","description":"ICD-GIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTF1","description":"ICD-JBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21453","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYD1","description":"ICD-KBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1280","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"TERT (telomerase reverse transcriptase) (eg_ thyroid carcinoma_ glioblastoma multiforme) gene analysis_ targeted sequence analysis (eg_ promoter region)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81345","description":"TERT (telomerase reverse transcriptase) (eg_ thyroid carcinoma_ glioblastoma multiforme) gene analysis_ targeted sequence analysis (eg_ promoter region)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chiropractic manj 5 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98942","description":"Chiropractic manj 5 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAA1","description":"ICD-MIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL55","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0601","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0601","description":"CDT-D0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spirmtry w/brnchdil inf-2 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94012","description":"Spirmtry w/brnchdil inf-2 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lang express goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9163","description":"Lang express goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRB1","description":"ICD-PKRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23020","description":"Release shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove intracorporeal device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33980","description":"Remove intracorporeal device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA51","description":"Very High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq&ic allg test drugs/biol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95018","description":"Perq&ic allg test drugs/biol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEC1","description":"ICD-FBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKD0","description":"ICD-GHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEME1","description":"ICD-KEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPF0","description":"ICD-KEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB36","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of rectal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45150","description":"Excision of rectal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQC0","description":"ICD-DCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20C","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"G compression stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6549","description":"G compression stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rheumatoid factor test qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86430","description":"Rheumatoid factor test qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychiatric symp absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1183F","description":"Neuropsychiatric symp absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67805","description":"Remove eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADA1","description":"ICD-EADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD116","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect clavicle tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23200","description":"Resect clavicle tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular Venous Arterialization_ Tibial Or Peroneal Vein_ With Transcatheter Placement Of Intravascular Stent Graft(S) And Closure By Any Method_ Including Percutaneous Or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0620T","description":"Endovascular Venous Arterialization_ Tibial Or Peroneal Vein_ With Transcatheter Placement Of Intravascular Stent Graft(S) And Closure By Any Method_ Including Percutaneous Or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA211","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27784","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (atypical hemolytic uremic syndrome [aHUS])_ genomic sequence analysis of 15 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ aHUS Genetic Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0268U","description":"Hematology (atypical hemolytic uremic syndrome [aHUS])_ genomic sequence analysis of 15 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ aHUS Genetic Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Closure of split wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12021","description":"Closure of split wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excellagen_ 0.1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4149","description":"Excellagen_ 0.1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CoreText or ProText_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4246","description":"CoreText or ProText_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx transantral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21385","description":"Opn tx orbit fx transantral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPC1","description":"ICD-KCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo sprng wir drsflx calf bd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1900","description":"Afo sprng wir drsflx calf bd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXA1","description":"ICD-JDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aorsubcl/carot/innom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35626","description":"Art byp aorsubcl/carot/innom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj estrogen conjugate 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1410","description":"Inj estrogen conjugate 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXA1","description":"ICD-JCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rickettsia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86757","description":"Rickettsia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52235","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92634","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","description":"CPT-92634","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interdiscal perq aspir dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62267","description":"Interdiscal perq aspir dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTC1","description":"ICD-ACTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJF0","description":"ICD-OIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKB0","description":"ICD-BIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27454","description":"Realignment of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esano ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4274","description":"Esano ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQD0","description":"ICD-PLQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37290","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","description":"CPT-37290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4371","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","description":"HCPCS-Q4371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBC1","description":"ICD-MKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWF1","description":"ICD-OFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 9 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP09","description":"Auto.test pane pricing code_ 9 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOB0","description":"ICD-GEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASA0","description":"ICD-KASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIC1","description":"ICD-NFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNA0","description":"ICD-GCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amniply_ for topical use only_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4249","description":"Amniply_ for topical use only_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGA0","description":"ICD-OHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYD0","description":"ICD-GAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEA0","description":"ICD-CCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj aripiprazole ext rel 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0401","description":"Inj aripiprazole ext rel 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2D","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFD1","description":"ICD-GBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hinge extension/flex wrist/f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3900","description":"Hinge extension/flex wrist/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rh ig full-dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90384","description":"Rh ig full-dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amphetamines 3or 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80325","description":"Amphetamines 3or 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mycoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86738","description":"Mycoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCC0","description":"ICD-OJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAC0","description":"ICD-JFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNB1","description":"ICD-BFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0482U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","description":"CPT-0482U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHE1","description":"ICD-NKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHC0","description":"ICD-KCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAD0","description":"ICD-AFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ younger than 12 years of age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31553","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ younger than 12 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAED0","description":"ICD-MAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep b core antibody total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86704","description":"Hep b core antibody total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray measurement of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74710","description":"X-ray measurement of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levalbuterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7615","description":"Levalbuterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHE0","description":"ICD-EIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lpn home care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1031","description":"Lpn home care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lev 1 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0380","description":"Lev 1 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opps/php; train & educ serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0177","description":"Opps/php; train & educ serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Near-infrared spectroscopy studies of lower extremity wounds (eg_ for oxyhemoglobin measurement)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0493T","description":"Near-infrared spectroscopy studies of lower extremity wounds (eg_ for oxyhemoglobin measurement)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of nos vitamin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84591","description":"Assay of nos vitamin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0407","description":"Inpt/tele follow up 25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTF1","description":"ICD-MFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAID0","description":"ICD-CAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5658","description":"Socket insert above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDC1","description":"ICD-EGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not on a statin (e.g._ pregnancy_ in vitro fertilization_ clomiphene Rx_ ESRD_ cirrhosis_ muscular pain and disease during the measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9940","description":"Documentation of medical reason(s) for not on a statin (e.g._ pregnancy_ in vitro fertilization_ clomiphene Rx_ ESRD_ cirrhosis_ muscular pain and disease during the measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27725","description":"Repair of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20B","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCD0","description":"ICD-AFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBD1","description":"ICD-MBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Culture anaerobe ident each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87076","description":"Culture anaerobe ident each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contracept iud","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4989","description":"Contracept iud","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWA1","description":"ICD-HAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace/irrigate catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62194","description":"Replace/irrigate catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx pancreatic unresectab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9107","description":"Onc dx pancreatic unresectab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72197","description":"MRI pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETD1","description":"ICD-CETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHA1","description":"ICD-KBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit simple cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5498","description":"Hit simple cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCA1","description":"ICD-CFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2196","description":"Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wedging of clubfoot cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29750","description":"Wedging of clubfoot cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aorcel/aormesen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35531","description":"Art byp grft aorcel/aormesen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECD1","description":"ICD-NECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXD1","description":"ICD-BBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPE0","description":"ICD-OCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYB1","description":"ICD-CHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Filtered nebulizer admin set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7006","description":"Filtered nebulizer admin set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXD1","description":"ICD-CEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQD1","description":"ICD-LCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJD0","description":"ICD-BBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70200","description":"X-ray exam of eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLD0","description":"ICD-IHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDB1","description":"ICD-BFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of residual cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57540","description":"Removal of residual cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acid perfusion of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91030","description":"Acid perfusion of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inhaled bronchodilator rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4025F","description":"Inhaled bronchodilator rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply long arm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29105","description":"Apply long arm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3350","description":"Shoe heel wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOB1","description":"ICD-LFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBE1","description":"ICD-EBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRE1","description":"ICD-DCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTA0","description":"ICD-JCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENF0","description":"ICD-BENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIA0","description":"ICD-ICIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRC1","description":"ICD-DGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQE0","description":"ICD-PBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGF1","description":"ICD-JAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA43","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9885","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYC0","description":"ICD-LFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBF1","description":"ICD-GFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATF0","description":"ICD-GATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAD0","description":"ICD-NBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mastectomy sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8010","description":"Mastectomy sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTB0","description":"ICD-CCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xcm biologic tiss matrix 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4142","description":"Xcm biologic tiss matrix 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27580","description":"Fusion of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKA0","description":"ICD-GIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFA1","description":"ICD-JDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscop mucosal resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43211","description":"Esophagoscop mucosal resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJD1","description":"ICD-BIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj >24 hr in ed gcs <15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9532","description":"Inj >24 hr in ed gcs <15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye/revise socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65114","description":"Remove eye/revise socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ amplified probe techniq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0005","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ amplified probe techniq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLA1","description":"ICD-FCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVE1","description":"ICD-NCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJC0","description":"ICD-KAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL02","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACF1","description":"ICD-OACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rollabout chair with casters","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1031","description":"Rollabout chair with casters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","description":"HCPCS-J0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECD1","description":"ICD-OECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBED0","description":"ICD-GBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKA1","description":"ICD-CEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHD1","description":"ICD-CCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with invasive interface (e.g. tracheostomy tube)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0463","description":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with invasive interface (e.g. tracheostomy tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychia interven rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4526F","description":"Neuropsychia interven rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Particle agglut antbdy titr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86406","description":"Particle agglut antbdy titr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALF0","description":"ICD-AALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompressive craniotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61322","description":"Decompressive craniotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEF1","description":"ICD-EBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYA1","description":"ICD-CGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMD0","description":"ICD-FCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ toe caps_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6573","description":"Gradient compression garment_ toe caps_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBB1","description":"ICD-ACBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral infus pump portab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9004","description":"Parenteral infus pump portab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5D","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test def 22+ classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0483","description":"Drug test def 22+ classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of kneecap tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27380","description":"Repair of kneecap tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXD1","description":"ICD-NJXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon t4_ n0 w/o prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9085","description":"Onc dx colon t4_ n0 w/o prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHA1","description":"ICD-CGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental inlay metl 3/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2530","description":"Dental inlay metl 3/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIF0","description":"ICD-GFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPE0","description":"ICD-GEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0620U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","description":"CPT-0620U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acylcarnitines qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82016","description":"Acylcarnitines qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Localized delivery antimicro","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4381","description":"Localized delivery antimicro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pet not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0235","description":"Pet not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8900","description":"Mra w/cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Herpes simplex nes antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86694","description":"Herpes simplex nes antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIED0","description":"ICD-EIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIA1","description":"ICD-JAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXB1","description":"ICD-CAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIC1","description":"ICD-NEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQB0","description":"ICD-GHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay dipstick","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83518","description":"Immunoassay dipstick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy nerve of eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67345","description":"Destroy nerve of eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPF0","description":"ICD-OEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYC1","description":"ICD-GFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUC0","description":"ICD-FIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXF0","description":"ICD-JBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMF0","description":"ICD-MGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJD0","description":"ICD-JFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Targeted Sequence Analysis (Eg_ 4 Oncology)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81352","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Targeted Sequence Analysis (Eg_ 4 Oncology)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9815","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9815","description":"HCPCS-C9815","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECC0","description":"ICD-MECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAND0","description":"ICD-FAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chimerism anal w/cell select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81268","description":"Chimerism anal w/cell select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQF0","description":"ICD-CIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSE0","description":"ICD-DHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB31","description":"ICD-3GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACF0","description":"ICD-IACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial hospitalization serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0201","description":"Partial hospitalization serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deep sedation/general anesthesia-first 30 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9220","description":"Deep sedation/general anesthesia-first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOF1","description":"ICD-GGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLC0","description":"ICD-EBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJE1","description":"ICD-JBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dispense fee initial 30 day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0333","description":"Dispense fee initial 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOE1","description":"ICD-GFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVC0","description":"ICD-FDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUC1","description":"ICD-ADUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUB1","description":"ICD-MLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHE0","description":"ICD-OLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLF1","description":"ICD-GDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Csi any other than pci 2 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8964","description":"Csi any other than pci 2 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSE1","description":"ICD-LHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pertuzumab_ trastuzumab_ and hyaluronidase-zzxf_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9316","description":"Injection_ pertuzumab_ trastuzumab_ and hyaluronidase-zzxf_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIE0","description":"ICD-NCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64451","description":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX16","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTD1","description":"ICD-IFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDF1","description":"ICD-OIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ceftazidime and avibactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0714","description":"Ceftazidime and avibactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTA1","description":"ICD-NLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA31","description":"ICD-1KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGND0","description":"ICD-OGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEE0","description":"ICD-BDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIE1","description":"ICD-EDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWC1","description":"ICD-GIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of foot bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28288","description":"Partial removal of foot bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of chest wall lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19260","description":"Removal of chest wall lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBB1","description":"ICD-FDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPE1","description":"ICD-JFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFA0","description":"ICD-JAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOA1","description":"ICD-HDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0021","description":"Alcohol and/or drug training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy lower leg soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27613","description":"Biopsy lower leg soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABE1","description":"ICD-CABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous vertebral augmentations_ first lumbar and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7508","description":"Percutaneous vertebral augmentations_ first lumbar and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRF1","description":"ICD-OJRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1152","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLB0","description":"ICD-KGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL54","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc hand tum deep 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26113","description":"Exc hand tum deep 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81259","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAC1","description":"ICD-JBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLB0","description":"ICD-MBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sterile gauze > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6404","description":"Sterile gauze > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC11","description":"ICD-4KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXC1","description":"ICD-JGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKF0","description":"ICD-NJKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDID1","description":"ICD-JDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 7.12-20","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2302","description":"Lens sphere trifocal 7.12-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVF1","description":"ICD-KIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family psytx w/patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90847","description":"Family psytx w/patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trach/laryn tube non-cuffed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7520","description":"Trach/laryn tube non-cuffed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ pmkr/aicd combination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1899","description":"Lead_ pmkr/aicd combination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIE0","description":"ICD-JBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRB1","description":"ICD-DFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHE0","description":"ICD-NDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0090U","description":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ls < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8660","description":"Fun stat score ls < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33280","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56606","description":"Biopsy of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB21","description":"ICD-1DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFB1","description":"ICD-KFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLF0","description":"ICD-JCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dent anesthesia w/o surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9210","description":"Dent anesthesia w/o surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient achieves refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9391","description":"Patient achieves refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove cerv artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22864","description":"Remove cerv artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-P9027","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","description":"HCPCS-P9027","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2004","description":"HCPCS-A2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWF0","description":"ICD-CHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1040T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1040T","description":"CPT-1040T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42226","description":"Lengthening of palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFF0","description":"ICD-CAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54304","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB231","description":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43453","description":"Dilate esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heparin neutralization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85525","description":"Heparin neutralization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart tmr w/other procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33141","description":"Heart tmr w/other procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMB0","description":"ICD-KFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGA0","description":"ICD-KBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGA0","description":"ICD-OJGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLB0","description":"ICD-NDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21C","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLE0","description":"ICD-OJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSF0","description":"ICD-GDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIA0","description":"ICD-EBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastro-Enterology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4006","description":"Gastro-Enterology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mast rad urban type","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19306","description":"Mast rad urban type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRA0","description":"ICD-GCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHF1","description":"ICD-ECHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq lumbosacral injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22511","description":"Perq lumbosacral injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm adult fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4010","description":"Cast sup sht arm adult fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31785","description":"Remove windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96170","description":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy & ureter catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52005","description":"Cystoscopy & ureter catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interro eval npgs sleep apne","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0434T","description":"Interro eval npgs sleep apne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAA0","description":"ICD-OKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53_ NY-ESO-1_ CAGE_ GBU4-5_ SOX2_ MAGE A4_ and HuD)_ plasma_ algorithm reported as a categoric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0360U","description":"Oncology (lung)_ enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53_ NY-ESO-1_ CAGE_ GBU4-5_ SOX2_ MAGE A4_ and HuD)_ plasma_ algorithm reported as a categoric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFA1","description":"ICD-GBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBE1","description":"ICD-CHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKA0","description":"ICD-OLKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tract equip cervical tract","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0860","description":"Tract equip cervical tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKD1","description":"ICD-FCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arch supp att to shoe long/m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3090","description":"Arch supp att to shoe long/m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDF0","description":"ICD-IFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIE1","description":"ICD-IBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMA1","description":"ICD-ADMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILE0","description":"ICD-CILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolong serv w/o contact add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99359","description":"Prolong serv w/o contact add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVC0","description":"ICD-CBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAE0","description":"ICD-AFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAD1","description":"ICD-FFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93017","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLB0","description":"ICD-CBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFB1","description":"ICD-FEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam pituitary saddle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70240","description":"X-ray exam pituitary saddle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Refused To Participate At Admission And/Or Discharge; Patient Unable To Complete The Neck Fs Prom At Admission Or Discharge Due To Cognitive Deficit_ Visual Deficit_ M","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2166","description":"Patient Refused To Participate At Admission And/Or Discharge; Patient Unable To Complete The Neck Fs Prom At Admission Or Discharge Due To Cognitive Deficit_ Visual Deficit_ M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Instillation_ ciprofloxacin otic suspension_ 6 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7342","description":"Instillation_ ciprofloxacin otic suspension_ 6 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63700","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6006","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5A","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKA0","description":"ICD-OEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74420","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGE1","description":"ICD-KFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAB1","description":"ICD-AIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7356","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","description":"HCPCS-J7356","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDF1","description":"ICD-CFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMD1","description":"ICD-JFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUA0","description":"ICD-ECUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPB0","description":"ICD-OIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCC0","description":"ICD-FHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHD1","description":"ICD-BIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLE0","description":"ICD-CCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ster wd ifx 30 d postop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8571","description":"Ster wd ifx 30 d postop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq abltj lvr cryoablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47383","description":"Perq abltj lvr cryoablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88160","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOF1","description":"ICD-LFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAE0","description":"ICD-MHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sirolimus protein-bound particles_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9331","description":"Injection_ sirolimus protein-bound particles_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWA1","description":"ICD-HFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Performance Not Met: The Residual Change Score Is Less Than 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2167","description":"Performance Not Met: The Residual Change Score Is Less Than 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQE1","description":"ICD-KAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gefitinib oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8565","description":"Gefitinib oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAE1","description":"ICD-AHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Protein e-phoresis serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84165","description":"Protein e-phoresis serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWF0","description":"ICD-OLWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSA1","description":"ICD-OJSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARD1","description":"ICD-DARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB23","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway pressure tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7037","description":"Pos airway pressure tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11A","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEE0","description":"ICD-MLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0594","description":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBB1","description":"ICD-BIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHE1","description":"ICD-CIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJC0","description":"ICD-KGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGF1","description":"ICD-CFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQE0","description":"ICD-CEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDD1","description":"ICD-CHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDC0","description":"ICD-ICDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEE0","description":"ICD-GBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem oct rta phys/qhp ea 30d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0606T","description":"Rem oct rta phys/qhp ea 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUB0","description":"ICD-ODUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1409","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","description":"HCPCS-M1409","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23120","description":"Partial removal collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNC0","description":"ICD-CHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvef greater than 35%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3056F","description":"Lvef greater than 35%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bilat dil retinal exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3000","description":"Bilat dil retinal exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELC0","description":"ICD-CELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressant not specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80338","description":"Antidepressant not specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC31","description":"ICD-2DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYD0","description":"ICD-KBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC10","description":"High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leucovorin calcium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0640","description":"Leucovorin calcium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8005","description":"HCPCS-C8005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28H","description":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home vent invasive interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0465","description":"Home vent invasive interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSB1","description":"ICD-HGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJE1","description":"ICD-FHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEA0","description":"ICD-FGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWF0","description":"ICD-CBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral)_ biochemical assays_ tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)_ interferon gamma-induced protein-10 (IP-10)_ and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0351U","description":"Infectious disease (bacterial or viral)_ biochemical assays_ tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)_ interferon gamma-induced protein-10 (IP-10)_ and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tens two lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0720","description":"Tens two lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1601","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1601","description":"CDT-D1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBF1","description":"ICD-FGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial foot exam pt lops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0245","description":"Initial foot exam pt lops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine eltrd perq aray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63661","description":"Remove spine eltrd perq aray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFA1","description":"ICD-KHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRA1","description":"ICD-PKRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOB1","description":"ICD-DHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPD0","description":"ICD-NGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDF1","description":"ICD-FCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture groin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35132","description":"Repair artery rupture groin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small animal inoculation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87003","description":"Small animal inoculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYA0","description":"ICD-OHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGD1","description":"ICD-CFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Organic acids qual each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83919","description":"Organic acids qual each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHF0","description":"ICD-EAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1003","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1003","description":"CDT-D1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIB0","description":"ICD-BHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDC0","description":"ICD-KHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRB1","description":"ICD-OHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIA0","description":"ICD-NBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJF1","description":"ICD-OGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMD0","description":"ICD-IBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBD1","description":"ICD-JEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psych diag eval w/med srvcs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90792","description":"Psych diag eval w/med srvcs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; device(s) supply with daily recording(s) or program","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99454","description":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; device(s) supply with daily recording(s) or program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aurothioglucose injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2910","description":"Aurothioglucose injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYB0","description":"ICD-KFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acute hepatitis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80074","description":"Acute hepatitis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 anytime during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9910","description":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 anytime during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28820","description":"Amputation of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0261U","description":"Oncology (colorectal cancer)_ image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGF1","description":"ICD-CGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUE1","description":"ICD-NLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57135","description":"Remove vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Outpatient_ ed_ or observation visits that result in an inpatient admission","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2176","description":"Outpatient_ ed_ or observation visits that result in an inpatient admission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWE0","description":"ICD-OCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx head/neck m1 mets rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9111","description":"Onc dx head/neck m1 mets rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAF1","description":"ICD-EAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy_ arrhythmia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0747T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy_ arrhythmia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pralatrexate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9307","description":"Pralatrexate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCD1","description":"ICD-GGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc chro add","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9608","description":"Perc d-e cor revasc chro add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC106","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65093","description":"Revise eye with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQC1","description":"ICD-LAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spkt/v greater than or equal to 1. 2 (single-pool clearance of urea [kt] / volume [v])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8713","description":"Spkt/v greater than or equal to 1. 2 (single-pool clearance of urea [kt] / volume [v])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of galactose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82760","description":"Assay of galactose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1483","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","description":"HCPCS-M1483","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVC0","description":"ICD-OJVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab and hyaluronidase_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9467","description":"Injection_ rituximab and hyaluronidase_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22D","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTE0","description":"ICD-ICTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glycosylated acute phase proteins (GlycA)_ nuclear magnetic resonance spectroscopy_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0024U","description":"Glycosylated acute phase proteins (GlycA)_ nuclear magnetic resonance spectroscopy_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHA0","description":"ICD-GEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICA1","description":"ICD-EICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA145","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRD0","description":"ICD-LDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0801T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transfer tub rail attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0246","description":"Transfer tub rail attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPF1","description":"ICD-KBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anterior asis pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1250","description":"Anterior asis pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strep a dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87650","description":"Strep a dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI ct scan ord rvwd rqstd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3324F","description":"MRI ct scan ord rvwd rqstd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lobar lung transplantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2060","description":"Lobar lung transplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brief alcohol misuse counsel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0443","description":"Brief alcohol misuse counsel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTD0","description":"ICD-AGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWD0","description":"ICD-HCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSD1","description":"ICD-LCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJC1","description":"ICD-KEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGB0","description":"ICD-JFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBA0","description":"ICD-KCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0500U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","description":"CPT-0500U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJC0","description":"ICD-JFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision Or Replacement Of Hypoglossal Nerve Neurostimulator Array And Distal Respiratory Sensor Electrode Or Electrode Array_ Including Connection To Existing Pulse Generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64583","description":"Revision Or Replacement Of Hypoglossal Nerve Neurostimulator Array And Distal Respiratory Sensor Electrode Or Electrode Array_ Including Connection To Existing Pulse Generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBC1","description":"ICD-EHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of thigh brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20663","description":"Application of thigh brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; electrode only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0531T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; electrode only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Buprenorphine implant_ 74.2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0570","description":"Buprenorphine implant_ 74.2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23455","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBB1","description":"ICD-ADBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXF0","description":"ICD-CAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder fb deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23333","description":"Remove shoulder fb deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18G","description":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA217","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUA1","description":"ICD-NIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"(Zerbaxa) Injection_ Ceftolozane 50mg And Tazobactam 25 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9452","description":"(Zerbaxa) Injection_ Ceftolozane 50mg And Tazobactam 25 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMB1","description":"ICD-ACMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLF1","description":"ICD-OKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMC0","description":"ICD-GFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amphetamine or methamphetamine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6042","description":"Amphetamine or methamphetamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ is referred within 1 month of the reactive hcv antibody test to a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1229","description":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ is referred within 1 month of the reactive hcv antibody test to a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frame depth 22 to 25 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2204","description":"Frame depth 22 to 25 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNF0","description":"ICD-JHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAB0","description":"ICD-NDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg artery-vein three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33519","description":"Cabg artery-vein three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD235","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDB0","description":"ICD-KIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect diaphragm simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39560","description":"Resect diaphragm simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABB0","description":"ICD-NABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDB1","description":"ICD-BIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit sing/m/fam couns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99510","description":"Home visit sing/m/fam couns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Molecular pathology interpr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0452","description":"Molecular pathology interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; each additional 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96137","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; each additional 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBB0","description":"ICD-FHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grafix Core and GrafixPL Core_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4132","description":"Grafix Core and GrafixPL Core_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"22nf sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2361","description":"22nf sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXD0","description":"ICD-CGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert and remove bone pin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20650","description":"Insert and remove bone pin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILB0","description":"ICD-OILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ftl cgen abnor 3 proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81509","description":"Ftl cgen abnor 3 proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVF0","description":"ICD-FGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTF1","description":"ICD-NGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Long-acting inhaled bronchodilator prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9695","description":"Long-acting inhaled bronchodilator prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX22","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYD1","description":"ICD-HAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace vad intra w/bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33983","description":"Replace vad intra w/bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDB1","description":"ICD-MJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01656","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","description":"CPT-01656","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEE1","description":"ICD-ICEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIA0","description":"ICD-AGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIA0","description":"ICD-IHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc app","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44979","description":"Laparoscope proc app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ maintenance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9005","description":"Mccd_ risk adj_ maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNE1","description":"ICD-OFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29405","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNA0","description":"ICD-FFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBD1","description":"ICD-ODBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Male sling procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53440","description":"Male sling procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth chest surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54051","description":"Anesth chest surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJA1","description":"ICD-FAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip core decompression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2325","description":"Hip core decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABD0","description":"ICD-CABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOB0","description":"ICD-PAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXE1","description":"ICD-GHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3204","description":"Hightop w/ supp/pronator inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAB1","description":"ICD-IAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sperm procure init visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4030","description":"Sperm procure init visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9376","description":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXE1","description":"ICD-OBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc abd les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22902","description":"Exc abd les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPD0","description":"ICD-CBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sewhfo cap desgn w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3977","description":"Sewhfo cap desgn w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOD0","description":"ICD-OLOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj hi_ initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9003","description":"Mccd_ risk adj hi_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLF1","description":"ICD-BBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATA1","description":"ICD-KATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fos c chld non-ther per mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0042","description":"Fos c chld non-ther per mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAID1","description":"ICD-OAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHD0","description":"ICD-CCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDB0","description":"ICD-EEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUC1","description":"ICD-NLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEF0","description":"ICD-FBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDF0","description":"ICD-CHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEF1","description":"ICD-NBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery of great vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33916","description":"Surgery of great vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQF1","description":"ICD-KDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close mult vsd w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33676","description":"Close mult vsd w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD155","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of amylase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82150","description":"Assay of amylase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bl exchange/transfuse non-nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36455","description":"Bl exchange/transfuse non-nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rem endovas vena cava filter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37193","description":"Rem endovas vena cava filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insulin cartridge 300 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5566","description":"Insulin cartridge 300 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genetic testing als","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3800","description":"Genetic testing als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4435","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","description":"HCPCS-Q4435","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAD1","description":"ICD-FAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUF0","description":"ICD-GDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self-mgmt educ & train 1 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98960","description":"Self-mgmt educ & train 1 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCD0","description":"ICD-IBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTC1","description":"ICD-JHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJB1","description":"ICD-OBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQD1","description":"ICD-CCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXA0","description":"ICD-KHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient use of hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9693","description":"Patient use of hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPD0","description":"ICD-KDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISB1","description":"ICD-PISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFD1","description":"ICD-OGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOB1","description":"ICD-PCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRC0","description":"ICD-CHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61556","description":"Incise skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External urinary catheter; non-disposable_ for use with suction pump_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6591","description":"External urinary catheter; non-disposable_ for use with suction pump_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBA1","description":"ICD-OHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUB0","description":"ICD-JAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQD0","description":"ICD-PFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELC0","description":"ICD-GELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alprostadil for injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0270","description":"Alprostadil for injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHC0","description":"ICD-AEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGA0","description":"ICD-CDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0D","description":"Medium Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXE1","description":"ICD-OAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLA1","description":"ICD-MFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adlt disp und/pull on abv xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4544","description":"Adlt disp und/pull on abv xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWA1","description":"ICD-CEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCE1","description":"ICD-KCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUB1","description":"ICD-OGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroestradiol f 18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9591","description":"Fluoroestradiol f 18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBF0","description":"ICD-OEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA210","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDD0","description":"ICD-EBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0205","description":"HCPCS-A0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBB0","description":"ICD-EEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Detect agnt mult dna ampli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87801","description":"Detect agnt mult dna ampli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWF1","description":"ICD-DAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Swivel adaptor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8186","description":"Swivel adaptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTE0","description":"ICD-MBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHF1","description":"ICD-OFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Linezolid injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2020","description":"Linezolid injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1742","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1742","description":"HCPCS-C1742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1094","description":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid plastic pre one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0490","description":"Tlso rigid plastic pre one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt srv p day 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90969","description":"Esrd home pt srv p day 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01340","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","description":"CPT-01340","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTD0","description":"ICD-CFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No abd imag w/o reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9457","description":"No abd imag w/o reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMF0","description":"ICD-JBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTA0","description":"ICD-OFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMA0","description":"ICD-OEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change of bladder tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51710","description":"Change of bladder tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo ak/hip knee extens assi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5850","description":"Endo ak/hip knee extens assi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBE0","description":"ICD-ECBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBC0","description":"ICD-BHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4C","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUB0","description":"ICD-BIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not achieve a PDC of at least 75% for their asthma controller medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9811","description":"Patient did not achieve a PDC of at least 75% for their asthma controller medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic custom molded shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5501","description":"Diabetic custom molded shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA21","description":"ICD-4KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOB0","description":"ICD-PEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ amivantamab-vmjw_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9083","description":"Injection_ amivantamab-vmjw_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy & decompress","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45337","description":"Sigmoidoscopy & decompress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contour cranial bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21181","description":"Contour cranial bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Day habil waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2020","description":"Day habil waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES241","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWD1","description":"ICD-DAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor liver/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47146","description":"Prep donor liver/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTA0","description":"ICD-MLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISC1","description":"ICD-PISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXC1","description":"ICD-BIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAD1","description":"ICD-GEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suture small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44602","description":"Suture small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWE1","description":"ICD-LFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJC0","description":"ICD-BEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artificial saliva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9155","description":"Artificial saliva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Soft tissue allograft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4275","description":"Soft tissue allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBE1","description":"ICD-EDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSE0","description":"ICD-PHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWB0","description":"ICD-LCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBE1","description":"ICD-EGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Barbiturates_ not elsewhere specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6043","description":"Barbiturates_ not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB206","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSF0","description":"ICD-OKSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILF0","description":"ICD-GILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo transthoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93303","description":"Echo transthoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4438","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMA1","description":"ICD-BEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0997T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","description":"CPT-0997T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1099T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1099T","description":"CPT-1099T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGF0","description":"ICD-KHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHF1","description":"ICD-EBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frame depth less than 22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2203","description":"Frame depth less than 22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"100 insulin syringes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8490","description":"100 insulin syringes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJA1","description":"ICD-BCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE136","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETD1","description":"ICD-IETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preparation palate mold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42280","description":"Preparation palate mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUF0","description":"ICD-AHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRE0","description":"ICD-OLRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17280","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCE0","description":"ICD-IDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mastectomy bra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8000","description":"Mastectomy bra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-27458","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","description":"CPT-27458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01464","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","description":"CPT-01464","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODID0","description":"ICD-ODID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAF0","description":"ICD-KFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemi-wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1083","description":"Hemi-wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18I","description":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69905","description":"Remove inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHA1","description":"ICD-IDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBB0","description":"ICD-NFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6063","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEF0","description":"ICD-NEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psori tool doc w/benchmk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9649","description":"Psori tool doc w/benchmk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants_ Low-Pass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81349","description":"Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants_ Low-Pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVF1","description":"ICD-NEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Soft tissue graft firsttooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4277","description":"Soft tissue graft firsttooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJB0","description":"ICD-KEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMF0","description":"ICD-MCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tx contour defects >10.0 cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11954","description":"Tx contour defects >10.0 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Work related disability exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99455","description":"Work related disability exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seat width 24-27 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2202","description":"Seat width 24-27 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCE0","description":"ICD-OGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBME0","description":"ICD-IBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobramycin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3260","description":"Tobramycin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJA0","description":"ICD-JFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNF0","description":"ICD-CGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSC1","description":"ICD-CGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYD0","description":"ICD-ODYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNC0","description":"ICD-JHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis of a patient-specific panel_ cell-free DNA_ subsequent assessment with comparison to pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0307U","description":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis of a patient-specific panel_ cell-free DNA_ subsequent assessment with comparison to pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHD1","description":"ICD-OIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWA0","description":"ICD-LBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD240","description":"Special Care High _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain/ceramic subs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2740","description":"Crown porcelain/ceramic subs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary plastic pouch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4381","description":"Urinary plastic pouch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20A","description":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6011","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIE1","description":"ICD-AAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0965T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","description":"CPT-0965T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVF1","description":"ICD-FIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGE0","description":"ICD-OBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBB0","description":"ICD-EFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Humidifier nonheated w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0561","description":"Humidifier nonheated w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Addition to lower extremity_ user adjustable_ mechanical_ residual limb volume management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5783","description":"Addition to lower extremity_ user adjustable_ mechanical_ residual limb volume management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEB1","description":"ICD-KCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLA1","description":"ICD-BBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Daunorubicin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9150","description":"Daunorubicin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBF1","description":"ICD-EFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Misc dialysis supplies noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4913","description":"Misc dialysis supplies noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5261","description":"Hearing aid_ digit_ bin_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFC0","description":"ICD-CEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQE1","description":"ICD-KDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXB1","description":"ICD-GGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXB1","description":"ICD-OAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cftr gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81222","description":"Cftr gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETE0","description":"ICD-IETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98985","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","description":"CPT-98985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain image < 4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78600","description":"Brain image < 4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEF1","description":"ICD-BDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2B","description":"Medium Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Children who were screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9966","description":"Children who were screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGE0","description":"ICD-NHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICC0","description":"ICD-AICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFC0","description":"ICD-GCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31400","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJB0","description":"ICD-OCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXF0","description":"ICD-KGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOE1","description":"ICD-OLOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg1a-b no pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9113","description":"Onc dx ovarian stg1a-b no pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Potent antivir thxpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4276F","description":"Potent antivir thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVC1","description":"ICD-FHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFC0","description":"ICD-GHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAA1","description":"ICD-CEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC56","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mopath procedure level 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81402","description":"Mopath procedure level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVC1","description":"ICD-JGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ing hernia baby reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49495","description":"Rpr ing hernia baby reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDB1","description":"ICD-IEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC151","description":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYB0","description":"ICD-CHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27641","description":"Partial removal of fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX30","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOB0","description":"ICD-KDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLD1","description":"ICD-ABLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation thru metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28805","description":"Amputation thru metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAC0","description":"ICD-BEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of hip joint/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27036","description":"Excision of hip joint/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"12-lead ecg performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3120F","description":"12-lead ecg performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of facial bone(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21026","description":"Excision of facial bone(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow fair lead cable dir fo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6586","description":"Elbow fair lead cable dir fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTD0","description":"ICD-MLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNA0","description":"ICD-JBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVD1","description":"ICD-KBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJF0","description":"ICD-BCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ost skn barr convex <=4 sq i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4409","description":"Ost skn barr convex <=4 sq i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00866","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","description":"CPT-00866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise lesion testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54512","description":"Excise lesion testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWE1","description":"ICD-DAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metacarp fx orthosis pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3918","description":"Metacarp fx orthosis pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLD0","description":"ICD-ACLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJE0","description":"ICD-GHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53210","description":"Removal of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE117","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXD1","description":"ICD-NDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFB0","description":"ICD-CGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIA1","description":"ICD-FCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Req ret or w/in 90d of surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9514","description":"Req ret or w/in 90d of surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Verteporfin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3396","description":"Verteporfin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERE0","description":"ICD-KERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFID1","description":"ICD-BFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB260","description":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thromblytic art/ven therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37213","description":"Thromblytic art/ven therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ bupivacaine liposome","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9290","description":"Inj_ bupivacaine liposome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Encephaltis east eqne anbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86652","description":"Encephaltis east eqne anbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXC1","description":"ICD-BFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSC0","description":"ICD-CCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBF1","description":"ICD-MBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx w/fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21346","description":"Opn tx nasomax fx w/fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Stool collection pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4330","description":"Stool collection pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20979","description":"Us bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDD0","description":"ICD-KGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICED0","description":"ICD-ICED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Curette/treat cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65436","description":"Curette/treat cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pet img wholbod melano nonco","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0219","description":"Pet img wholbod melano nonco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair by enlargement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33610","description":"Repair by enlargement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKD0","description":"ICD-FEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLF0","description":"ICD-MCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18F","description":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRB0","description":"ICD-PIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITE0","description":"ICD-OITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES215","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVA1","description":"ICD-OLVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0465T","description":"Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHA0","description":"ICD-NCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVD0","description":"ICD-OEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLF1","description":"ICD-MHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIC1","description":"ICD-OGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBF1","description":"ICD-IIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRB0","description":"ICD-GGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQE0","description":"ICD-CDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQA0","description":"ICD-GIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDF0","description":"ICD-BBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5C","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27137","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj protamine sulfate/10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2720","description":"Inj protamine sulfate/10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay_ plasma_ algorithm reports risk of cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0359U","description":"Oncology (prostate cancer)_ analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay_ plasma_ algorithm reports risk of cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMD0","description":"ICD-KAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRD0","description":"ICD-GDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip midline cath insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5523","description":"Hip midline cath insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEB1","description":"ICD-CHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHID1","description":"ICD-BHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDE0","description":"ICD-IBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - comprehensive series of radiographic images - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0387","description":"intraoral tomosynthesis - comprehensive series of radiographic images - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFA1","description":"ICD-CGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peritoneal dialysis clamp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1634","description":"Peritoneal dialysis clamp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0080","description":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCB1","description":"ICD-KBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEC0","description":"ICD-FIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQB1","description":"ICD-LAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWA1","description":"ICD-GIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00868","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","description":"CPT-00868","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/o leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1171","description":"Wheelchair amputee w/o leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSB0","description":"ICD-GHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEE0","description":"ICD-OGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVB1","description":"ICD-KGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g._ general_ intravenous sedation (monitored anesthesia ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0330","description":"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g._ general_ intravenous sedation (monitored anesthesia ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0565U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","description":"CPT-0565U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Standing frame sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0638","description":"Standing frame sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral mucoadhesive_ any type (liquid_ gel_ paste_ etc.)_ per 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9156","description":"Oral mucoadhesive_ any type (liquid_ gel_ paste_ etc.)_ per 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco Screening Not Performed Or Tobacco Cessation Intervention Not Provided On The Date Of The Encounter Or Within The Previous 12 Months_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0029","description":"Tobacco Screening Not Performed Or Tobacco Cessation Intervention Not Provided On The Date Of The Encounter Or Within The Previous 12 Months_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12A","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPA1","description":"ICD-ODPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTB1","description":"ICD-ADTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRC0","description":"ICD-KFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prostatic microwave thermotx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53850","description":"Prostatic microwave thermotx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgery/speech prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31611","description":"Surgery/speech prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMA0","description":"ICD-KAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00811","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","description":"CPT-00811","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECB0","description":"ICD-CECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fluocinolone acetonide_ intravitreal implant (Yutiq)_ 0.01 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7314","description":"Injection_ fluocinolone acetonide_ intravitreal implant (Yutiq)_ 0.01 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLB0","description":"ICD-GCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0203","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0203","description":"CDT-D0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEA0","description":"ICD-JAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cad measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8489","description":"Cad measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLF1","description":"ICD-MDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Are Not Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0047","description":"Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Are Not Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (multiple myeloma)_ liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ monoclonal paraprotein sequencing analysis_ serum_ results reported as baseline pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0450U","description":"Oncology (multiple myeloma)_ liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ monoclonal paraprotein sequencing analysis_ serum_ results reported as baseline pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wc planar back cush wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2621","description":"Wc planar back cush wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDA1","description":"ICD-GFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg coma or sleep only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95822","description":"Eeg coma or sleep only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chimerism anal no cell selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81267","description":"Chimerism anal no cell selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mobility current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8978","description":"Mobility current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ spinal_ with integrated neurostimulator_ including imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0784T","description":"Insertion or replacement of percutaneous electrode array_ spinal_ with integrated neurostimulator_ including imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pessary_ non rubber_any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4562","description":"Pessary_ non rubber_any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whirlpool tub_ walk-in_ portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1301","description":"Whirlpool tub_ walk-in_ portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACA1","description":"ICD-GACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBED0","description":"ICD-MBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQC1","description":"ICD-GHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMD1","description":"ICD-OJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast_ Followed By Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0638T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast_ Followed By Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1411","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","description":"HCPCS-M1411","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHA1","description":"ICD-KEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLD1","description":"ICD-MHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEF0","description":"ICD-BIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Helminth antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86682","description":"Helminth antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2003","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2003","description":"CDT-D2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afo rig ant tib prefab tcf/=","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1932","description":"Afo rig ant tib prefab tcf/=","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay iga/igd/igg/igm each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82784","description":"Assay iga/igd/igg/igm each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient spent greater than or equal to three days in hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9861","description":"Patient spent greater than or equal to three days in hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYD1","description":"ICD-HHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA11","description":"ICD-4LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10D","description":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport wheelch van","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0130","description":"Noner transport wheelch van","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Beta blckr admin w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4115F","description":"Beta blckr admin w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy ring each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4404","description":"Ostomy ring each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDC0","description":"ICD-JBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRA1","description":"ICD-DBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPB0","description":"ICD-OAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special eye evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92020","description":"Special eye evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRB0","description":"ICD-PBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVF1","description":"ICD-BHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Filters elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0500","description":"Filters elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-81524","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","description":"CPT-81524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERD0","description":"ICD-LERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hydromorphone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1170","description":"Hydromorphone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nhl relapse/refractor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9137","description":"Onc dx nhl relapse/refractor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc of neg or man pos tb scn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9359","description":"Doc of neg or man pos tb scn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No low pecarn ped head traum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9597","description":"No low pecarn ped head traum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of big toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28310","description":"Revision of big toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOC0","description":"ICD-OBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human fibrinogen conc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7178","description":"Human fibrinogen conc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Or Care Partner Decline Assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0036","description":"Patient Or Care Partner Decline Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","description":"HCPCS-J2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Healthcare Professional Online Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 11-20 Minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2062","description":"Qualified Nonphysician Healthcare Professional Online Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 11-20 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRD0","description":"ICD-OIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lyme dis dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87477","description":"Lyme dis dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTE0","description":"ICD-NKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A5001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5001","description":"HCPCS-A5001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meals per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9977","description":"Meals per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1013","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo hormon antineopl sq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96402","description":"Chemo hormon antineopl sq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mouth piece","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4617","description":"Mouth piece","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESA1","description":"ICD-PESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aortoiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35537","description":"Art byp grft aortoiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of unstable kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27420","description":"Revision of unstable kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSA1","description":"ICD-KDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXD0","description":"ICD-JEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59135","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRA0","description":"ICD-LHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB145","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBD1","description":"ICD-EFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ped wc modify width adjustm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1011","description":"Ped wc modify width adjustm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVB0","description":"ICD-CCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18C","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx complx malar fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21365","description":"Opn tx complx malar fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTE0","description":"ICD-CBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0027","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ talquetamab-tgvs_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9163","description":"Injection_ talquetamab-tgvs_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cid ext speech process repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8627","description":"Cid ext speech process repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLB0","description":"ICD-MGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert major vessel graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33330","description":"Insert major vessel graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSB1","description":"ICD-DCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHD0","description":"ICD-MIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFC0","description":"ICD-FGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEF1","description":"ICD-NKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVE1","description":"ICD-GIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHD1","description":"ICD-JDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4046","description":"Cast sup sht leg splnt fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18A","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthesis_ breast_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1789","description":"Prosthesis_ breast_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGA0","description":"ICD-BAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUC0","description":"ICD-NGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCF1","description":"ICD-MBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDE1","description":"ICD-FHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Commissure splint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5987","description":"Commissure splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrode stimulation brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95961","description":"Electrode stimulation brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLID0","description":"ICD-MLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCID0","description":"ICD-CCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of middle ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70134","description":"X-ray exam of middle ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB213","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUC1","description":"ICD-IIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29700","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKF0","description":"ICD-JAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES140","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNE0","description":"ICD-CBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPF0","description":"ICD-OFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWC0","description":"ICD-LIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc opioid tx 1x at ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9579","description":"No doc opioid tx 1x at ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDE0","description":"ICD-IFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHD0","description":"ICD-CDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"History aids-defining cond","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3490F","description":"History aids-defining cond","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKE0","description":"ICD-BGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJA0","description":"ICD-OCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Death did not occur during the index acute care hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9815","description":"Death did not occur during the index acute care hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Death occurring after discharge from the hospital but within 30 days post procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9816","description":"Death occurring after discharge from the hospital but within 30 days post procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27258","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHB1","description":"ICD-NAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMB0","description":"ICD-MHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Initial Prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0569T","description":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Initial Prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAID0","description":"ICD-FAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rv1 vacc 2 dose live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90681","description":"Rv1 vacc 2 dose live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHF1","description":"ICD-ACHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHID1","description":"ICD-NHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adrenalin epinephrine inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0171","description":"Adrenalin epinephrine inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7552","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDA0","description":"ICD-EHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Administration of a standardized_ evidence-based social determinants of health risk assessment tool_ 5-15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0136","description":"Administration of a standardized_ evidence-based social determinants of health risk assessment tool_ 5-15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist/forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25116","description":"Remove wrist/forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAA1","description":"ICD-JIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMA0","description":"ICD-OIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFB0","description":"ICD-OJFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Qual life tool 2x same/impr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9634","description":"Qual life tool 2x same/impr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTD1","description":"ICD-MLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUE0","description":"ICD-NFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18H","description":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYD1","description":"ICD-CCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67500","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acp discuss-no dscnmkr docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1124F","description":"Acp discuss-no dscnmkr docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCD0","description":"ICD-GCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQB0","description":"ICD-OEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dna/rna direct probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87149","description":"Dna/rna direct probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ferritin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82728","description":"Assay of ferritin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJE0","description":"ICD-KIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57200","description":"Repair of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiotherapy dose plan imrt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77301","description":"Radiotherapy dose plan imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNF0","description":"ICD-CHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFED0","description":"ICD-IFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLE0","description":"ICD-GHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHF0","description":"ICD-MIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0950","description":"Tray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEF0","description":"ICD-KHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEF1","description":"ICD-OJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRD0","description":"ICD-DCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFID0","description":"ICD-AFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOE1","description":"ICD-OEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26607","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISB0","description":"ICD-HISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0669","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0669","description":"HCPCS-G0669","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDE0","description":"ICD-GBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFE1","description":"ICD-BHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay metallic 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2542","description":"Dental onlay metallic 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLC1","description":"ICD-FGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breath tst attain/anal c-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78267","description":"Breath tst attain/anal c-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDC1","description":"ICD-JGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLD1","description":"ICD-MBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJC0","description":"ICD-CDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SUPRATHEL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2012","description":"SUPRATHEL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Next Gen aco model>20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9870","description":"Next Gen aco model>20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rotavirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86759","description":"Rotavirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBD1","description":"ICD-KCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I&d absc intraoral soft tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7510","description":"I&d absc intraoral soft tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTF0","description":"ICD-MBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALB0","description":"ICD-KALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frozen blood freeze/thaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86932","description":"Frozen blood freeze/thaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bartonella dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87472","description":"Bartonella dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEA0","description":"ICD-AFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGB0","description":"ICD-JGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDF0","description":"ICD-BFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carcinoembryonic antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82378","description":"Carcinoembryonic antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8A","description":"High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bumetanide 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0171","description":"Bumetanide 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATD1","description":"ICD-EATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUB1","description":"ICD-CGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are receiving comfort care only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9930","description":"Patients who are receiving comfort care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJA1","description":"ICD-NJJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQE0","description":"ICD-GGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRD1","description":"ICD-ODRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLF1","description":"ICD-BHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMB0","description":"ICD-ODMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDA1","description":"ICD-EEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAA1","description":"ICD-OFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12D","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tibial length sock fx or equ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2840","description":"Tibial length sock fx or equ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSA0","description":"ICD-DDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bld glucose monitor w lance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2101","description":"Bld glucose monitor w lance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAE0","description":"ICD-KAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"5%dextrose/0.45%saline1000ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5013","description":"5%dextrose/0.45%saline1000ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28F","description":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","description":"CPT-15015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth ear surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12051","description":"Anesth ear surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1081","description":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDB0","description":"ICD-CFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12A","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Was Not Prescribed_ Reason Not","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2096","description":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Was Not Prescribed_ Reason Not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTF0","description":"ICD-EFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAC0","description":"ICD-KAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip clevis type 2 posit jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2570","description":"Hip clevis type 2 posit jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20D","description":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23125","description":"Removal of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQF1","description":"ICD-CDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"So airplane w/wo joint cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3674","description":"So airplane w/wo joint cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML07","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB224","description":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKF0","description":"ICD-CEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate bone tumor(s) perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20983","description":"Ablate bone tumor(s) perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBC1","description":"ICD-IBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0070","description":"Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arch supp att to shoe metata","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3080","description":"Arch supp att to shoe metata","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99308","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRC0","description":"ICD-GCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADA1","description":"ICD-MADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthro w/femoroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29914","description":"Hip arthro w/femoroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laryngotomy (thyrotomy_ laryngofissure)_ with removal of tumor or laryngocele_ cordectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31300","description":"Laryngotomy (thyrotomy_ laryngofissure)_ with removal of tumor or laryngocele_ cordectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJC1","description":"ICD-NDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of serum albumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82040","description":"Assay of serum albumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAB0","description":"ICD-BBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biodfence dryflex_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4138","description":"Biodfence dryflex_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCF0","description":"ICD-FFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49610","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ carfilzomib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9047","description":"Injection_ carfilzomib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIE0","description":"ICD-FAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m mertiatide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9562","description":"Tc99m mertiatide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14C","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANB1","description":"ICD-BANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sinusoidal rotational test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92546","description":"Sinusoidal rotational test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v thin layer redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88143","description":"Cytopath c/v thin layer redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35472","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No interv req for leak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9305","description":"No interv req for leak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACF0","description":"ICD-MACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCC1","description":"ICD-JCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFE0","description":"ICD-OJFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDB0","description":"ICD-FIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASB1","description":"ICD-HASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6123","description":"Implant Supported Retainer For Metal Fpd - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDF1","description":"ICD-NBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28725","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYD1","description":"ICD-PHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDA0","description":"ICD-CHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEE0","description":"ICD-GFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAC0","description":"ICD-JCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60271","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep ak ischial direct form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5570","description":"Prep ak ischial direct form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASC0","description":"ICD-OASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23460","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLB1","description":"ICD-KHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCE0","description":"ICD-GHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXA1","description":"ICD-NCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place perm pacing cardiovert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0448","description":"Place perm pacing cardiovert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom breast prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8035","description":"Custom breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRE0","description":"ICD-PLRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt trans to hosp post d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8914","description":"Pt trans to hosp post d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCD0","description":"ICD-IFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Was Provided Pallative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9993","description":"Patient Was Provided Pallative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFC0","description":"ICD-NBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLED0","description":"ICD-NLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRB1","description":"ICD-LCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLA0","description":"ICD-NFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33031","description":"Partial removal of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25A","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4339","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","description":"HCPCS-Q4339","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0826T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ewho w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3764","description":"Ewho w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of intraosseous basivertebral nerve_ first two vertebral bodies_ including imaging guidance (e.g._ fluoroscopy)_ lu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9752","description":"Destruction of intraosseous basivertebral nerve_ first two vertebral bodies_ including imaging guidance (e.g._ fluoroscopy)_ lu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQA0","description":"ICD-KEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5140","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","description":"HCPCS-Q5140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0539U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","description":"CPT-0539U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXF1","description":"ICD-OGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSA1","description":"ICD-PCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWC0","description":"ICD-KIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICF0","description":"ICD-OICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTB0","description":"ICD-KCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKD1","description":"ICD-BAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No wet-dry drssings rx recmd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4266F","description":"No wet-dry drssings rx recmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hocm 150-199mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9959","description":"Hocm 150-199mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFB1","description":"ICD-NHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILB1","description":"ICD-GILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hh aide or cn aide per visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1021","description":"Hh aide or cn aide per visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ft insert ucb berkeley shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3000","description":"Ft insert ucb berkeley shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay malate dehydrogenase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83775","description":"Assay malate dehydrogenase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALF0","description":"ICD-IALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFB1","description":"ICD-NDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLE1","description":"ICD-ECLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHE0","description":"ICD-NIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE117","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6020","description":"Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5246","description":"Hearing aid_ prog_ mon_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHD0","description":"ICD-JCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj gadoterate meglumi 0.1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9575","description":"Inj gadoterate meglumi 0.1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGD1","description":"ICD-FFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUE0","description":"ICD-CEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEC0","description":"ICD-MEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEE0","description":"ICD-BCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of skin wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15829","description":"Removal of skin wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB17","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIE1","description":"ICD-EAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA151","description":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFC1","description":"ICD-FIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Off assis eol iss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9380","description":"Off assis eol iss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Services performed by birth a doula birth workers_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1032","description":"Services performed by birth a doula birth workers_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOE1","description":"ICD-KHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB11","description":"ICD-2EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Haloperidol decanoate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1631","description":"Haloperidol decanoate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUB1","description":"ICD-EIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHB0","description":"ICD-GEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Most recent BP is less than or equal to 140/90 mm Hg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9788","description":"Most recent BP is less than or equal to 140/90 mm Hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJE0","description":"ICD-FCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1834","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","description":"HCPCS-J1834","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIA1","description":"ICD-BAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDME0","description":"ICD-CDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUA0","description":"ICD-MJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRE1","description":"ICD-GIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRF0","description":"ICD-DIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01210","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","description":"CPT-01210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00560","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","description":"CPT-00560","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDC0","description":"ICD-CFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKD1","description":"ICD-KBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMD1","description":"ICD-ECMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDA1","description":"ICD-JDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVE0","description":"ICD-JCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCC0","description":"ICD-MCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSB1","description":"ICD-OLSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization admin by intramuscular injection of s (SARS-CoV-2) ([COVID-19]) vacc_ mRNA-LNP_ spike protein_ presev free_ 30mcg/0.3 mL dosage_ tris-sucrose formula; third dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053A","description":"Immunization admin by intramuscular injection of s (SARS-CoV-2) ([COVID-19]) vacc_ mRNA-LNP_ spike protein_ presev free_ 30mcg/0.3 mL dosage_ tris-sucrose formula; third dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMB1","description":"ICD-GFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tech other than surfc cultr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4261F","description":"Tech other than surfc cultr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCF1","description":"ICD-OFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHF1","description":"ICD-FEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0525","description":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB43","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDE1","description":"ICD-GBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERC0","description":"ICD-LERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions)_ DNA_ 22 drug metabolism and transporter genes_ real-time PCR_ blood or buccal swab_ genotype and metabolizer status for therapeutic d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015U","description":"Drug metabolism (adverse drug reactions)_ DNA_ 22 drug metabolism and transporter genes_ real-time PCR_ blood or buccal swab_ genotype and metabolizer status for therapeutic d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWC0","description":"ICD-DCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPD1","description":"ICD-CDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"SC GNOTYP ERMAP EXONS 4 12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0199U","description":"SC GNOTYP ERMAP EXONS 4 12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXF0","description":"ICD-OBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETA0","description":"ICD-JETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRD1","description":"ICD-CIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27427","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXE1","description":"ICD-BIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0502","description":"HCPCS-A0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27592","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUB0","description":"ICD-ECUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroretinography with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92275","description":"Electroretinography with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJB0","description":"ICD-KBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMD0","description":"ICD-GGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUC1","description":"ICD-NAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENB0","description":"ICD-OENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each multiplex probe stain p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0853T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each multiplex probe stain p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSA1","description":"ICD-HDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBND0","description":"ICD-OBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgraft xt_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4269","description":"Surgraft xt_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLD1","description":"ICD-GGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSA0","description":"ICD-GDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp ilio-mesenteric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35633","description":"Art byp ilio-mesenteric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALA0","description":"ICD-CALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection Factor V111 FC Fusion Protein (Recombinant) Per IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9975","description":"Injection Factor V111 FC Fusion Protein (Recombinant) Per IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEF0","description":"ICD-MAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGC1","description":"ICD-OBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWA0","description":"ICD-OLWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAC1","description":"ICD-JIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAC1","description":"ICD-JAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAE1","description":"ICD-GGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23C","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67930","description":"Repair eyelid wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFND0","description":"ICD-JFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHB1","description":"ICD-NBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEB0","description":"ICD-KBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imm admin by intramuscular inj of  (SARS[1]CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNALNP_ spike protein_ pres free_ 10 mcg/0.2 mL dosage; booster dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0074A","description":"Imm admin by intramuscular inj of  (SARS[1]CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNALNP_ spike protein_ pres free_ 10 mcg/0.2 mL dosage; booster dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUA0","description":"ICD-JAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74455","description":"X-ray urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIF0","description":"ICD-KDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPB0","description":"ICD-OCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diag tst detect mucos abnorm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0431","description":"Diag tst detect mucos abnorm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB112","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8E","description":"High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18I","description":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth biopsy of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16451","description":"Anesth biopsy of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHC1","description":"ICD-AIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRB1","description":"ICD-HDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEE0","description":"ICD-EDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDC0","description":"ICD-KIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce/graft eye wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67255","description":"Reinforce/graft eye wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAID1","description":"ICD-EAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUA0","description":"ICD-CGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEE1","description":"ICD-OEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB156","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s)_ and atherectomy_ includ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9775","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s)_ and atherectomy_ includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1389","description":"HCPCS-M1389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRB0","description":"ICD-PHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7569","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7569","description":"HCPCS-C7569","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDA0","description":"ICD-OIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13C","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFE1","description":"ICD-GCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 52mg 5 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7298","description":"Levonorgestrel iu 52mg 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay resin 3 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2663","description":"Dental onlay resin 3 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD112","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vibrate quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0107T","description":"Vibrate quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hgb quant transcutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88738","description":"Hgb quant transcutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUE0","description":"ICD-BBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA156","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","description":"HCPCS-M1374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAA1","description":"ICD-GBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged iv inf_ req pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8957","description":"Prolonged iv inf_ req pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove anal fist complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46280","description":"Remove anal fist complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee disart expand wall sock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5653","description":"Knee disart expand wall sock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVA0","description":"ICD-GBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD246","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITD1","description":"ICD-MITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLC0","description":"ICD-NGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOF0","description":"ICD-GCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bk mold socket sach ft endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5301","description":"Bk mold socket sach ft endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBC1","description":"ICD-BIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOF0","description":"ICD-DAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited dental tx primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8010","description":"Limited dental tx primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD104","description":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWF0","description":"ICD-KGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEA0","description":"ICD-IIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUD0","description":"ICD-EFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC144","description":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICC0","description":"ICD-FICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25A","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCD0","description":"ICD-ODCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt scrnd unhlthy oh use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3016F","description":"Pt scrnd unhlthy oh use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of forearm cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29075","description":"Application of forearm cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23100","description":"Biopsy of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing warfarin or another FDA-approved oral anticoagulant that is FDA approved for the prevention of thromboembolism (e.g._ pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8969","description":"Documentation of patient reason(s) for not prescribing warfarin or another FDA-approved oral anticoagulant that is FDA approved for the prevention of thromboembolism (e.g._ pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQE0","description":"ICD-GBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vaccina ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90393","description":"Vaccina ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAB1","description":"ICD-IEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0093A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE156","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUB1","description":"ICD-GEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAC0","description":"ICD-MKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHA0","description":"ICD-AIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHA0","description":"ICD-KAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBD0","description":"ICD-KHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lumasiran_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0224","description":"Injection_ lumasiran_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVD0","description":"ICD-CHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELA1","description":"ICD-BELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Placement of seton","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46020","description":"Placement of seton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDF1","description":"ICD-GCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC17","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other power whlchr base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0014","description":"Other power whlchr base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC117","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt queried pain fxn w/ instr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1502F","description":"Pt queried pain fxn w/ instr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJD0","description":"ICD-CFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSC0","description":"ICD-HCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPE1","description":"ICD-CCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort iii w/ lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21155","description":"Lefort iii w/ lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQB0","description":"ICD-LBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNF0","description":"ICD-FGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXF0","description":"ICD-FCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGD1","description":"ICD-CCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBC1","description":"ICD-MIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc cur funct assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8541","description":"No doc cur funct assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIC0","description":"ICD-NKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSA1","description":"ICD-PBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSA0","description":"ICD-HHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0224T","description":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFF1","description":"ICD-FGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJD1","description":"ICD-JEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8B","description":"Medium Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16378","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16378","description":"CPT-16378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58200","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQA0","description":"ICD-CGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of intraosseous basivertebral nerve_ each additional vertebral body_ including imaging guidance (e.g._ fluoroscopy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9753","description":"Destruction of intraosseous basivertebral nerve_ each additional vertebral body_ including imaging guidance (e.g._ fluoroscopy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Accessing and retorquing loose implant screw - per screw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6089","description":"Accessing and retorquing loose implant screw - per screw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIB0","description":"ICD-AIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATC0","description":"ICD-BATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIME1","description":"ICD-BIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg dev eval impltbl sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93260","description":"Prgrmg dev eval impltbl sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61708","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCB0","description":"ICD-KGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUE1","description":"ICD-MEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v auto rescreen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88148","description":"Cytopath c/v auto rescreen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGD0","description":"ICD-BIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEC0","description":"ICD-CHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0520","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0520","description":"HCPCS-Q0520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITC1","description":"ICD-AITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq art m-thrombect &/nfs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61645","description":"Perq art m-thrombect &/nfs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20D","description":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB11","description":"ICD-4BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICD1","description":"ICD-CICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJE1","description":"ICD-BBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQC0","description":"ICD-KDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta)_ quantification_ including reverse transcription_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87523","description":"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta)_ quantification_ including reverse transcription_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOC1","description":"ICD-PJOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reop req bld grft oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8577","description":"Reop req bld grft oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac mgmt dif pt comorb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9060","description":"Onc prac mgmt dif pt comorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEC1","description":"ICD-EEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVF1","description":"ICD-JDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGE0","description":"ICD-NIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immunization adm by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vac_ mRNA\u0002LNP_ spike_ third dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0083A","description":"Immunization adm by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vac_ mRNA\u0002LNP_ spike_ third dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJE0","description":"ICD-NGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test 3 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95863","description":"Muscle test 3 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ transluminal intravascular lithotripsy_ coronary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1761","description":"Catheter_ transluminal intravascular lithotripsy_ coronary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6030","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","description":"HCPCS-L6030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAA1","description":"ICD-ADAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bekesy audiometry screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92560","description":"Bekesy audiometry screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL56","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Netupitant palonosetron oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8655","description":"Netupitant palonosetron oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSB0","description":"ICD-DHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPC0","description":"ICD-NHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of clot in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35875","description":"Removal of clot in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAD1","description":"ICD-KBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHD1","description":"ICD-OCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXD0","description":"ICD-NGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Toc tool incl key elem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9655","description":"Toc tool incl key elem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62121","description":"Incise skull repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRC1","description":"ICD-LFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74280","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt w out cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9241","description":"Doc pt w out cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUA1","description":"ICD-NJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCA0","description":"ICD-KHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection pantroprazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0164","description":"Injection pantroprazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRD0","description":"ICD-KHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce eye wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67250","description":"Reinforce eye wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ONC SOLID TUMOR 30 PRTN TRGT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174U","description":"ONC SOLID TUMOR 30 PRTN TRGT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDD1","description":"ICD-KDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Njx px nfrosgrm &/urtrgrm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50430","description":"Njx px nfrosgrm &/urtrgrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat tail bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27202","description":"Treat tail bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXE1","description":"ICD-CFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orbital replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5928","description":"Orbital replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHD0","description":"ICD-KEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:2 to 1:3)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1729","description":"Employment - Employment Skills Development (1:2 to 1:3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHME0","description":"ICD-AHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clsd red comp malar/zygma fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7760","description":"Clsd red comp malar/zygma fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mometasone sinus implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1090","description":"Mometasone sinus implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRB1","description":"ICD-CGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWB0","description":"ICD-HFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incompl donor egg case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4023","description":"Incompl donor egg case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetone assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82010","description":"Acetone assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20D","description":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9711","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ondansetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2405","description":"Ondansetron hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSD0","description":"ICD-PHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCF1","description":"ICD-NDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYF1","description":"ICD-OLYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23485","description":"Revision of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPC1","description":"ICD-GFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32609","description":"Thoracoscopy w/bx pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEC1","description":"ICD-CBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQE1","description":"ICD-HDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADE1","description":"ICD-IADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0370T","description":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE245","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELC1","description":"ICD-FELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26615","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve and glove combination_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6574","description":"Gradient compression arm sleeve and glove combination_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITA1","description":"ICD-EITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVE1","description":"ICD-KGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00537","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","description":"CPT-00537","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0616U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","description":"CPT-0616U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; subsequent vein(s) treated in a si","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36474","description":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; subsequent vein(s) treated in a si","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKC0","description":"ICD-NGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27840","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complement fixation each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86171","description":"Complement fixation each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAC0","description":"ICD-GEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intranasal biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30100","description":"Intranasal biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTE1","description":"ICD-NJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12C","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDE0","description":"ICD-MFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJE0","description":"ICD-OLJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytp fna eval ea addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88177","description":"Cytp fna eval ea addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBB1","description":"ICD-NKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Not nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9291","description":"Not nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSB0","description":"ICD-LHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/subs interv 15-30mn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0396","description":"Alcohol/subs interv 15-30mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUD1","description":"ICD-GAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown full cast high noble m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2790","description":"Crown full cast high noble m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hep a vac series prev recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4155F","description":"Hep a vac series prev recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC130","description":"Clinically Complex _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYC0","description":"ICD-KHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEC0","description":"ICD-JHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAF0","description":"ICD-IIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Portable oxygen concentrator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1392","description":"Portable oxygen concentrator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0857","description":"Pwc gp3 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle-skin graft trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15734","description":"Muscle-skin graft trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB11","description":"ICD-1EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide cardiocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76930","description":"Echo guide cardiocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ntsty modul rad tx dlvr cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77386","description":"Ntsty modul rad tx dlvr cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUF0","description":"ICD-GEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparotomy islet cell transp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0343","description":"Laparotomy islet cell transp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA52","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"American amnion_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4307","description":"American amnion_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr);","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0301U","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr);","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Basic life disability exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99450","description":"Basic life disability exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) ongoing maintenance se ss ions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9882","description":"Two Medica re Diabetes Prevention Program (MDPP) ongoing maintenance se ss ions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc rsn no adeno/neopl detec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9496","description":"Doc rsn no adeno/neopl detec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSA0","description":"ICD-KDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary colon ca dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81435","description":"Hereditary colon ca dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJC0","description":"ICD-JEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPA1","description":"ICD-GCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj filgrastim gcsf biosimil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5101","description":"Inj filgrastim gcsf biosimil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj pudendal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64430","description":"N block inj pudendal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove exostosis maxilla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21032","description":"Remove exostosis maxilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Instll rx agnt into rnal tub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50391","description":"Instll rx agnt into rnal tub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFE1","description":"ICD-KDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab_ via intravitreal implant (Susvimo)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2779","description":"Injection_ ranibizumab_ via intravitreal implant (Susvimo)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of head brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20661","description":"Application of head brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSC1","description":"ICD-PFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFE0","description":"ICD-CCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42836","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20C","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXF0","description":"ICD-NCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Truss double w/ standard pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8310","description":"Truss double w/ standard pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB30","description":"Low Rehab_ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB42","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOE0","description":"ICD-KDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQA1","description":"ICD-PBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXD0","description":"ICD-KBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTC1","description":"ICD-KCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOB0","description":"ICD-CIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pentazocine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3070","description":"Pentazocine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting proced","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0135U","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting proced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug_brand name","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5001","description":"Prescription drug_brand name","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33510","description":"Cabg vein single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACED0","description":"ICD-ACED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiological Evaluation Of Implantable Cardioverter-Defibrillator System With Substernal Electrode (Includes Defibrillation Threshold Evaluation_ Induction Of Arrhythm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0577T","description":"Electrophysiological Evaluation Of Implantable Cardioverter-Defibrillator System With Substernal Electrode (Includes Defibrillation Threshold Evaluation_ Induction Of Arrhythm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVB0","description":"ICD-BDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPF1","description":"ICD-BFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYB0","description":"ICD-HGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHF1","description":"ICD-NGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; Over 12 Channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77787","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; Over 12 Channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBE1","description":"ICD-CBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27266","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prochlorperazine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0780","description":"Prochlorperazine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19020","description":"Incision of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGA1","description":"ICD-OFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRB0","description":"ICD-OBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd biopsy single/multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43239","description":"Egd biopsy single/multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dstrj neurofibromata xtnsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0419T","description":"Dstrj neurofibromata xtnsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fr frz plasma donor retested","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9060","description":"Fr frz plasma donor retested","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal t4_n_m0 no prg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9093","description":"Onc dx rectal t4_n_m0 no prg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEE1","description":"ICD-OJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE214","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulpal regeneration interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3356","description":"Pulpal regeneration interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUA1","description":"ICD-MJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELC0","description":"ICD-OELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_autosys and md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0141","description":"Scr c/v cyto_autosys and md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGND0","description":"ICD-KGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC126","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pan-tumor)_ genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR)_ whole blood_ reported as a high or low proba","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0332U","description":"Oncology (pan-tumor)_ genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR)_ whole blood_ reported as a high or low proba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit picc insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5520","description":"Hit picc insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQE0","description":"ICD-GDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJF1","description":"ICD-GIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX40","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJB0","description":"ICD-GDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOE0","description":"ICD-OIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hmes or trach valve housing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7505","description":"Hmes or trach valve housing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXA0","description":"ICD-BIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01490","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","description":"CPT-01490","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYD1","description":"ICD-GBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap insert tunnel ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49324","description":"Lap insert tunnel ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIID0","description":"ICD-IIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rheumatology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4032","description":"Rheumatology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGD1","description":"ICD-BHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAE0","description":"ICD-NHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vivaglobin_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1562","description":"Vivaglobin_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31635","description":"Bronchoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUA0","description":"ICD-CAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRE1","description":"ICD-HHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nicotine patch nonlegend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4991","description":"Nicotine patch nonlegend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elbow fair lead cable molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6584","description":"Elbow fair lead cable molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iodine I-131 iobenguane_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9408","description":"Iodine I-131 iobenguane_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACB0","description":"ICD-FACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHB1","description":"ICD-BFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGA0","description":"ICD-CFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFE1","description":"ICD-CFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDA1","description":"ICD-MBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCD1","description":"ICD-ABCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOF1","description":"ICD-OLOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Odontoplasty 1-2 teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9971","description":"Odontoplasty 1-2 teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of cervix radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57531","description":"Removal of cervix radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36483","description":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auricular prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8045","description":"Auricular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTA1","description":"ICD-OGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBF0","description":"ICD-BBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnion bio or Axobiomembrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4211","description":"Amnion bio or Axobiomembrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHC0","description":"ICD-MAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAE0","description":"ICD-ACAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHD1","description":"ICD-BDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEA0","description":"ICD-FAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgraft tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4263","description":"Surgraft tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKF0","description":"ICD-BCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMB1","description":"ICD-OCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ketorolac tromethamine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1885","description":"Ketorolac tromethamine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXD0","description":"ICD-JFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWB0","description":"ICD-HGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0106","description":"HCPCS-A0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYC0","description":"ICD-KEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAA0","description":"ICD-KIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair brake extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0961","description":"Wheelchair brake extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supply/accessory/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9900","description":"Supply/accessory/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBA0","description":"ICD-AGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAC1","description":"ICD-IAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24620","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMF0","description":"ICD-BIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGE0","description":"ICD-OJGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4037","description":"Urology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm transmitter ald","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5288","description":"Ald fm/dm transmitter ald","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAF1","description":"ICD-BEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNE1","description":"ICD-JCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of wrist capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25085","description":"Incision of wrist capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0558","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","description":"HCPCS-G0558","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJD0","description":"ICD-FGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBB1","description":"ICD-NHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHB1","description":"ICD-OGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism intermountain clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1022","description":"Clinical decision support mechanism intermountain clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPC0","description":"ICD-CDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMF0","description":"ICD-IDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBD1","description":"ICD-BFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levonorgestrel implant sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7306","description":"Levonorgestrel implant sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68520","description":"Removal of tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74445","description":"X-ray exam of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4297","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","description":"HCPCS-A4297","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJED0","description":"ICD-MJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14C","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heroin metabolite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80356","description":"Heroin metabolite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 5-10 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99421","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 5-10 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (congenital neutropenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Congenital Neutropenia Panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0271U","description":"Hematology (congenital neutropenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Congenital Neutropenia Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Francisella tularensis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86668","description":"Francisella tularensis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQC1","description":"ICD-KHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9494","description":"Hit antibiotic total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSE0","description":"ICD-HHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANB0","description":"ICD-OANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1402","description":"HCPCS-B1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBF1","description":"ICD-GHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCD1","description":"ICD-JFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKD1","description":"ICD-KFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCED1","description":"ICD-CCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMD1","description":"ICD-KGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Candida dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87480","description":"Candida dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ear cartilage graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21235","description":"Ear cartilage graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWA1","description":"ICD-PKWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDF1","description":"ICD-AGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEC1","description":"ICD-BEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam spinal canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76800","description":"Us exam spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"T cell absolute count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86361","description":"T cell absolute count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal intraop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93318","description":"Echo transesophageal intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (pemrydi rtu)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9324","description":"Injection_ pemetrexed (pemrydi rtu)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVD1","description":"ICD-JHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67107","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 3-4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73522","description":"X-ray exam hips bi 3-4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3D","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Co57 cyano","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9559","description":"Co57 cyano","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXB0","description":"ICD-CBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTA1","description":"ICD-OFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKD1","description":"ICD-GHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67835","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJC1","description":"ICD-CHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28G","description":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rh-immunoglobulin order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8809","description":"Rh-immunoglobulin order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQF0","description":"ICD-GCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKE1","description":"ICD-NDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAC1","description":"ICD-EGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBND1","description":"ICD-CBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC15","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Is Using Palliative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9994","description":"Patient Is Using Palliative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSD0","description":"ICD-PGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92653","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUE1","description":"ICD-JHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAA1","description":"ICD-JBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDD1","description":"ICD-FDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHA1","description":"ICD-JIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAB1","description":"ICD-GFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMD1","description":"ICD-OAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYE0","description":"ICD-PAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28A","description":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSD1","description":"ICD-HGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYA1","description":"ICD-CAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPF1","description":"ICD-OJPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (xembify)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1558","description":"Injection_ immune globulin (xembify)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Provision of COVID-19 test_ nonprescription self-administered and self-collected use_ FDA approved_ authorized or cleared_ one test count","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1034","description":"Provision of COVID-19 test_ nonprescription self-administered and self-collected use_ FDA approved_ authorized or cleared_ one test count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUE0","description":"ICD-OHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICC1","description":"ICD-GICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2151","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","description":"HCPCS-J2151","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MLG-Complete_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4256","description":"MLG-Complete_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision secondary cataract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66820","description":"Incision secondary cataract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACD1","description":"ICD-IACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUE1","description":"ICD-FEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLF1","description":"ICD-IHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sf3B1 (Splicing Factor [3B] Subunit B1) (Eg_ Myelodysplastic Syndrome/Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ A672T_ E622D_ L833F_ R625C_ R625L)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81347","description":"Sf3B1 (Splicing Factor [3B] Subunit B1) (Eg_ Myelodysplastic Syndrome/Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ A672T_ E622D_ L833F_ R625C_ R625L)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEC1","description":"ICD-KEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Beta amyloid_ AB42/40 ratio_ immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific prot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0412U","description":"Beta amyloid_ AB42/40 ratio_ immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific prot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Walker w trunk support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0140","description":"Walker w trunk support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPF0","description":"ICD-KIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDE1","description":"ICD-BCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0649U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0649U","description":"CPT-0649U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fecal bilirubin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82252","description":"Fecal bilirubin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reusable nipple prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8032","description":"Reusable nipple prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pancreatic stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48020","description":"Removal of pancreatic stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc new diag 1st/addl mdd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3093F","description":"Doc new diag 1st/addl mdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14B","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX41","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTD1","description":"ICD-GHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALE1","description":"ICD-IALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ glove_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6521","description":"Gradient compression garment_ glove_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBD0","description":"ICD-ECBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1235","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech volume modulation system_ any type_ including all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1009","description":"Speech volume modulation system_ any type_ including all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETA1","description":"ICD-KETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75741","description":"Artery x-rays lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBC0","description":"ICD-FHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOA1","description":"ICD-GEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOA1","description":"ICD-OKOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy tube collar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7526","description":"Tracheostomy tube collar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63017","description":"Remove spine lamina >2 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bupivicaine_ not otherwise specified_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0665","description":"Injection_ bupivicaine_ not otherwise specified_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMD0","description":"ICD-AEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLF1","description":"ICD-OHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUA1","description":"ICD-EGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVD1","description":"ICD-BHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1022","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1022","description":"HCPCS-E1022","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAB1","description":"ICD-GEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pituitary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61548","description":"Removal of pituitary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFB0","description":"ICD-CHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHF1","description":"ICD-JCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKD1","description":"ICD-NEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; clinical staff under the direction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0822T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; clinical staff under the direction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATD1","description":"ICD-NATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNF1","description":"ICD-CBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUD0","description":"ICD-KDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8815","description":"Doc reas no statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB136","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Segmental pneumatic chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0657","description":"Segmental pneumatic chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPF1","description":"ICD-CGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCF0","description":"ICD-EFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL24","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLB1","description":"ICD-KBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prenatalcare enhanced srv pk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1005","description":"Prenatalcare enhanced srv pk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIF1","description":"ICD-OKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIF1","description":"ICD-BDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orth foot non-stndard size/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3254","description":"Orth foot non-stndard size/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMA1","description":"ICD-NFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of aqueous shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66184","description":"Revision of aqueous shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXB0","description":"ICD-JDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive review of data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88325","description":"Comprehensive review of data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSF1","description":"ICD-PCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUD0","description":"ICD-NHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXB1","description":"ICD-OHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPD0","description":"ICD-FBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJD0","description":"ICD-JIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Couns potent glauc impct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4174F","description":"Couns potent glauc impct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWE0","description":"ICD-CAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESA1","description":"ICD-LESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB101","description":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGE1","description":"ICD-BCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIC0","description":"ICD-NGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ANNUAL ALCOHOL MISUSE SCREENING_ 15 MINUTES","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0442","description":"ANNUAL ALCOHOL MISUSE SCREENING_ 15 MINUTES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIA0","description":"ICD-OFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Agalsidase beta injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0180","description":"Agalsidase beta injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESF0","description":"ICD-CESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3D","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKC1","description":"ICD-KDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home visit mech ventilator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99504","description":"Home visit mech ventilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTE1","description":"ICD-JDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQE0","description":"ICD-HHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDB1","description":"ICD-MKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXF0","description":"ICD-CDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef calorie dense>/=1.5kcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4152","description":"Ef calorie dense>/=1.5kcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKE0","description":"ICD-OCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHB0","description":"ICD-BCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYA0","description":"ICD-CCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27457","description":"Realignment of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKC0","description":"ICD-FAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX02","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1408","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","description":"HCPCS-M1408","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIED1","description":"ICD-MIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRB0","description":"ICD-CCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69705","description":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calcium infusion test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82331","description":"Calcium infusion test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUF1","description":"ICD-MLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44141","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTC0","description":"ICD-KCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0105","description":"HCPCS-B0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITF0","description":"ICD-EITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6068","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJC1","description":"ICD-GIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA146","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc neck les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21555","description":"Exc neck les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGB1","description":"ICD-GAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fem urinary collect dev cup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4327","description":"Fem urinary collect dev cup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder bone part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23130","description":"Remove shoulder bone part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQB1","description":"ICD-CCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22614","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPA0","description":"ICD-FBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whole mitochondrial genome","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81460","description":"Whole mitochondrial genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero & or pyeloscope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52351","description":"Cystouretero & or pyeloscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthroscop rotator cuff repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29827","description":"Arthroscop rotator cuff repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC31","description":"ICD-3KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIE1","description":"ICD-BGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPB1","description":"ICD-GFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of urethra abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53040","description":"Drainage of urethra abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frozen blood prep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86930","description":"Frozen blood prep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home care supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99340","description":"Domicil/r-home care supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOB1","description":"ICD-LCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1429","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","description":"HCPCS-M1429","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18B","description":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMA1","description":"ICD-IBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBD1","description":"ICD-OGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0A","description":"Low Rehab_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2113","description":"Spherocylindr 7.25d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVC0","description":"ICD-OIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pain Management_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 36 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0290U","description":"Pain Management_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 36 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOF1","description":"ICD-CAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES320","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTE0","description":"ICD-KGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJF1","description":"ICD-BGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMB1","description":"ICD-GEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of artery/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35761","description":"Exploration of artery/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNC1","description":"ICD-JFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prefab steel crown primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2934","description":"Prefab steel crown primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRC1","description":"ICD-KDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSB1","description":"ICD-DGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMF0","description":"ICD-KDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of eye water bath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76513","description":"Echo exam of eye water bath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1068T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1068T","description":"CPT-1068T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ ziv-aflibercept_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9400","description":"Inj_ ziv-aflibercept_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83069","description":"Assay of urine hemoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJF0","description":"ICD-GIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTE1","description":"ICD-IDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJD0","description":"ICD-BGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Meningococcal conjugate vaccine_ serogroups A_ C_ W_ Y_ quadrivalent_ tetanus toxoid carrier (MenACWY-TT)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90619","description":"Meningococcal conjugate vaccine_ serogroups A_ C_ W_ Y_ quadrivalent_ tetanus toxoid carrier (MenACWY-TT)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITF0","description":"ICD-JITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1476","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","description":"HCPCS-M1476","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB201","description":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKC1","description":"ICD-KBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repr per/vag pouch dbl proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46712","description":"Repr per/vag pouch dbl proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNE0","description":"ICD-NFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETD0","description":"ICD-EETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMD1","description":"ICD-EHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36810","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sever cranial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64771","description":"Sever cranial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysat sol fld vol > 999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4721","description":"Dialysat sol fld vol > 999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBC1","description":"ICD-MCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXA0","description":"ICD-FIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Calibrator solution/chips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4256","description":"Calibrator solution/chips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKF0","description":"ICD-JHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIE1","description":"ICD-ADIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELA0","description":"ICD-IELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRB0","description":"ICD-HBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMA1","description":"ICD-BGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXA0","description":"ICD-OFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIE1","description":"ICD-CIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKB1","description":"ICD-JBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIE0","description":"ICD-ADIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace vad pump ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33981","description":"Replace vad pump ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dev delay prev dp ch_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2037","description":"Dev delay prev dp ch_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIF0","description":"ICD-EFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of tibiofibular joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27871","description":"Fusion of tibiofibular joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIB1","description":"ICD-NIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11303","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAE1","description":"ICD-BIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASA1","description":"ICD-HASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound char size etc docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2050F","description":"Wound char size etc docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWB0","description":"ICD-GGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0202","description":"HCPCS-C0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Jak2 (Janus Kinase 2) (Eg_ Myeloproliferative Disorder) Targeted Sequence Analysis (Eg_ Exons 12 And 13)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81279","description":"Jak2 (Janus Kinase 2) (Eg_ Myeloproliferative Disorder) Targeted Sequence Analysis (Eg_ Exons 12 And 13)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTC1","description":"ICD-GDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Total hip arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27132","description":"Total hip arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEC0","description":"ICD-JCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDC0","description":"ICD-NDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA16","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOC0","description":"ICD-PBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMD0","description":"ICD-GCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRD0","description":"ICD-LCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKC0","description":"ICD-FIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACC0","description":"ICD-CACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fqhc visit_ estab pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0467","description":"Fqhc visit_ estab pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastroenterology (Barrett esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 DNA methylation analysis using PCR_ formalin-fixed paraffin-embedded (FFPE) tissue_ algorithm reported as risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0398U","description":"Gastroenterology (Barrett esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 DNA methylation analysis using PCR_ formalin-fixed paraffin-embedded (FFPE) tissue_ algorithm reported as risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWD0","description":"ICD-DAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ovulation mgmt per cycle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4042","description":"Ovulation mgmt per cycle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTB1","description":"ICD-NHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablation Pros Tr Hifu Incl I Guid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9747","description":"Ablation Pros Tr Hifu Incl I Guid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMD0","description":"ICD-EBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLE0","description":"ICD-MGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext wear ost skn barr >4sqin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4408","description":"Ext wear ost skn barr >4sqin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQA1","description":"ICD-GIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQB0","description":"ICD-GAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Speed of Care_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1016","description":"Clinical decision support mechanism Speed of Care_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUB1","description":"ICD-FDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bupropion hcl sr 60 tablets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0106","description":"Bupropion hcl sr 60 tablets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVC1","description":"ICD-FBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coll-e-Derm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4193","description":"Coll-e-Derm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Portable liquid oxygen sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0433","description":"Portable liquid oxygen sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACID0","description":"ICD-ACID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vessel injection procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36299","description":"Vessel injection procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELC1","description":"ICD-NELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl soft interface_ helmet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8004","description":"Repl soft interface_ helmet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mobilize erupted/malpos toot","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7282","description":"Mobilize erupted/malpos toot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluoro polarize fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83663","description":"Fluoro polarize fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFE1","description":"ICD-KGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFE1","description":"ICD-ODFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zidovudine_ oral_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0104","description":"Zidovudine_ oral_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43860","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25443","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Beremagene geperpavec-svdt for topical administration_ containing nominal 5 x 10^9 pfu/ml vector genomes_ per 0.1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3401","description":"Beremagene geperpavec-svdt for topical administration_ containing nominal 5 x 10^9 pfu/ml vector genomes_ per 0.1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneum walk boot pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4387","description":"Non-pneum walk boot pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAE1","description":"ICD-OGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCC1","description":"ICD-ECCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81186","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection(S)_ Bone-Substitute Material (Eg_ Calcium Phosphate) Into Subchondral Bone Defect (Ie_ Bone Marrow Lesion_ Bone Bruise_ Stress Injury_ Microtrabecular Fracture)_ Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0707T","description":"Injection(S)_ Bone-Substitute Material (Eg_ Calcium Phosphate) Into Subchondral Bone Defect (Ie_ Bone Marrow Lesion_ Bone Bruise_ Stress Injury_ Microtrabecular Fracture)_ Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD226","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sewhfo airplane w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3978","description":"Sewhfo airplane w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25272","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIE1","description":"ICD-OJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCED0","description":"ICD-KCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCD0","description":"ICD-ADCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLD0","description":"ICD-ADLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64792","description":"Removal of nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ny heart assoc class docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3118F","description":"Ny heart assoc class docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPF0","description":"ICD-NBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay carbamazepine total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80156","description":"Assay carbamazepine total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88029","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEE1","description":"ICD-MFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous breast biopsies using stereotactic guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the biops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7501","description":"Percutaneous breast biopsies using stereotactic guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the biops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVA1","description":"ICD-GGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA120","description":"Clinically Complex _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOD1","description":"ICD-GCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12B","description":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHA1","description":"ICD-CFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWA0","description":"ICD-KBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTA1","description":"ICD-OLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDC0","description":"ICD-KDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMC1","description":"ICD-BBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4341","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","description":"HCPCS-Q4341","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61686","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sgd accessory noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2599","description":"Sgd accessory noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Baclofen intrathecal trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0476","description":"Baclofen intrathecal trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cerv cancer screen docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3015F","description":"Cerv cancer screen docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27156","description":"Revision of hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53502","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETA0","description":"ICD-CETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTB0","description":"ICD-JGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject for spine disk x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62291","description":"Inject for spine disk x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLD0","description":"ICD-NDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genital surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55899","description":"Genital surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYE1","description":"ICD-CGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Sublocade)_ greater than 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9992","description":"Injection_ buprenorphine extended-release (Sublocade)_ greater than 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACF1","description":"ICD-KACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHC0","description":"ICD-NFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy & revise urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52275","description":"Cystoscopy & revise urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE106","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carotid intima atheroma eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93895","description":"Carotid intima atheroma eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNA1","description":"ICD-CHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Car seat/bed test 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94780","description":"Car seat/bed test 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ RNA_ BCR/ABL1 major and minor breakpoint fusion transcripts_ quantitative PCR amplification_ blood or bone marrow_ report of fusion not de","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0016U","description":"Oncology (hematolymphoid neoplasia)_ RNA_ BCR/ABL1 major and minor breakpoint fusion transcripts_ quantitative PCR amplification_ blood or bone marrow_ report of fusion not de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rectal catheter for use with the manual pump-operated enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4453","description":"Rectal catheter for use with the manual pump-operated enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIF1","description":"ICD-EFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTD1","description":"ICD-OBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALF0","description":"ICD-BALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disposable underpads","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4554","description":"Disposable underpads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUD0","description":"ICD-KAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOD0","description":"ICD-DAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thor rib belt custom fabrica","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0220","description":"Thor rib belt custom fabrica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBB1","description":"ICD-MFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBA0","description":"ICD-OEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCF1","description":"ICD-MCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA114","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"PermeaDerm C_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2018","description":"PermeaDerm C_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBF1","description":"ICD-KDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28C","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHA0","description":"ICD-OBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHME0","description":"ICD-EHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDD0","description":"ICD-MGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reoperation bypass graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35700","description":"Reoperation bypass graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adhere pos air press therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8851","description":"Adhere pos air press therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIC0","description":"ICD-MJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40720","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of thyroglobulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84432","description":"Assay of thyroglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1076T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1076T","description":"CPT-1076T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHB0","description":"ICD-BEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vendaje_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4252","description":"Vendaje_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJA0","description":"ICD-GCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMC1","description":"ICD-CDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat spinal canal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62282","description":"Treat spinal canal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vantas implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9225","description":"Vantas implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQA1","description":"ICD-CDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMA0","description":"ICD-MKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDC0","description":"ICD-IFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSC0","description":"ICD-KGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDB0","description":"ICD-NFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytarabine liposome inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9098","description":"Cytarabine liposome inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXA1","description":"ICD-BHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGD0","description":"ICD-CAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone imaging multiple areas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78305","description":"Bone imaging multiple areas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00924","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","description":"CPT-00924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVB1","description":"ICD-GDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQD1","description":"ICD-DHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1902","description":"HCPCS-C1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove part thorax vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22101","description":"Remove part thorax vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHB0","description":"ICD-KHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECC1","description":"ICD-JECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFB1","description":"ICD-NKFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLA1","description":"ICD-EDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abx pres w/in 10 dys of symp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9505","description":"Abx pres w/in 10 dys of symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC250","description":"Reduced Physical Function _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phospholipid pltlt neutraliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85597","description":"Phospholipid pltlt neutraliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ciliary transsleral therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66710","description":"Ciliary transsleral therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAC0","description":"ICD-JEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYA1","description":"ICD-DHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILC1","description":"ICD-AILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/.12-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2303","description":"Lens sphcy trifocal 4.0/.12-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQB1","description":"ICD-HEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB217","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ neck/head_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6566","description":"Gradient compression garment_ neck/head_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHB0","description":"ICD-OFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mltispectrl digital les alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0401T","description":"Mltispectrl digital les alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRD1","description":"ICD-PIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICD1","description":"ICD-NICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8010","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8010","description":"HCPCS-C8010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJC0","description":"ICD-OCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35475","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplant/graft palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26489","description":"Transplant/graft palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKD1","description":"ICD-JFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Receiving >5 Mg Daily Prednisone (Or Equivalent) For Longer Than 6 Months_ And Improvement Or No Change In Disease Activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2113","description":"Patient Receiving >5 Mg Daily Prednisone (Or Equivalent) For Longer Than 6 Months_ And Improvement Or No Change In Disease Activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder over 12.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2114","description":"Spherocylinder over 12.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSB1","description":"ICD-KDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"So 8 abd restraint pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3650","description":"So 8 abd restraint pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXF1","description":"ICD-KFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOD1","description":"ICD-KIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC224","description":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin sub graft face/nk/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15275","description":"Skin sub graft face/nk/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct ulna/radioulnar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25337","description":"Reconstruct ulna/radioulnar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periph field stimul perm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0283T","description":"Periph field stimul perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIB0","description":"ICD-IEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5258","description":"Hearing aid_ digit_ bin_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUE0","description":"ICD-KBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRD0","description":"ICD-KIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31786","description":"Remove windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWB0","description":"ICD-DHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCD1","description":"ICD-EBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA42","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUF1","description":"ICD-AEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMB0","description":"ICD-KEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYB0","description":"ICD-CDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBE0","description":"ICD-AGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHID0","description":"ICD-KHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCB0","description":"ICD-KBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVA1","description":"ICD-FIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orchiectomy partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54522","description":"Orchiectomy partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEE1","description":"ICD-JCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHF1","description":"ICD-NBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4380","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","description":"HCPCS-Q4380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHB1","description":"ICD-KAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMD1","description":"ICD-MKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unsched dialysis esrd pt hos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0257","description":"Unsched dialysis esrd pt hos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSC0","description":"ICD-PJSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Egd us exam duodenum/jejunum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43259","description":"Egd us exam duodenum/jejunum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAME0","description":"ICD-EAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTE0","description":"ICD-EFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alatrofloxacin mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0200","description":"Alatrofloxacin mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEE1","description":"ICD-MCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cerliponase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9014","description":"Injection_ cerliponase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNC1","description":"ICD-JDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJF1","description":"ICD-OIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sales tax","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9985","description":"Sales tax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIME0","description":"ICD-KIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAD0","description":"ICD-BCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bortezomib_ (dr. reddy_s)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9046","description":"Injection_ bortezomib_ (dr. reddy_s)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLE1","description":"ICD-OKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comm psy face-face per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0036","description":"Comm psy face-face per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA246","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADF1","description":"ICD-GADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNC1","description":"ICD-KCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01680","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","description":"CPT-01680","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion during 3-dimensn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0241T","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion during 3-dimensn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destroy nerve face muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64612","description":"Destroy nerve face muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical enc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1350","description":"Patients who had a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical enc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUF0","description":"ICD-NLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBID1","description":"ICD-IBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/12-2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2107","description":"Spherocylinder 4.25d/12-2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Water seal drain container","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7041","description":"Water seal drain container","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tobramycin comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7685","description":"Tobramycin comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHA0","description":"ICD-BEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUA1","description":"ICD-CGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVA0","description":"ICD-ODVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92631","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","description":"CPT-92631","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIID1","description":"ICD-JIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ewhfo rigid w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3765","description":"Ewhfo rigid w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEA0","description":"ICD-CFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal)_ quantitative assessment of three urine metabolites","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0107U","description":"Oncology (colorectal)_ quantitative assessment of three urine metabolites","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professiona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95250","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNA0","description":"ICD-CHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACA0","description":"ICD-NACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 vhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0853","description":"Pwc gp 3 vhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prochlorperazine 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0183","description":"Prochlorperazine 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFC0","description":"ICD-KAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest home_ assi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2014","description":"Limited (30 minutes) care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest home_ assi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25530","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOB1","description":"ICD-PEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23146","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTA0","description":"ICD-GHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLB0","description":"ICD-EDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJA0","description":"ICD-NIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASB0","description":"ICD-OASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plasma volume single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78110","description":"Plasma volume single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4360","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","description":"HCPCS-Q4360","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASD0","description":"ICD-OASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFE0","description":"ICD-OAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of knee 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73560","description":"X-ray exam of knee 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOB1","description":"ICD-DEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4024","description":"Cast sup sht arm splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit sympathomim diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9348","description":"Hit sympathomim diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient receives hcv antibody test with reactive result","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1232","description":"Patient receives hcv antibody test with reactive result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2391","description":"Solid caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFB0","description":"ICD-KCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5135","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","description":"HCPCS-Q5135","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAE1","description":"ICD-OFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMC0","description":"ICD-OGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPD1","description":"ICD-NJPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trichomonas vagin dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87660","description":"Trichomonas vagin dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTA0","description":"ICD-OJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC11","description":"ICD-4EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOB1","description":"ICD-LHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removable soft interface le","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0672","description":"Removable soft interface le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFD1","description":"ICD-BAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ using magnetic-guided arterial and venous catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2171","description":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ using magnetic-guided arterial and venous catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27470","description":"Repair of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMD0","description":"ICD-FBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKID1","description":"ICD-MKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUD1","description":"ICD-OLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gel cap app device for trach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8515","description":"Gel cap app device for trach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth chest wall repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47251","description":"Anesth chest wall repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAA0","description":"ICD-BBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54340","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTC0","description":"ICD-EHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAB0","description":"ICD-KHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAF0","description":"ICD-JAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOC0","description":"ICD-PIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alglucerase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0205","description":"Alglucerase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye glass case","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2756","description":"Eye glass case","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB17","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0670U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0670U","description":"CPT-0670U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE206","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRF0","description":"ICD-GCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic analysis of cochlear implant_ patient younger than 7 years of age; subsequent reprogramming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92602","description":"Diagnostic analysis of cochlear implant_ patient younger than 7 years of age; subsequent reprogramming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB60","description":"Low Rehab_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIE0","description":"ICD-JGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fit spectacles single system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92354","description":"Fit spectacles single system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15D","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCE1","description":"ICD-OLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBD1","description":"ICD-CDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAC1","description":"ICD-GCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAF0","description":"ICD-FBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3-Dimensional Volumetric Imaging And Reconstruction Of Breast Or Axillary Lymph Node Tissue_ Each Excised Specimen_ 3-Dimensional Automatic Specimen Reorientation_ Interpretat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0694T","description":"3-Dimensional Volumetric Imaging And Reconstruction Of Breast Or Axillary Lymph Node Tissue_ Each Excised Specimen_ 3-Dimensional Automatic Specimen Reorientation_ Interpretat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUB0","description":"ICD-KBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGD1","description":"ICD-KBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMC0","description":"ICD-JIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ald unspecified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5274","description":"Ald unspecified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE254","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGD0","description":"ICD-KBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1502","description":"HCPCS-C1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1090","description":"Lumbar sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDE1","description":"ICD-JHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDA1","description":"ICD-NDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Macul result phy/qhp mng dm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5010F","description":"Macul result phy/qhp mng dm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81455","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLA0","description":"ICD-KCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt ref for speech lang path","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4552F","description":"Pt ref for speech lang path","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plaelet rich plasma unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9020","description":"Plaelet rich plasma unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTB1","description":"ICD-OJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anti-mullerian hormone (AMH)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82166","description":"Anti-mullerian hormone (AMH)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTD1","description":"ICD-CFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29200","description":"Strapping of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11442","description":"Exc face-mm b9+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1399","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","description":"HCPCS-M1399","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCE1","description":"ICD-BGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0746T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcath occlusion non-cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61626","description":"Transcath occlusion non-cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0679U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679U","description":"CPT-0679U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20B","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYE0","description":"ICD-GFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUC1","description":"ICD-CIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJF1","description":"ICD-BIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Space maintainer_ fixed_ bilateral_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1516","description":"Space maintainer_ fixed_ bilateral_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28555","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0490T","description":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of middle ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69440","description":"Exploration of middle ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFD0","description":"ICD-KDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sps ankle device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1816","description":"Sps ankle device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc stom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43659","description":"Laparoscope proc stom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anti-inflm/anlgsc otc assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1007F","description":"Anti-inflm/anlgsc otc assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWB1","description":"ICD-KFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACD1","description":"ICD-GACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aqueous shunt prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8612","description":"Aqueous shunt prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUF1","description":"ICD-OFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFE1","description":"ICD-FIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES124","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYD0","description":"ICD-OGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQA1","description":"ICD-OEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNF1","description":"ICD-GFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHA1","description":"ICD-IHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of 17-hydroxypregneno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84143","description":"Assay of 17-hydroxypregneno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISF1","description":"ICD-KISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25C","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVD0","description":"ICD-GIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCC0","description":"ICD-FBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gerd symps assessed 12 month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1118F","description":"Gerd symps assessed 12 month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHD0","description":"ICD-OCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVC0","description":"ICD-FGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHA0","description":"ICD-KCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esoph scope w/submucous inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43201","description":"Esoph scope w/submucous inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUC0","description":"ICD-BGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDE1","description":"ICD-CHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQD0","description":"ICD-PBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Admit w/in 180d req remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9410","description":"Admit w/in 180d req remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35241","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65135","description":"Insert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of hip socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27120","description":"Reconstruction of hip socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC120","description":"Special Care Low _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine bacteria culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87088","description":"Urine bacteria culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXF1","description":"ICD-NAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFF1","description":"ICD-CBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMD1","description":"ICD-CEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRC1","description":"ICD-HFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7562","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7562","description":"HCPCS-C7562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYC0","description":"ICD-PIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Zoledronic acid 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3489","description":"Zoledronic acid 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECC0","description":"ICD-BECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apexification/recalc initial","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3351","description":"Apexification/recalc initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Specimen handling office-lab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99000","description":"Specimen handling office-lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tte w/o doppler complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93307","description":"Tte w/o doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Legg perthes orth newington","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1710","description":"Legg perthes orth newington","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0920T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","description":"CPT-0920T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital observation per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0378","description":"Hospital observation per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFE0","description":"ICD-ODFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49605","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABA1","description":"ICD-NABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abd imag w/o liv/kid/adr les","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9551","description":"Abd imag w/o liv/kid/adr les","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMC1","description":"ICD-IBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHB1","description":"ICD-BIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47612","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWD0","description":"ICD-CEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB31","description":"ICD-4DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long leg plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4029","description":"Cast sup long leg plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJB1","description":"ICD-JDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCE1","description":"ICD-KFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12B","description":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANC0","description":"ICD-CANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1_ 2_ And 3) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81194","description":"Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1_ 2_ And 3) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOC0","description":"ICD-OIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCE0","description":"ICD-MJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96131","description":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCF1","description":"ICD-ABCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIB0","description":"ICD-EAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDA0","description":"ICD-EBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPC1","description":"ICD-NIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBB1","description":"ICD-KFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBA1","description":"ICD-OLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Advnc care plan tlk docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1158F","description":"Advnc care plan tlk docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPB1","description":"ICD-FDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4C","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDD1","description":"ICD-BGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOE1","description":"ICD-LEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vis item/svc in other code","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2797","description":"Vis item/svc in other code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXA0","description":"ICD-BBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPF1","description":"ICD-JGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBF0","description":"ICD-GBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEND0","description":"ICD-JEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction_ technical analysis_ and result","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0477T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction_ technical analysis_ and result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKF0","description":"ICD-GDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Filter_ non disposable w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7039","description":"Filter_ non disposable w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTE0","description":"ICD-NFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl perph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33969","description":"Ecmo/ecls rmvl perph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1086","description":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy dx sep proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58555","description":"Hysteroscopy dx sep proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVE1","description":"ICD-OHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEC0","description":"ICD-JFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBED1","description":"ICD-EBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90484","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","description":"CPT-90484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pneuma/vac walk boot pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4361","description":"Pneuma/vac walk boot pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLC1","description":"ICD-IFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst nbl mtl 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6614","description":"Onlay cst nbl mtl 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral mr contrast_ 100 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9954","description":"Oral mr contrast_ 100 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNE0","description":"ICD-FGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGF0","description":"ICD-JCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUA1","description":"ICD-BHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01634","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","description":"CPT-01634","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc advncd dis cmfrt not 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1153F","description":"Doc advncd dis cmfrt not 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ex h rate for sz ovr 30 day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0385T","description":"Ex h rate for sz ovr 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRB1","description":"ICD-HCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRB0","description":"ICD-GCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIE1","description":"ICD-MDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAF1","description":"ICD-MHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDB1","description":"ICD-ADDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPE0","description":"ICD-NEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDA1","description":"ICD-ODDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRC0","description":"ICD-DGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve teasing preparations","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88362","description":"Nerve teasing preparations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB160","description":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extended steel shank","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2360","description":"Extended steel shank","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMF1","description":"ICD-CDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPD1","description":"ICD-OKPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Membrane wrap-hydro_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4290","description":"Membrane wrap-hydro_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"A/d halfway house_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2034","description":"A/d halfway house_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elective surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9643","description":"Elective surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28X","description":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87590","description":"N.gonorrhoeae dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL01","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPA1","description":"ICD-JCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22B","description":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovaginal Cryogen-Cooled_ Monopolar Radiofrequency Remodeling Of The Tissues Surrounding The Female Bladder Neck And Proximal Urethra For Urinary Incontinence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0672T","description":"Endovaginal Cryogen-Cooled_ Monopolar Radiofrequency Remodeling Of The Tissues Surrounding The Female Bladder Neck And Proximal Urethra For Urinary Incontinence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0771T","description":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Craniectomy_ suboccipital; for mesencephalic tractotomy or pedunculotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61480","description":"Craniectomy_ suboccipital; for mesencephalic tractotomy or pedunculotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRC1","description":"ICD-KIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transition service coordination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7337","description":"Transition service coordination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQF1","description":"ICD-HHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory flow volume loop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94375","description":"Respiratory flow volume loop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPF1","description":"ICD-BBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA145","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab-eqrn (cimerli)_ biosimilar_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5128","description":"Injection_ ranibizumab-eqrn (cimerli)_ biosimilar_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Afluria vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2035","description":"Afluria vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 1 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64490","description":"Inj paravert f jnt c/t 1 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise oral mucosa for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40818","description":"Excise oral mucosa for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKB0","description":"ICD-JAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC25","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITD1","description":"ICD-BITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIE0","description":"ICD-CAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXA0","description":"ICD-GCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of a subcutaneous peritoneal ascites pump_ including reconnection between pump and indwelling bladder and peritoneal catheters_ including initial programming and i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0871T","description":"Replacement of a subcutaneous peritoneal ascites pump_ including reconnection between pump and indwelling bladder and peritoneal catheters_ including initial programming and i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAE0","description":"ICD-ECAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHD0","description":"ICD-OAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise lwr jaw cyst w/repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21047","description":"Excise lwr jaw cyst w/repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB124","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIC0","description":"ICD-OIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDD0","description":"ICD-FCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX51","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRA0","description":"ICD-HGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGC1","description":"ICD-NIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28F","description":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace cvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36580","description":"Replace cvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levorphanol tartrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1960","description":"Levorphanol tartrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDD1","description":"ICD-OKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc supervision palliative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9054","description":"Onc supervision palliative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLF1","description":"ICD-EGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWB0","description":"ICD-HIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPF1","description":"ICD-NCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Air polymer-type A intrauterine foam_ 0.1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9574","description":"Air polymer-type A intrauterine foam_ 0.1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOB1","description":"ICD-KGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0517F","description":"Glaucoma plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOC1","description":"ICD-PAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQA1","description":"ICD-GFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43605","description":"Biopsy of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic Analysis With Complex Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0590T","description":"Electronic Analysis With Complex Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Buttock fasciotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27027","description":"Buttock fasciotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEA1","description":"ICD-NHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDC1","description":"ICD-FCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lifts elevation metal extens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3330","description":"Lifts elevation metal extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWE0","description":"ICD-GAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJE1","description":"ICD-FDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXE0","description":"ICD-CIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ mRNA_ microarray gene expression profiling of 209 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as molecular subtype (lumina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0016M","description":"Oncology (bladder)_ mRNA_ microarray gene expression profiling of 209 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as molecular subtype (lumina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQF1","description":"ICD-OGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of big toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28240","description":"Release of big toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69950","description":"Incise inner ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28G","description":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl garment for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0608","description":"Repl garment for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cidofovir injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0740","description":"Cidofovir injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNF0","description":"ICD-BFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Metabolic panel total ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80048","description":"Metabolic panel total ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Individual_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96159","description":"Health Behavior Intervention_ Individual_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient is not on a statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9797","description":"Patient is not on a statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE220","description":"Special Care High _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKC0","description":"ICD-GFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB11","description":"ICD-2FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine_ thoracolumbar_ standing (scoliosis)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72069","description":"Radiologic examination_ spine_ thoracolumbar_ standing (scoliosis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diabetes prev standard curr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0403T","description":"Diabetes prev standard curr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61850","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRA1","description":"ICD-OFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla class i high defin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86832","description":"Hla class i high defin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chloroprocaine hcl ophthalmic_ 3% gel_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2403","description":"Chloroprocaine hcl ophthalmic_ 3% gel_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDD1","description":"ICD-MGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1352","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14C","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOC1","description":"ICD-PCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1704","description":"HCPCS-A1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18B","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2182","description":"Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc ext at dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9069","description":"Onc dx sclc/nsclc ext at dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7528","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA SHIGA-LIKE TOXIN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87427","description":"IAAD IA SHIGA-LIKE TOXIN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0C","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung perf&ventilat diferentl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78598","description":"Lung perf&ventilat diferentl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSE0","description":"ICD-OGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace molded calf lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4050","description":"Replace molded calf lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESF1","description":"ICD-PESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJD1","description":"ICD-OJJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUE1","description":"ICD-EAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMB1","description":"ICD-AGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPD1","description":"ICD-GBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain image w/flow 4 + views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78606","description":"Brain image w/flow 4 + views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUA1","description":"ICD-NFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Memory goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9169","description":"Memory goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIF1","description":"ICD-ABIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJE0","description":"ICD-NFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUE1","description":"ICD-FFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intercep dental tx transitn","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8060","description":"Intercep dental tx transitn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mold sckt ext knee shin sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5150","description":"Mold sckt ext knee shin sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHB1","description":"ICD-IBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDC0","description":"ICD-KEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFF0","description":"ICD-NJFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagectomy_ total or near total_ with thoracoscopic mobilization of the upper_ middle_ and lower mediastinal esophagus_ with separate laparoscopic proximal gastrectomy_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43288","description":"Esophagectomy_ total or near total_ with thoracoscopic mobilization of the upper_ middle_ and lower mediastinal esophagus_ with separate laparoscopic proximal gastrectomy_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcath occlusion cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61624","description":"Transcath occlusion cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29898","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5151","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","description":"HCPCS-Q5151","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBD0","description":"ICD-MBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bp not performed/doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8478","description":"Bp not performed/doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28C","description":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWF0","description":"ICD-GEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSF0","description":"ICD-PFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Disease progn ra good docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3476F","description":"Disease progn ra good docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETE0","description":"ICD-NETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHB1","description":"ICD-IEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraut copper contraceptive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7300","description":"Intraut copper contraceptive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIB0","description":"ICD-JFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiography neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70548","description":"Mr angiography neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2004","description":"HCPCS-B2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Growth hormone antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86277","description":"Growth hormone antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE120","description":"Special Care Low _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQE0","description":"ICD-DHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOC0","description":"ICD-LIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECB0","description":"ICD-AECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGC0","description":"ICD-KDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL03","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKF0","description":"ICD-OFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28I","description":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Necropsy (autopsy) procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88099","description":"Necropsy (autopsy) procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFF0","description":"ICD-NHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBB1","description":"ICD-IEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Single vitamin nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9152","description":"Single vitamin nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWD1","description":"ICD-PDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHC1","description":"ICD-NHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGD1","description":"ICD-GEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOF0","description":"ICD-HEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWC1","description":"ICD-HIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUF1","description":"ICD-GFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTA1","description":"ICD-GDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27705","description":"Incision of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bupren/nal over 10mg bupreno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0575","description":"Bupren/nal over 10mg bupreno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIED0","description":"ICD-FIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINA1","description":"ICD-OINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLB0","description":"ICD-OKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18C","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA21","description":"ICD-4IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osteopath manj 9-10 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98929","description":"Osteopath manj 9-10 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33820","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLD0","description":"ICD-MJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANB1","description":"ICD-JANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIF1","description":"ICD-CHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine quadrivalent (IIV4)_ inactivated_ adjuvanted_ preservative free_ 0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90689","description":"Influenza virus vaccine quadrivalent (IIV4)_ inactivated_ adjuvanted_ preservative free_ 0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE205","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Osseous surgl-3teethperquad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4261","description":"Osseous surgl-3teethperquad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKC1","description":"ICD-KAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL60","description":"High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive sternum surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21632","description":"Extensive sternum surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth procedures on eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14051","description":"Anesth procedures on eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUD1","description":"ICD-NCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPD1","description":"ICD-KFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct injured chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32820","description":"Reconstruct injured chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc tb scrng-rslts interpd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3510F","description":"Doc tb scrng-rslts interpd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chiropract manj 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98940","description":"Chiropract manj 1-2 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNB1","description":"ICD-CFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHB0","description":"ICD-EFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4372","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","description":"HCPCS-Q4372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGME1","description":"ICD-AGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFA0","description":"ICD-KHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Above elbow switch control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6950","description":"Above elbow switch control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18E","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOF1","description":"ICD-OCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISF1","description":"ICD-DISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Im admin each addl component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90461","description":"Im admin each addl component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28G","description":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRF1","description":"ICD-KCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNA0","description":"ICD-NJNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23D","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHA1","description":"ICD-MJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB114","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBE1","description":"ICD-OGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCC0","description":"ICD-OBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Conform band n/s w>=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6444","description":"Conform band n/s w>=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-programble infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0782","description":"Non-programble infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHB0","description":"ICD-NFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHB1","description":"ICD-GFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSD1","description":"ICD-OCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIE1","description":"ICD-FAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHC0","description":"ICD-BFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNE1","description":"ICD-NGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2980","description":"Crown repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKA1","description":"ICD-GBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Convert nephrostomy catheter to nephroureteral catheter_ percutaneous via pre-existing nephrostomy tract_ with ureteral stricture balloon dialation_ including diagnostic nephr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7547","description":"Convert nephrostomy catheter to nephroureteral catheter_ percutaneous via pre-existing nephrostomy tract_ with ureteral stricture balloon dialation_ including diagnostic nephr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFE1","description":"ICD-FHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINA0","description":"ICD-GINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47741","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIE0","description":"ICD-MHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYC0","description":"ICD-CBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICA1","description":"ICD-GICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36260","description":"Insertion of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSA0","description":"ICD-PHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICC0","description":"ICD-NICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKD1","description":"ICD-FAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALF0","description":"ICD-GALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg >16<=48 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6255","description":"Absorpt drg >16<=48 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2D","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Space maintainer_ fixed_ bilateral_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1517","description":"Space maintainer_ fixed_ bilateral_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDA1","description":"ICD-FEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acupunct w/stimul 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97813","description":"Acupunct w/stimul 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interdental fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21110","description":"Interdental fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYD1","description":"ICD-GDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVF0","description":"ICD-CGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human papilloma virus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 45_ 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0354U","description":"Human papilloma virus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 45_ 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal mucosal integrity testing by electrical impedance_ transoral (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9777","description":"Esophageal mucosal integrity testing by electrical impedance_ transoral (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMA1","description":"ICD-EFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tmj meniscectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7850","description":"Tmj meniscectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Leukocyte histamine release","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86343","description":"Leukocyte histamine release","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVD1","description":"ICD-JEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCD0","description":"ICD-MBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXA0","description":"ICD-NFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47135","description":"Transplantation of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of CHA2DS2-VASc risk score of 0 or 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9931","description":"Documentation of CHA2DS2-VASc risk score of 0 or 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYD1","description":"ICD-PLYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70310","description":"X-ray exam of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTA0","description":"ICD-JBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYD0","description":"ICD-PDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXC1","description":"ICD-KHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scalp cooling_ mechanical; initial measurement and calibration of cap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0662T","description":"Scalp cooling_ mechanical; initial measurement and calibration of cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKA1","description":"ICD-JEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11644","description":"Exc f/e/e/n/l mal+mrg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESE0","description":"ICD-CESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTA1","description":"ICD-KDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUE1","description":"ICD-GGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYF1","description":"ICD-HHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caries susceptibility test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0425","description":"Caries susceptibility test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheeled cart_ port cyl/conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1354","description":"Wheeled cart_ port cyl/conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABE0","description":"ICD-AABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentures adjust part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5421","description":"Dentures adjust part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Whole body photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96904","description":"Whole body photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEA0","description":"ICD-JBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHB1","description":"ICD-MAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJA1","description":"ICD-OFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Daptomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0878","description":"Daptomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ moxetumomab pasudotox-tdfx_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9045","description":"Injection_ moxetumomab pasudotox-tdfx_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXF1","description":"ICD-OHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHD1","description":"ICD-NCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBA1","description":"ICD-ECBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDA0","description":"ICD-MLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA33","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abd imag and followup no rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9550","description":"Abd imag and followup no rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNE0","description":"ICD-GFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBD1","description":"ICD-ADBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Congo red blood test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2029","description":"Congo red blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA160","description":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAF1","description":"ICD-BAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on external_ middle_ and inner ear including biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0117U","description":"Anesthesia for procedures on external_ middle_ and inner ear including biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBD0","description":"ICD-JIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXE1","description":"ICD-NEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPC1","description":"ICD-NGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCA0","description":"ICD-NHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vein byp pop-tibl peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35587","description":"Vein byp pop-tibl peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1487","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","description":"HCPCS-M1487","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDE1","description":"ICD-ODDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPB1","description":"ICD-JGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALB0","description":"ICD-NALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service_ 16-30 minutes time Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0311","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service_ 16-30 minutes time Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUE1","description":"ICD-FDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDB0","description":"ICD-KGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert pleural cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32550","description":"Insert pleural cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular prosthesis interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5923","description":"Ocular prosthesis interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCE0","description":"ICD-JGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95724","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHD1","description":"ICD-CEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPF0","description":"ICD-CAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Busulfan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0594","description":"Busulfan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPA1","description":"ICD-OCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth head/neck/ptrunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30051","description":"Anesth head/neck/ptrunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJF1","description":"ICD-OJJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gene test niemann-pick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3849","description":"Gene test niemann-pick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSE0","description":"ICD-KGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1109","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ACApatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4325","description":"ACApatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYC1","description":"ICD-LCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Other specified case mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9012","description":"Other specified case mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJF1","description":"ICD-FIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA17","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"West nile virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86789","description":"West nile virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67924","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject congenital card cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93563","description":"Inject congenital card cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAF0","description":"ICD-NHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spirom doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3023F","description":"Spirom doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMF0","description":"ICD-FBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGE1","description":"ICD-KIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15B","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Procedure-Related Bp_S Not Taken During An Outpatient Visit. Examples Include Same Day Surgery_ Ambulatory Service Center_ G.I. Lab_ Dialysis_ Infusion Center_ Chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2129","description":"Procedure-Related Bp_S Not Taken During An Outpatient Visit. Examples Include Same Day Surgery_ Ambulatory Service Center_ G.I. Lab_ Dialysis_ Infusion Center_ Chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDB0","description":"ICD-NLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assessment Of Salivary Flow By Measurement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0419","description":"Assessment Of Salivary Flow By Measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADC0","description":"ICD-MADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXC1","description":"ICD-JBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9808","description":"HCPCS-C9808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRC1","description":"ICD-CDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRE0","description":"ICD-HDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4350","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","description":"HCPCS-Q4350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVB0","description":"ICD-NAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGF0","description":"ICD-CFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIB1","description":"ICD-EHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay metl 4/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2544","description":"Dental onlay metl 4/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5148","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","description":"HCPCS-Q5148","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Idet 1 or more levels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22527","description":"Idet 1 or more levels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAF1","description":"ICD-IEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIB0","description":"ICD-JEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10D","description":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caloric vstblr test w/rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92537","description":"Caloric vstblr test w/rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWC1","description":"ICD-HAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD156","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99335","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skilled services of a registered nurse (RN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requires skil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0493","description":"Skilled services of a registered nurse (RN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requires skil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCE0","description":"ICD-BBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADE0","description":"ICD-JADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo_ colon_ retro imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1749","description":"Endo_ colon_ retro imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFC0","description":"ICD-OCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unspecified oral anti-emetic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0181","description":"Unspecified oral anti-emetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIC0","description":"ICD-FEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRA1","description":"ICD-PCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oropharyngeal suction catheter_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4628","description":"Oropharyngeal suction catheter_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVD1","description":"ICD-BDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWE1","description":"ICD-OAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGD1","description":"ICD-FGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLB0","description":"ICD-AFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIC1","description":"ICD-KDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Large size footplate each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0041","description":"Large size footplate each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01939","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","description":"CPT-01939","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of wrist bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25215","description":"Removal of wrist bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Molded socket shin sach foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5100","description":"Molded socket shin sach foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNA1","description":"ICD-OCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair degenerated kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27418","description":"Repair degenerated kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICD0","description":"ICD-OICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMC1","description":"ICD-MCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/>6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2310","description":"Lens sphc trifocal 4.25-7/>6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99401","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWB0","description":"ICD-GHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVD0","description":"ICD-NIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intrafraction track motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6017","description":"Intrafraction track motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fqhc visit new patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0466","description":"Fqhc visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Furnsh initial orthosis only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1200","description":"Furnsh initial orthosis only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1176","description":"Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIF1","description":"ICD-GAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMF1","description":"ICD-JIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Band stabilization - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2976","description":"Band stabilization - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of intracatheter or catheter into renal pelvis for drainag and/or injection_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50392","description":"Introduction of intracatheter or catheter into renal pelvis for drainag and/or injection_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estrogens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82671","description":"Assay of estrogens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01933","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","description":"CPT-01933","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEB1","description":"ICD-OKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPD0","description":"ICD-FDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYA0","description":"ICD-OCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65110","description":"Removal of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0555","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","description":"HCPCS-G0555","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJB1","description":"ICD-KHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enterectomy live donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44133","description":"Enterectomy live donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFD1","description":"ICD-CAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGC1","description":"ICD-GAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIB1","description":"ICD-KFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mastoidectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69501","description":"Mastoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ruptured tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24342","description":"Repair of ruptured tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5D","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLF1","description":"ICD-CBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDC0","description":"ICD-FBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injecte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1322","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injecte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1078","description":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVB1","description":"ICD-JGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2C","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N-et; encounter/trip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2003","description":"N-et; encounter/trip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFC1","description":"ICD-OEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo dbl solid stirrup w/o j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2030","description":"Kafo dbl solid stirrup w/o j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEB0","description":"ICD-NJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRF0","description":"ICD-PLRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADB1","description":"ICD-FADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2197","description":"Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWF1","description":"ICD-OLWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTE1","description":"ICD-OKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGC1","description":"ICD-GEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMC0","description":"ICD-FAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEF1","description":"ICD-KFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA11","description":"ICD-3GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALE0","description":"ICD-FALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vascular surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37799","description":"Vascular surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATF1","description":"ICD-CATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQA0","description":"ICD-KDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33130","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIC1","description":"ICD-AIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJD0","description":"ICD-NEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKC1","description":"ICD-FBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Artificial larynx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8500","description":"Artificial larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply hand/wrist cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29085","description":"Apply hand/wrist cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYC1","description":"ICD-GCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24362","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74410","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJA0","description":"ICD-FFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB212","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOE1","description":"ICD-PKOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (brixadi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0576","description":"Injection_ buprenorphine extended-release (brixadi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing loss dup/del analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81431","description":"Hearing loss dup/del analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sutimlimab-jome_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1302","description":"Injection_ sutimlimab-jome_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX12","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALC1","description":"ICD-BALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plast socket jts/thgh lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5105","description":"Plast socket jts/thgh lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of total thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84436","description":"Assay of total thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung bx plug w/del sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2613","description":"Lung bx plug w/del sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explr/decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67414","description":"Explr/decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clear outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69200","description":"Clear outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGF0","description":"ICD-BDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRC1","description":"ICD-KHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Safety equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0700","description":"Safety equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0633U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0633U","description":"CPT-0633U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLB1","description":"ICD-AGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPF0","description":"ICD-NEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAE1","description":"ICD-BDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHND0","description":"ICD-FHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKD1","description":"ICD-JEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech evaluation complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70371","description":"Speech evaluation complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEA0","description":"ICD-NFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAD0","description":"ICD-KHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCC1","description":"ICD-BGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81464","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29805","description":"Shoulder arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWD0","description":"ICD-PIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28I","description":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted preventive service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99429","description":"Unlisted preventive service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-70471","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","description":"CPT-70471","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDF1","description":"ICD-CEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTA0","description":"ICD-MFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOE1","description":"ICD-GAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj hypogas plxs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64517","description":"N block inj hypogas plxs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fungus nes antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86671","description":"Fungus nes antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHA1","description":"ICD-MGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESB1","description":"ICD-LESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exposure impact tooth orthod","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7280","description":"Exposure impact tooth orthod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICF0","description":"ICD-JICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of biceps tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24340","description":"Repair of biceps tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVC1","description":"ICD-NAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMD1","description":"ICD-JIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACA0","description":"ICD-MACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMA0","description":"ICD-BIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHB0","description":"ICD-JHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Micro w exam of surg margins","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0474","description":"Micro w exam of surg margins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMA0","description":"ICD-KGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPA0","description":"ICD-BAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGE1","description":"ICD-NBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDF1","description":"ICD-NEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKF0","description":"ICD-CAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCF0","description":"ICD-NFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE240","description":"Reduced Physical Function _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGE0","description":"ICD-CBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQA1","description":"ICD-OHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shrinker upper limb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8465","description":"Shrinker upper limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53270","description":"Removal of urethra gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic salivary reflex s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0755","description":"Electronic salivary reflex s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEB0","description":"ICD-GBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aor/carot/innom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35526","description":"Art byp grft aor/carot/innom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISF0","description":"ICD-DISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGF1","description":"ICD-NAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain canal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61050","description":"Remove brain canal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA115","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELA0","description":"ICD-JELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Myomectomy abdom method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58140","description":"Myomectomy abdom method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATE1","description":"ICD-AATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug/substance nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80376","description":"Drug/substance nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYA1","description":"ICD-KDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEA0","description":"ICD-KGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBB1","description":"ICD-OBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDB0","description":"ICD-BFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA141","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy with ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44401","description":"Colonoscopy with ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11642","description":"Exc f/e/e/n/l mal+mrg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRA1","description":"ICD-CGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHD0","description":"ICD-ACHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMB0","description":"ICD-FBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQC1","description":"ICD-KAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRD1","description":"ICD-CDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Guided tissue regeneration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3432","description":"Guided tissue regeneration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional_ per calendar month. (list separately in additio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3003","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional_ per calendar month. (list separately in additio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22B","description":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKB0","description":"ICD-OEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CO GNOTYP AQP1 EXON 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0181U","description":"CO GNOTYP AQP1 EXON 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bupivacaine_ Collagen-Matrix Implant_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9089","description":"Bupivacaine_ Collagen-Matrix Implant_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPB1","description":"ICD-FCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRE1","description":"ICD-DGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Car seat/bed test + 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94781","description":"Car seat/bed test + 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABE0","description":"ICD-FABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAA1","description":"ICD-FHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDA0","description":"ICD-EEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90838","description":"Psytx pt&/fam w/e&m 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXF0","description":"ICD-BDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Organic acids total quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83918","description":"Organic acids total quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pegaptanib sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2503","description":"Pegaptanib sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWB0","description":"ICD-LHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0959T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","description":"CPT-0959T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUE0","description":"ICD-JHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJE1","description":"ICD-FBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSD1","description":"ICD-GFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted maaa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81599","description":"Unlisted maaa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA154","description":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp add on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99150","description":"Mod sed diff phys/qhp add on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMA0","description":"ICD-CDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC11","description":"ICD-3GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2002","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2002","description":"CDT-D2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA234","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58285","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50727","description":"Revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ferric derisomaltose_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1437","description":"Injection_ ferric derisomaltose_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEB1","description":"ICD-EHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHA1","description":"ICD-OAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAA0","description":"ICD-GCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2374","description":"HCPCS-J2374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBC0","description":"ICD-GHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCE0","description":"ICD-KBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRE1","description":"ICD-OHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant radiation dosimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4650","description":"Implant radiation dosimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIA0","description":"ICD-NDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plmt nephrostomy catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50432","description":"Plmt nephrostomy catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25D","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Addition to lower extremity prosthesis_ endoskeletal_ knee disarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5926","description":"Addition to lower extremity prosthesis_ endoskeletal_ knee disarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUC1","description":"ICD-EDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASC0","description":"ICD-CASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUC0","description":"ICD-ICUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEE1","description":"ICD-NDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact layer >16<= 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6207","description":"Contact layer >16<= 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCE1","description":"ICD-IDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA03","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Torsion mechanism wrist/elbo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3891","description":"Torsion mechanism wrist/elbo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0519","description":"Management of new patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOF0","description":"ICD-LAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27892","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Voriconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80285","description":"Voriconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAC0","description":"ICD-EFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis one evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90935","description":"Hemodialysis one evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73070","description":"X-ray exam of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLF0","description":"ICD-MJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44238","description":"Laparoscope proc intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEC1","description":"ICD-GEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest wall manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94667","description":"Chest wall manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99190","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVA1","description":"ICD-CDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27881","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88373","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mouth surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40899","description":"Mouth surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSB1","description":"ICD-DHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQD0","description":"ICD-LCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDC0","description":"ICD-JHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Av fistula revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36833","description":"Av fistula revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special med equip_ noswaiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2029","description":"Special med equip_ noswaiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKF0","description":"ICD-BBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEE0","description":"ICD-ABEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIC0","description":"ICD-GFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERE1","description":"ICD-LERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/drug abuse svc nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0047","description":"Alcohol/drug abuse svc nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTE0","description":"ICD-FGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tongue suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41512","description":"Tongue suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m sestamibi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9500","description":"Tc99m sestamibi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPB1","description":"ICD-BBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOD0","description":"ICD-HIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC154","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX34","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ methylprednisolone acetate_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1010","description":"Injection_ methylprednisolone acetate_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGB0","description":"ICD-FAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21A","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFC1","description":"ICD-OLFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change nephroureteral cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50387","description":"Change nephroureteral cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIA0","description":"ICD-MKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB07","description":"High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray female genital tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74740","description":"X-ray female genital tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nipple exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19110","description":"Nipple exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHF1","description":"ICD-AFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjustable chair for esrd pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1570","description":"Adjustable chair for esrd pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRA1","description":"ICD-OHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQB0","description":"ICD-KBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKB1","description":"ICD-NIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEB0","description":"ICD-IHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Weekly Bundle Not Including The Drug_ Including Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Testing If Performed (Pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2074","description":"Medication Assisted Treatment_ Weekly Bundle Not Including The Drug_ Including Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Testing If Performed (Pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRC1","description":"ICD-GIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63005","description":"Remove spine lamina 1/2 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVE0","description":"ICD-CIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTE0","description":"ICD-OCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens trifocal speciality","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2399","description":"Lens trifocal speciality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYF1","description":"ICD-LCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endocrine surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60699","description":"Endocrine surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70380","description":"X-ray exam of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0935T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","description":"CPT-0935T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antithrombin iii injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7197","description":"Antithrombin iii injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDF0","description":"ICD-ICDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx pancreatic unknwn nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9108","description":"Onc dx pancreatic unknwn nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7566","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7566","description":"HCPCS-C7566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWC1","description":"ICD-DIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHE1","description":"ICD-EBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECB0","description":"ICD-OECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAA0","description":"ICD-ACAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBF1","description":"ICD-FIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ ha_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2635","description":"Brachytx_ non-str_ ha_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","description":"HCPCS-J3403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ first 30 minutes in a month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2214","description":"Initial or subsequent psychiatric collaborative care management_ first 30 minutes in a month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEME1","description":"ICD-BEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13D","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGF0","description":"ICD-FFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJB0","description":"ICD-OJJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPB0","description":"ICD-OFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve repair; with nerve allograft_ each additional strand (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64913","description":"Nerve repair; with nerve allograft_ each additional strand (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOE0","description":"ICD-CFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTF0","description":"ICD-KFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1459","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","description":"HCPCS-M1459","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDB0","description":"ICD-CIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Photosensitivity tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95056","description":"Photosensitivity tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMA0","description":"ICD-NHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOE0","description":"ICD-DDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASC1","description":"ICD-HASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLA0","description":"ICD-JBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Temperature gradient studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93740","description":"Temperature gradient studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95146","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of prostaglandin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84150","description":"Assay of prostaglandin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd pneum dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87486","description":"Chylmd pneum dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQE1","description":"ICD-CIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB211","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIA0","description":"ICD-OBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration Not Followed By Surgical Repair_ Artery; Lower Extremity (Eg_ Common Femoral_ Deep Femoral_ Superficial Femoral_ Popliteal_ Tibial_ Peroneal)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35703","description":"Exploration Not Followed By Surgical Repair_ Artery; Lower Extremity (Eg_ Common Femoral_ Deep Femoral_ Superficial Femoral_ Popliteal_ Tibial_ Peroneal)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUB1","description":"ICD-JCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAC0","description":"ICD-MDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1014T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","description":"CPT-1014T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESF1","description":"ICD-GESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transpl allograft pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48554","description":"Transpl allograft pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Woundfix_ BioWound_ Woundfix Plus_ BioWound Plus_ Woundfix Xplus or BioWound Xplus_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4217","description":"Woundfix_ BioWound_ Woundfix Plus_ BioWound Plus_ Woundfix Xplus or BioWound Xplus_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryotherapy of skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17340","description":"Cryotherapy of skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens gas permeable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2531","description":"Contact lens gas permeable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syphilis test non-trep qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86592","description":"Syphilis test non-trep qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31050","description":"Exploration sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMF0","description":"ICD-NBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9463","description":"Injection_ aprepitant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBID1","description":"ICD-OBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMB0","description":"ICD-KHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37200","description":"Transcatheter biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJA1","description":"ICD-OIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flurazepam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6051","description":"Flurazepam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES336","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCF0","description":"ICD-BDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Forearm/arm cuffs free motio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3720","description":"Forearm/arm cuffs free motio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strep a dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87652","description":"Strep a dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHF1","description":"ICD-OGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0607","description":"Repl batt for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCF1","description":"ICD-AFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23929","description":"Shoulder surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE236","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bortezomib_ not otherwise specified_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9044","description":"Injection_ bortezomib_ not otherwise specified_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73600","description":"X-ray exam of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCB1","description":"ICD-KDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEB0","description":"ICD-EAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42335","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0949T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","description":"CPT-0949T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBC0","description":"ICD-MHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tactile breast img uni/bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0422T","description":"Tactile breast img uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAC0","description":"ICD-IDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYC0","description":"ICD-GCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC250","description":"Special Care Low _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINA0","description":"ICD-BINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20D","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27558","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"N block inj axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64417","description":"N block inj axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36625","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28B","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJA0","description":"ICD-BBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFB0","description":"ICD-JFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNA0","description":"ICD-OFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJE0","description":"ICD-JFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIC1","description":"ICD-OAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDD0","description":"ICD-NGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sps wrist device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1806","description":"Sps wrist device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace denture teeth complt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5520","description":"Replace denture teeth complt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB21","description":"ICD-2LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystometrogram w/up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51727","description":"Cystometrogram w/up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lyme dis dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87475","description":"Lyme dis dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELB1","description":"ICD-CELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKA0","description":"ICD-OKKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Financial management_ self-directed_ waiver; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2050","description":"Financial management_ self-directed_ waiver; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHB0","description":"ICD-GGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vascular biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75970","description":"Vascular biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAA0","description":"ICD-MBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change g-tube to g-j perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49446","description":"Change g-tube to g-j perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hfo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3913","description":"Hfo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56152","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AstraZeneca COVID-19 vaccine administration — second dose","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1706","description":"AstraZeneca COVID-19 vaccine administration — second dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial release of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32225","description":"Partial release of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28E","description":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eribulin mesylate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9179","description":"Eribulin mesylate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of end stage renal disease (esrd)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1187","description":"Patients with a diagnosis of end stage renal disease (esrd)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33927","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr e/n/e/l 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14060","description":"Tis trnfr e/n/e/l 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Administration Of Chemotherapy Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0618","description":"Hospital Special Treatment Room Support Component (Hstrsc) Administration Of Chemotherapy Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYC1","description":"ICD-PDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5252","description":"Hearing aid_ prog_ bin_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRD1","description":"ICD-PBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEA1","description":"ICD-JFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTB1","description":"ICD-OCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compre dental tx adolescent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8080","description":"Compre dental tx adolescent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vbac delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59610","description":"Vbac delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lvonorgestrl-Rls Iu Coc Sys 19.5 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9984","description":"Lvonorgestrl-Rls Iu Coc Sys 19.5 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGD1","description":"ICD-FEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVD0","description":"ICD-NJVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBE1","description":"ICD-IFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA155","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair mouth/nose fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30600","description":"Repair mouth/nose fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAA1","description":"ICD-FIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABD0","description":"ICD-IABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQF1","description":"ICD-PAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of abdomen artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37617","description":"Ligation of abdomen artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEF1","description":"ICD-GBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC31","description":"ICD-1DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 100 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0148U","description":"Drug assay_ definitive_ 100 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ustekinumab Intravenous Inj 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9989","description":"Ustekinumab Intravenous Inj 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3A","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPD1","description":"ICD-NIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOA1","description":"ICD-OHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54220","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNC0","description":"ICD-NJNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYA0","description":"ICD-OKYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytomeg dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87497","description":"Cytomeg dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sewho airplan desig abdu pos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3960","description":"Sewho airplan desig abdu pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis via catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4054F","description":"Hemodialysis via catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYC0","description":"ICD-PLYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMB0","description":"ICD-NJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEC0","description":"ICD-CGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8H","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTE0","description":"ICD-GGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTE1","description":"ICD-MDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQD0","description":"ICD-HEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24410","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evasc prlng admn rx agnt add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61651","description":"Evasc prlng admn rx agnt add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIID1","description":"ICD-AIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX31","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSB1","description":"ICD-PJSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test panel pricing code_ 22+ tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP22","description":"Auto.test panel pricing code_ 22+ tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0044U","description":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC213","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special teletx port plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77321","description":"Special teletx port plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXB0","description":"ICD-JFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bl donor search management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38204","description":"Bl donor search management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dihydrotestosterone (DHT)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82642","description":"Dihydrotestosterone (DHT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC111","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther fostercare child /month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5146","description":"Ther fostercare child /month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8A","description":"Medium Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWD1","description":"ICD-LCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0586U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","description":"CPT-0586U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj milrinone lactate / 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2260","description":"Inj milrinone lactate / 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31257","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of knees","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73565","description":"X-ray exam of knees","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15C","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHB1","description":"ICD-EEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXB0","description":"ICD-BFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAB1","description":"ICD-OEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQD0","description":"ICD-DIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24576","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1_ Cripto-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0163U","description":"Oncology (colorectal) screening_ biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1_ Cripto-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CT scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9348","description":"CT scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAD1","description":"ICD-MGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2036","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","description":"HCPCS-A2036","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMD1","description":"ICD-KBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBID1","description":"ICD-JBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB21","description":"ICD-4FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPA1","description":"ICD-NDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPE1","description":"ICD-BBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKA0","description":"ICD-BGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCV2 3MCG TRS-SUCR 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0081A","description":"ADM SARSCV2 3MCG TRS-SUCR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGED1","description":"ICD-MGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTF1","description":"ICD-BFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCED1","description":"ICD-MCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOC1","description":"ICD-PKOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lung extrapleural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32445","description":"Removal of lung extrapleural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISB0","description":"ICD-CISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 35","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0408","description":"Inpt/tele follow up 35","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Periodontal medicament carrier with peripheral seal - laboratory processed - mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5996","description":"Periodontal medicament carrier with peripheral seal - laboratory processed - mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDA1","description":"ICD-EDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHF1","description":"ICD-IEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt recvd no inhal anesthic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4555F","description":"Pt recvd no inhal anesthic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cerliponase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0567","description":"Injection_ cerliponase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTC0","description":"ICD-NJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHE0","description":"ICD-NGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXB1","description":"ICD-JHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIB1","description":"ICD-NAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef special metabolic inherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4157","description":"Ef special metabolic inherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87280","description":"Respiratory syncytial ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0940T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","description":"CPT-0940T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair no. 2 footplates","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0970","description":"Wheelchair no. 2 footplates","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJE1","description":"ICD-NIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUE1","description":"ICD-FHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open tx nose fx uncomplicatd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21325","description":"Open tx nose fx uncomplicatd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA21","description":"ICD-3LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9874","description":"Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPD0","description":"ICD-FEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8F","description":"High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJE0","description":"ICD-OHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC11","description":"ICD-1HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLF0","description":"ICD-BDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHC1","description":"ICD-OKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYB1","description":"ICD-DAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA46","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES310","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cntct toric prism ballast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2511","description":"Cntct toric prism ballast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4D","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMD0","description":"ICD-EDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOD0","description":"ICD-PKOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUB0","description":"ICD-NIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAF1","description":"ICD-MDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFE1","description":"ICD-BAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pros sock single ply ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8480","description":"Pros sock single ply ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair major blood vessel(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33322","description":"Repair major blood vessel(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUF0","description":"ICD-GFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABC0","description":"ICD-FABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc mntl tst b/4 bk trxmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2044F","description":"Doc mntl tst b/4 bk trxmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0C","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALF1","description":"ICD-BALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIE1","description":"ICD-MCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINA0","description":"ICD-FINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRF0","description":"ICD-PCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Job Coaching 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1733","description":"Employment - Job Coaching 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37293","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","description":"CPT-37293","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Truss single w/ standard pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8300","description":"Truss single w/ standard pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epilepsy Genomic Sequence Analysis Panel_ Must Include Analyses For Aldh7A1_ Cacna1A_ Cdkl5_ Chd2_ Gabrg2_ Grin2A_ Kcnq2_ Mecp2_ Pcdh19_ Polg_ Prrt2_ Scn1A_ Scn1B_ Scn2A_ Scn8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81419","description":"Epilepsy Genomic Sequence Analysis Panel_ Must Include Analyses For Aldh7A1_ Cacna1A_ Cdkl5_ Chd2_ Gabrg2_ Grin2A_ Kcnq2_ Mecp2_ Pcdh19_ Polg_ Prrt2_ Scn1A_ Scn1B_ Scn2A_ Scn8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXD1","description":"ICD-NFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0601","description":"HCPCS-C0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1027T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1027T","description":"CPT-1027T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert drug implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11981","description":"Insert drug implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL51","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mt bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20957","description":"Mt bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGE1","description":"ICD-NHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC23","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFF0","description":"ICD-FIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sps forearm device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1818","description":"Sps forearm device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parasymp&symp hrt rate test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95943","description":"Parasymp&symp hrt rate test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITF0","description":"ICD-BITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBA1","description":"ICD-BIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1330","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1330","description":"HCPCS-L1330","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPC1","description":"ICD-JAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES130","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc chl syp documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9228","description":"Gc chl syp documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMF1","description":"ICD-BIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mecasermin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2170","description":"Mecasermin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLE1","description":"ICD-CBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKB1","description":"ICD-GDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext wear ost skn barr <=4sqin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4407","description":"Ext wear ost skn barr <=4sqin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat odontoid fx w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22318","description":"Treat odontoid fx w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA11","description":"ICD-3AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAED0","description":"ICD-EAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10D","description":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flex foot system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5980","description":"Flex foot system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELD1","description":"ICD-JELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monthly supplies for use of device coded at e0733","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4541","description":"Monthly supplies for use of device coded at e0733","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gammaplex injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1557","description":"Gammaplex injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of amikacin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80150","description":"Assay of amikacin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Csi per asx pt w/pci 2 yrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8963","description":"Csi per asx pt w/pci 2 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAF0","description":"ICD-GEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYC0","description":"ICD-DHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFB0","description":"ICD-KEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJB0","description":"ICD-CEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4023","description":"Cast sup sht arm splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fondaparinux sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1652","description":"Fondaparinux sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB121","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86551","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEF0","description":"ICD-OEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVD0","description":"ICD-KAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray nose to rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76010","description":"X-ray nose to rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKD1","description":"ICD-ODKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA126","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine/urea-n","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84540","description":"Assay of urine/urea-n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVE0","description":"ICD-GGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breathing circuits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4618","description":"Breathing circuits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKED1","description":"ICD-MKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATD1","description":"ICD-JATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA11","description":"ICD-3DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETD1","description":"ICD-NETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 6 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP06","description":"Auto.test pane pricing code_ 6 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEA0","description":"ICD-ACEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLB0","description":"ICD-CDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4433","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","description":"HCPCS-Q4433","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWA1","description":"ICD-OAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGA1","description":"ICD-GGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration/repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45562","description":"Exploration/repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTD1","description":"ICD-AGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Interpretation And Report On Fracture-Risk Only By Other Qualified Health Care Professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77092","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Interpretation And Report On Fracture-Risk Only By Other Qualified Health Care Professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE117","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Stanson_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1010","description":"Clinical Decision Support Mechanism Stanson_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronch ebus samplng 1/2 node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31652","description":"Bronch ebus samplng 1/2 node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer not used w oxygen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7017","description":"Nebulizer not used w oxygen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYD0","description":"ICD-CFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB15","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8I","description":"Medium Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRB1","description":"ICD-PBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILC1","description":"ICD-FILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corticoster sparng thrpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4142F","description":"Corticoster sparng thrpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hi enrgy eswt plantar fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28890","description":"Hi enrgy eswt plantar fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYD1","description":"ICD-KDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy w/tumor excise","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31640","description":"Bronchoscopy w/tumor excise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Single energy x-ray study","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0130","description":"Single energy x-ray study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPB0","description":"ICD-JIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHF0","description":"ICD-OBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLD1","description":"ICD-EHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRF1","description":"ICD-KBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC21","description":"ICD-4FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14C","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-op asst doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9615","description":"Pre-op asst doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0411U","description":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB31","description":"ICD-4FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4344","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","description":"HCPCS-Q4344","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIA1","description":"ICD-MAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINF1","description":"ICD-FINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP)_ urine_ reported as likelihood of blad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0452U","description":"Oncology (bladder)_ methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP)_ urine_ reported as likelihood of blad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARE1","description":"ICD-DARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHF0","description":"ICD-EGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQD0","description":"ICD-HFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXF1","description":"ICD-CDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRC1","description":"ICD-CBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILA1","description":"ICD-NILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHF1","description":"ICD-FBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLA1","description":"ICD-ICLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3A","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor viii reltd antgn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85244","description":"Clot factor viii reltd antgn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGB0","description":"ICD-BIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAF1","description":"ICD-KCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEC1","description":"ICD-JEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63746","description":"Removal of spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHC0","description":"ICD-OKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Simple cystometrogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51725","description":"Simple cystometrogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAA1","description":"ICD-FBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVB0","description":"ICD-JFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGF0","description":"ICD-FDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKC1","description":"ICD-FEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJC1","description":"ICD-OLJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"U/s trtmt_ not leiomyomata","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9734","description":"U/s trtmt_ not leiomyomata","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18D","description":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Portable 02 contents_ liquid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0444","description":"Portable 02 contents_ liquid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMF1","description":"ICD-FIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPB0","description":"ICD-FBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair Of Orthodontic Appliance - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8696","description":"Repair Of Orthodontic Appliance - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXE0","description":"ICD-BCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB140","description":"Reduced Physical Function _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43425","description":"Repair esophagus opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plasmaprotein fract_5%_250ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9048","description":"Plasmaprotein fract_5%_250ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADE1","description":"ICD-AADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDD1","description":"ICD-KHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psa/t/glsc docd b/4 txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3268F","description":"Psa/t/glsc docd b/4 txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obstetric panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80055","description":"Obstetric panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rocking bed w/ or w/o side r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0462","description":"Rocking bed w/ or w/o side r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAA0","description":"ICD-JIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01925","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","description":"CPT-01925","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fabrication athletic guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9941","description":"Fabrication athletic guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVA0","description":"ICD-CCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1200","description":"Wheelchair amputee fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC135","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cult skin grft t/a/l addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15151","description":"Cult skin grft t/a/l addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALD0","description":"ICD-FALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPB1","description":"ICD-JFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELC1","description":"ICD-MELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBE0","description":"ICD-KGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laser surgery anal lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46917","description":"Laser surgery anal lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBED1","description":"ICD-OBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy br/wa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44380","description":"Small bowel endoscopy br/wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Centruroides immune f(ab)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0716","description":"Centruroides immune f(ab)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54115","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esano aca_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4275","description":"Esano aca_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETF1","description":"ICD-BETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTA1","description":"ICD-CGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch w/flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5054","description":"Clsd ostomy pouch w/flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1703","description":"HCPCS-B1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal fluid drainage w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59074","description":"Fetal fluid drainage w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWC0","description":"ICD-HDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHA0","description":"ICD-OAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASD0","description":"ICD-HASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult size pull-on sm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4525","description":"Adult size pull-on sm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVF1","description":"ICD-CBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCB0","description":"ICD-KDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cad meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8498","description":"Cad meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15A","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Post chmbr intraocular lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2632","description":"Post chmbr intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCB0","description":"ICD-BCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescribed anticoagulant medication during the performance period_ history of GI bleeding_ history of intracranial bleeding_ bl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1056","description":"Prescribed anticoagulant medication during the performance period_ history of GI bleeding_ history of intracranial bleeding_ bl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMF0","description":"ICD-IAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSF0","description":"ICD-OHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKB1","description":"ICD-KIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23C","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O shoe add instep extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3570","description":"O shoe add instep extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncoprotein her-2/neu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83950","description":"Oncoprotein her-2/neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSE1","description":"ICD-GHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53450","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15D","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERC0","description":"ICD-HERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX02","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCB0","description":"ICD-EHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPF0","description":"ICD-KFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQE1","description":"ICD-OCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10121","description":"Remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ct chest spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72129","description":"Ct chest spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB02","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDD1","description":"ICD-NGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIA1","description":"ICD-ACIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0024","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIC1","description":"ICD-CBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRF1","description":"ICD-KGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31237","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNF1","description":"ICD-OFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33362","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ bivalent spike protein_ preservative free_ 3 mcg/0.2 mL dosage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91317","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ bivalent spike protein_ preservative free_ 3 mcg/0.2 mL dosage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59812","description":"Treatment of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIE0","description":"ICD-OAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronch ebus samplng 3/> node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31653","description":"Bronch ebus samplng 3/> node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0487U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","description":"CPT-0487U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/2.1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2204","description":"Lens sphcy bifocal 4.00d/2.1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYB1","description":"ICD-PLYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLD0","description":"ICD-KBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRE1","description":"ICD-CIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antithrombin recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7196","description":"Antithrombin recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD224","description":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC236","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC141","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHF0","description":"ICD-OHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECA0","description":"ICD-KECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBC0","description":"ICD-ABBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBE0","description":"ICD-MEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOE1","description":"ICD-LHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUE1","description":"ICD-BEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGF1","description":"ICD-CEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmv ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90291","description":"Cmv ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAD1","description":"ICD-ECAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEC0","description":"ICD-MKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEE1","description":"ICD-MKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXC1","description":"ICD-CHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multi den insert direct form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5512","description":"Multi den insert direct form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXD0","description":"ICD-KHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 30 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91320","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 30 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40808","description":"Biopsy of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52214","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung perfusion differential","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78597","description":"Lung perfusion differential","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0550U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0550U","description":"CPT-0550U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telehealth transmit_ per min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1014","description":"Telehealth transmit_ per min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9146","description":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kafo sing fre stirr thi/calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2000","description":"Kafo sing fre stirr thi/calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit midline cath insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5521","description":"Hit midline cath insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIA1","description":"ICD-OEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay galactose transferase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82775","description":"Assay galactose transferase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA124","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFND1","description":"ICD-GFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQA1","description":"ICD-CIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPB0","description":"ICD-FEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69610","description":"Repair of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUC0","description":"ICD-MCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBD1","description":"ICD-GDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9250","description":"Methotrexate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIC0","description":"ICD-OAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNF0","description":"ICD-KCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFME1","description":"ICD-IFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e._ remote patient monitoring)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0322","description":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e._ remote patient monitoring)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transtemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61595","description":"Transtemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSF1","description":"ICD-LFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFE1","description":"ICD-CBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYE1","description":"ICD-OAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA50","description":"Medium Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt scrned for inj drug use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4290F","description":"Pt scrned for inj drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEB1","description":"ICD-OGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Should sling/vest/abrestrain","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4566","description":"Should sling/vest/abrestrain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBB1","description":"ICD-OHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOC1","description":"ICD-KCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVE1","description":"ICD-JFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLE1","description":"ICD-CCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABE1","description":"ICD-MABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21A","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg_patients with malignant)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9346","description":"Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg_patients with malignant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPD0","description":"ICD-KCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB30","description":"Very High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPB1","description":"ICD-NEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHC0","description":"ICD-NHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMB1","description":"ICD-OGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML21","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAD0","description":"ICD-AIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAB0","description":"ICD-ACAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB151","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIA1","description":"ICD-JDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0205","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0205","description":"CDT-D0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUF1","description":"ICD-JBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50040","description":"Drainage of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFC0","description":"ICD-NIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBD1","description":"ICD-NDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No knee/ankle joints w/ ft b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5210","description":"No knee/ankle joints w/ ft b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMA0","description":"ICD-NBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza imm order/admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4037F","description":"Influenza imm order/admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove lung foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32151","description":"Remove lung foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99212","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ bra_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6529","description":"Gradient compression garment_ bra_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFC0","description":"ICD-KIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCC1","description":"ICD-OKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE146","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMF0","description":"ICD-JGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD226","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILE1","description":"ICD-MILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11B","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug test presump opt inst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0478","description":"Drug test presump opt inst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFD1","description":"ICD-FEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","description":"HCPCS-J3404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDD1","description":"ICD-KFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ mRNA lipid nanoparticles_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90683","description":"Respiratory syncytial virus vaccine_ mRNA lipid nanoparticles_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDD1","description":"ICD-ICDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUD0","description":"ICD-ADUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of hydroxyapatite regeneration medicament - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2991","description":"Application of hydroxyapatite regeneration medicament - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA11","description":"ICD-1DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transplant forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25312","description":"Transplant forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Admission to mccm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9480","description":"Admission to mccm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional brain mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96020","description":"Functional brain mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENB0","description":"ICD-GENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection into brain canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61055","description":"Injection into brain canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASB1","description":"ICD-OASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D6-2D7 hybrid gene) (List separately in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D6-2D7 hybrid gene) (List separately in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADME0","description":"ICD-ADME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXB1","description":"ICD-JDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removable partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5281","description":"Removable partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRF0","description":"ICD-KHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57280","description":"Suspension of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Placement of intraocular radiation source applicator (List separately in addition to primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0190T","description":"Placement of intraocular radiation source applicator (List separately in addition to primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMD1","description":"ICD-MBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50075","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYA1","description":"ICD-GDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFE0","description":"ICD-BCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARD1","description":"ICD-KARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90613","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","description":"CPT-90613","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2B","description":"Ultra High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUE0","description":"ICD-NIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA CRYPTOSPORIDIUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87328","description":"IAAD IA CRYPTOSPORIDIUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray frnt lat oblique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71022","description":"Chest x-ray frnt lat oblique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99494","description":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Epidrm autogrft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15111","description":"Epidrm autogrft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSC1","description":"ICD-OHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apc gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81203","description":"Apc gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pre-visit patient screening","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9912","description":"Pre-visit patient screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC11","description":"ICD-1DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYA1","description":"ICD-GGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDC1","description":"ICD-OLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ other than for screening for peripheral arteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0859T","description":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ other than for screening for peripheral arteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTA1","description":"ICD-BBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgicl dress hold non-reuse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4461","description":"Surgicl dress hold non-reuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUA0","description":"ICD-BBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indiv pdc not > 0.8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9513","description":"Indiv pdc not > 0.8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of indwelling bladder and peritoneal catheters_ including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump_ including imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0872T","description":"Replacement of indwelling bladder and peritoneal catheters_ including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump_ including imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ef incomplete/modular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4155","description":"Ef incomplete/modular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTC0","description":"ICD-EFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUA1","description":"ICD-ODUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove thyroid duct lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60281","description":"Remove thyroid duct lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl & rplcmt dfb gen 2 lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33263","description":"Rmvl & rplcmt dfb gen 2 lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSD1","description":"ICD-OBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBF1","description":"ICD-FFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNF1","description":"ICD-FFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Application of a modality to 1 or more areas; low-level laser therapy (ie_ nonthermal and non-ablative) for post-operative pain reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97037","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie_ nonthermal and non-ablative) for post-operative pain reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXC1","description":"ICD-FAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXA1","description":"ICD-NAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27606","description":"Incision of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0585T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crown-indirect resin based","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6710","description":"Crown-indirect resin based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMA1","description":"ICD-CCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4B","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAB1","description":"ICD-OGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANA0","description":"ICD-KANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAB0","description":"ICD-ECAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTB1","description":"ICD-FDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCE1","description":"ICD-GGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKC0","description":"ICD-OIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1221","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDB1","description":"ICD-CIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICF1","description":"ICD-FICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; diagnostic_ including collection of specimen(s) by brushing or washing_ when performed (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0652T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; diagnostic_ including collection of specimen(s) by brushing or washing_ when performed (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEC1","description":"ICD-KBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLD1","description":"ICD-BCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUE0","description":"ICD-CFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFA1","description":"ICD-JEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCB0","description":"ICD-AHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAE0","description":"ICD-IGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of acth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82024","description":"Assay of acth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLA0","description":"ICD-MDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALA1","description":"ICD-OALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYF0","description":"ICD-LEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17264","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEB1","description":"ICD-IGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBA0","description":"ICD-MFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE230","description":"Special Care Low _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINA0","description":"ICD-CINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATE1","description":"ICD-JATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHD1","description":"ICD-GAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of carotene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82380","description":"Assay of carotene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelets_ pheresis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9034","description":"Platelets_ pheresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVC1","description":"ICD-NBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLF0","description":"ICD-BBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJC1","description":"ICD-FAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9259","description":"Injection_ paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1503","description":"HCPCS-B1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth neck vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35251","description":"Anesth neck vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55869","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","description":"CPT-55869","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1701","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1701","description":"CDT-D1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthroscopy biceps tenodesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29828","description":"Arthroscopy biceps tenodesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLA0","description":"ICD-GDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage mouth roof lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42000","description":"Drainage mouth roof lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup gauntlet ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4016","description":"Cast sup gauntlet ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11621","description":"Exc s/n/h/f/g mal+mrg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWF1","description":"ICD-PDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYE0","description":"ICD-PIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tacrolimus imme rel oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7507","description":"Tacrolimus imme rel oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic Analysis With Simple Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse Wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0589T","description":"Electronic Analysis With Simple Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse Wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1007","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1007","description":"HCPCS-L1007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15A","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABB1","description":"ICD-AABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1C","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1577","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1577","description":"HCPCS-J1577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLC1","description":"ICD-FDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coch imp ext proc/contr rplc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8619","description":"Coch imp ext proc/contr rplc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVB1","description":"ICD-CCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLF1","description":"ICD-ACLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Compl zift case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4014","description":"Compl zift case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAA0","description":"ICD-IFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine hydrochloride (biorphen)_ 20 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2372","description":"Injection_ phenylephrine hydrochloride (biorphen)_ 20 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAA0","description":"ICD-KHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93591","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Heart flow reserve measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93572","description":"Heart flow reserve measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSD0","description":"ICD-KGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHF1","description":"ICD-CGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJF1","description":"ICD-KIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59320","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEA0","description":"ICD-AHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXD0","description":"ICD-OIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLF0","description":"ICD-OCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Combination sit to stand sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0637","description":"Combination sit to stand sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMC1","description":"ICD-IEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINE1","description":"ICD-BINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBF1","description":"ICD-JGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIE0","description":"ICD-FIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wound closure by adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0168","description":"Wound closure by adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"removal of fixed orthodontic appliances for reasons other than completion of treatm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8695","description":"removal of fixed orthodontic appliances for reasons other than completion of treatm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSE1","description":"ICD-KHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pm device progr eval multi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93281","description":"Pm device progr eval multi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENB1","description":"ICD-CENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1133","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dolasetron 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0174","description":"Dolasetron 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPB0","description":"ICD-GCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOD1","description":"ICD-HEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECB0","description":"ICD-KECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninterest escort in non er","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0080","description":"Noninterest escort in non er","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shldr disartic myoelectronic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6965","description":"Shldr disartic myoelectronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVD0","description":"ICD-NDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9691","description":"Patient had hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93616","description":"Esophageal recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90477","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam drg > 48 sq in w/o brdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6211","description":"Foam drg > 48 sq in w/o brdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0663U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0663U","description":"CPT-0663U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFE1","description":"ICD-OLFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVE0","description":"ICD-JBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUE1","description":"ICD-AAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy by infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0084","description":"Chemotherapy by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82077","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBED1","description":"ICD-NBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Performance Met: The Residual Change Score  Is Equal To Or Greater Than 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2152","description":"Performance Met: The Residual Change Score  Is Equal To Or Greater Than 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBC0","description":"ICD-JIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reciprocating peritoneal dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1630","description":"Reciprocating peritoneal dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJE0","description":"ICD-ODJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUD0","description":"ICD-AAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0750T","description":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid skin barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4362","description":"Solid skin barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBF1","description":"ICD-IEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALB0","description":"ICD-JALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1826","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","description":"HCPCS-E1826","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQA0","description":"ICD-DEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj iris prosth sec io lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0618T","description":"Insj iris prosth sec io lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27530","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVC0","description":"ICD-FHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ limited_ joint or other nonvascular extremity structure(s) (eg_ joint space_ peri-articular tendon[s]_ muscle[s]_ nerve[s]_ other soft tissue structure[s]_ or soft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76882","description":"Ultrasound_ limited_ joint or other nonvascular extremity structure(s) (eg_ joint space_ peri-articular tendon[s]_ muscle[s]_ nerve[s]_ other soft tissue structure[s]_ or soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt reas no hcv infect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9453","description":"Pt reas no hcv infect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB21","description":"ICD-3HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4C","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSC0","description":"ICD-KCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision and/or reinsertion of transhepatic tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47530","description":"Revision and/or reinsertion of transhepatic tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emtricitabine 200mg and tenofovir alafenamide 25mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0751","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLE0","description":"ICD-MFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSF0","description":"ICD-PLSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEF1","description":"ICD-MJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject for spine disk x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62290","description":"Inject for spine disk x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical procedures that included the use of silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9757","description":"Surgical procedures that included the use of silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFF1","description":"ICD-BGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology colorectal scr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81528","description":"Oncology colorectal scr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUA0","description":"ICD-OIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fabrication & fitting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2628","description":"Fabrication & fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ankle joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27625","description":"Remove ankle joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAB1","description":"ICD-FDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35301","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJC1","description":"ICD-KGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQA0","description":"ICD-KAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth ear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12451","description":"Anesth ear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibula bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20955","description":"Fibula bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tiss exam molecular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88387","description":"Tiss exam molecular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Auditor evoke potent limit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92586","description":"Auditor evoke potent limit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pouch drainable w barrier at","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5061","description":"Pouch drainable w barrier at","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMD0","description":"ICD-MJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAE0","description":"ICD-OJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBC1","description":"ICD-GCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAC1","description":"ICD-KCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYC0","description":"ICD-OAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ue < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8668","description":"Fun stat score ue < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Allgrft implnt knee w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29867","description":"Allgrft implnt knee w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKF1","description":"ICD-FBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEF0","description":"ICD-OLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non coring needle or stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4212","description":"Non coring needle or stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTB0","description":"ICD-MFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64790","description":"Removal of nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBB1","description":"ICD-EIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBB0","description":"ICD-OGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAB0","description":"ICD-GCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGE0","description":"ICD-OAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGF1","description":"ICD-GHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL21","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJB0","description":"ICD-NDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJE0","description":"ICD-FFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBA1","description":"ICD-MJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDF1","description":"ICD-GGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA21","description":"ICD-3HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst stg1-2 noprogres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9072","description":"Onc dx brst stg1-2 noprogres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQD0","description":"ICD-PKQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL51","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIME0","description":"ICD-MIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKF1","description":"ICD-OBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ omacetaxine mep_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9262","description":"Inj_ omacetaxine mep_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coronary artery graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33503","description":"Coronary artery graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom grad sleeve heavy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8423","description":"Custom grad sleeve heavy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYE0","description":"ICD-DDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJB0","description":"ICD-ODJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOC1","description":"ICD-KHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTB1","description":"ICD-MKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDB1","description":"ICD-NDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0680U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680U","description":"CPT-0680U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSE0","description":"ICD-PFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rsa spine exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0348T","description":"Rsa spine exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBD1","description":"ICD-FIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBA1","description":"ICD-JDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln cmplt max lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5750","description":"Denture reln cmplt max lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5939","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5939","description":"CDT-D5939","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath concentrate tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88108","description":"Cytopath concentrate tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACD1","description":"ICD-EACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjustment gastric band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2083","description":"Adjustment gastric band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIF1","description":"ICD-NFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telehealth inpt pharm mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0459","description":"Telehealth inpt pharm mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUC1","description":"ICD-ECUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove jaw joint cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21060","description":"Remove jaw joint cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGE1","description":"ICD-NIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWA0","description":"ICD-DFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic sigmoidoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45330","description":"Diagnostic sigmoidoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","description":"CPT-76015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQC1","description":"ICD-CBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD245","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIA0","description":"ICD-IDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove ext hem groups 2+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46250","description":"Remove ext hem groups 2+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressants class 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80334","description":"Antidepressants class 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0A","description":"Medium Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUD1","description":"ICD-ICUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFB1","description":"ICD-FBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","description":"HCPCS-J0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBC0","description":"ICD-AIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKE0","description":"ICD-BIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2B","description":"High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC154","description":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFD0","description":"ICD-BAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA31","description":"ICD-1GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWC1","description":"ICD-PDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEE0","description":"ICD-GAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc lymphatic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38589","description":"Laparoscope proc lymphatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lt compres band >=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6449","description":"Lt compres band >=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no lipid profile","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8726","description":"Doc reas no lipid profile","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB41","description":"Medium Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20C","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQF0","description":"ICD-HFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAF0","description":"ICD-NDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKD1","description":"ICD-KDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy for bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45334","description":"Sigmoidoscopy for bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWA1","description":"ICD-OHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2002","description":"Limited (30 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC140","description":"Clinically Complex _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGE0","description":"ICD-NAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDB0","description":"ICD-GCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMB0","description":"ICD-NEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBF1","description":"ICD-ADBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complete phys skin exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2029F","description":"Complete phys skin exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nicardipine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2404","description":"Injection_ nicardipine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24D","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELA1","description":"ICD-AELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6556","description":"Gradient compression stocking_ thigh length_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADA1","description":"ICD-AADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGE1","description":"ICD-NFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB254","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug Screen_ Other Than Chromatographic; Any Number Of Drug Classes_ By Clia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0434","description":"Drug Screen_ Other Than Chromatographic; Any Number Of Drug Classes_ By Clia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOB1","description":"ICD-OFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBA1","description":"ICD-NJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIF0","description":"ICD-FFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Graphite crucible for preparation of Technetium Tc 99m-labeled carbon aerosol_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9506","description":"Graphite crucible for preparation of Technetium Tc 99m-labeled carbon aerosol_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGB1","description":"ICD-NBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28I","description":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIID1","description":"ICD-BIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEE0","description":"ICD-FEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDF1","description":"ICD-OKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Galsulfase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1458","description":"Galsulfase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILA0","description":"ICD-EILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of brow nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64732","description":"Incision of brow nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixed bilat space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1515","description":"Fixed bilat space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0904","description":"HCPCS-C0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUF0","description":"ICD-JAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33929","description":"Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKF0","description":"ICD-FIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC56","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOC1","description":"ICD-OJOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEC1","description":"ICD-IGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYA0","description":"ICD-OEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig; scrn clin dep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8433","description":"Pt inelig; scrn clin dep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTD1","description":"ICD-IBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBB0","description":"ICD-FGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILC0","description":"ICD-BILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Measure ureter pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50686","description":"Measure ureter pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXB1","description":"ICD-NAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical pathology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88399","description":"Surgical pathology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCB1","description":"ICD-MDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urine pch w ex wear bar conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4393","description":"Urine pch w ex wear bar conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dynamic surface emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96002","description":"Dynamic surface emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXC1","description":"ICD-OJXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Complement/function activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86161","description":"Complement/function activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ftl cgen abnor five anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81512","description":"Ftl cgen abnor five anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYE0","description":"ICD-LDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGD1","description":"ICD-KGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFD0","description":"ICD-NLFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clot inhibit prot c activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85303","description":"Clot inhibit prot c activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBME0","description":"ICD-KBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Motor &/ sens nrve cndj test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95905","description":"Motor &/ sens nrve cndj test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWF0","description":"ICD-KHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Os pch urine w bar/fange/tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4432","description":"Os pch urine w bar/fange/tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHME0","description":"ICD-CHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHF0","description":"ICD-BCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTC1","description":"ICD-FCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACB1","description":"ICD-CACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHC1","description":"ICD-KCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assess hlth/behave subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96151","description":"Assess hlth/behave subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apheresis rbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36512","description":"Apheresis rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of somatomedin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84305","description":"Assay of somatomedin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA115","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCB1","description":"ICD-CCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXF1","description":"ICD-JCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGB0","description":"ICD-KIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARC1","description":"ICD-CARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLE1","description":"ICD-MCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJC1","description":"ICD-ODJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aflibercept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0178","description":"Aflibercept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ranitidine hydrochloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2780","description":"Ranitidine hydrochloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADA1","description":"ICD-FADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAF1","description":"ICD-CAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDC0","description":"ICD-FGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOA1","description":"ICD-KCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWE1","description":"ICD-HDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGE1","description":"ICD-FHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD114","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHA1","description":"ICD-AHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92004","description":"Eye exam new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood collection tube/vacuum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4770","description":"Blood collection tube/vacuum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLB0","description":"ICD-OGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66762","description":"Revision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lysis + lavage w catheters","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7871","description":"Lysis + lavage w catheters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of rib fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21813","description":"Treatment of rib fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Indwelling catheter latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4338","description":"Indwelling catheter latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal placement of biodegradable material_ peri-prostatic_ single or multiple injection(s)_ including image guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55874","description":"Transperineal placement of biodegradable material_ peri-prostatic_ single or multiple injection(s)_ including image guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cysto w/prst8 commissurotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0619T","description":"Cysto w/prst8 commissurotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inject sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27096","description":"Inject sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGB0","description":"ICD-JDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5146","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","description":"HCPCS-Q5146","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTD1","description":"ICD-JGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Omalizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2357","description":"Omalizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQF1","description":"ICD-LGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHC1","description":"ICD-KBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWC0","description":"ICD-PJWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla ii typing 1 locus lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81376","description":"Hla ii typing 1 locus lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99252","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVC1","description":"ICD-KGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAB1","description":"ICD-EEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUD1","description":"ICD-KDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23A","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Powered air mattress overlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0372","description":"Powered air mattress overlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Palatal lift prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5955","description":"Palatal lift prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-82233","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","description":"CPT-82233","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHA1","description":"ICD-NDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computer-Aided Mapping Of Cervix Uteri During Colposcopy_ Including Optical Dynamic Spectral Imaging And Algorithmic Quantification Of The Acetowhitening Effect (List Separate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57465","description":"Computer-Aided Mapping Of Cervix Uteri During Colposcopy_ Including Optical Dynamic Spectral Imaging And Algorithmic Quantification Of The Acetowhitening Effect (List Separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27332","description":"Removal of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMF1","description":"ICD-GIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTB1","description":"ICD-GCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBC1","description":"ICD-MDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUF1","description":"ICD-MHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fev<60% pred & no copd sym","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8925","description":"Fev<60% pred & no copd sym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gad-base mr contrast nos_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9579","description":"Gad-base mr contrast nos_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNA1","description":"ICD-NKNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLD0","description":"ICD-JHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEA1","description":"ICD-KAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHB1","description":"ICD-FHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGA0","description":"ICD-KDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUE0","description":"ICD-FDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity prosthes nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7499","description":"Upper extremity prosthes nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVE1","description":"ICD-NAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHE0","description":"ICD-FBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain cavity shunt w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62201","description":"Brain cavity shunt w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIA0","description":"ICD-EFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBE1","description":"ICD-FHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21C","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tissue culture tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88239","description":"Tissue culture tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4377","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","description":"HCPCS-Q4377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLE1","description":"ICD-NBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQC1","description":"ICD-PFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETF0","description":"ICD-IETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYC0","description":"ICD-KAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80406","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXD0","description":"ICD-KCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (apotex)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9058","description":"Injection_ bendamustine hydrochloride (apotex)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNC0","description":"ICD-NGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1029","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cntct gas permeable sphericl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2510","description":"Cntct gas permeable sphericl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77610","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Lung)_ Mrna_ Quantitative Pcr Analysis Of 11 Genes (Bag1_ Brca1_ Cdc6_ Cdk2Ap1_ Erbb3_ Fut3_ Il11_ Lck_ Rnd3_ Sh3Bgr_ Wnt3A) And 3 Reference Genes (Esd_ Tbp_ Yap1)_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0288U","description":"Oncology (Lung)_ Mrna_ Quantitative Pcr Analysis Of 11 Genes (Bag1_ Brca1_ Cdc6_ Cdk2Ap1_ Erbb3_ Fut3_ Il11_ Lck_ Rnd3_ Sh3Bgr_ Wnt3A) And 3 Reference Genes (Esd_ Tbp_ Yap1)_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve palsy fascial graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15840","description":"Nerve palsy fascial graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBA1","description":"ICD-MHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx periorbital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21386","description":"Opn tx orbit fx periorbital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGB0","description":"ICD-OAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29882","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sacituzumab govitecan-hziy_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9317","description":"Injection_ sacituzumab govitecan-hziy_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDC1","description":"ICD-JEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii recomb obizur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7188","description":"Factor viii recomb obizur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2B","description":"High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Norsn not first line amox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9314","description":"Norsn not first line amox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gene test retinoblastoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3841","description":"Gene test retinoblastoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFB0","description":"ICD-NCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISE1","description":"ICD-PISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJB1","description":"ICD-BBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCC1","description":"ICD-KFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQD1","description":"ICD-LGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX42","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAF0","description":"ICD-NEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIC0","description":"ICD-KHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23A","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRC1","description":"ICD-DBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pelvis contents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58240","description":"Removal of pelvis contents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis a igm antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86709","description":"Hepatitis a igm antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc face les sbq 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21012","description":"Exc face les sbq 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOD0","description":"ICD-HGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reason for not administering trastuzumab documented (e.g._ patient declined_ patient died_ patient transferred_ contraindication or other clinical exclusion_ neoadjuvant chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9836","description":"Reason for not administering trastuzumab documented (e.g._ patient declined_ patient died_ patient transferred_ contraindication or other clinical exclusion_ neoadjuvant chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4B","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary stress test/simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94620","description":"Pulmonary stress test/simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amnt pain noted none prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1126F","description":"Amnt pain noted none prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1021T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","description":"CPT-1021T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEF1","description":"ICD-GHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOC1","description":"ICD-LEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Air pressure pad for mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0197","description":"Air pressure pad for mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4426","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","description":"HCPCS-Q4426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40761","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGD1","description":"ICD-KIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Thiamine hcl 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3411","description":"Thiamine hcl 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/svc dme non-oxygen eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0739","description":"Repair/svc dme non-oxygen eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC41","description":"Very High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chorion biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59015","description":"Chorion biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37299","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","description":"CPT-37299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPB1","description":"ICD-CIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES350","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder passive restor comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6310","description":"Shoulder passive restor comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJF0","description":"ICD-NKJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNE1","description":"ICD-CBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise hip/thigh nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64766","description":"Incise hip/thigh nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87183","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","description":"CPT-87183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMB1","description":"ICD-BAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAA0","description":"ICD-ABAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOF1","description":"ICD-DBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60522","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthro w/labral repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29916","description":"Hip arthro w/labral repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2711","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","description":"HCPCS-J2711","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acetaminophen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80143","description":"Acetaminophen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEA0","description":"ICD-AAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place cath xtrnl carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36227","description":"Place cath xtrnl carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis machine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1590","description":"Hemodialysis machine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNC1","description":"ICD-BDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0016","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Vestibuloplasty exten graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7350","description":"Vestibuloplasty exten graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emergency surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9752","description":"Emergency surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGA1","description":"ICD-GBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA14","description":"Default_ /5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Search for prior patient completed dicom format images not completed due to medical reasons(eg_CT studies performed for radiation treatment planning or image-guided radiation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9343","description":"Search for prior patient completed dicom format images not completed due to medical reasons(eg_CT studies performed for radiation treatment planning or image-guided radiation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0765T","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0521","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","description":"HCPCS-Q0521","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ublituximab-xiiy_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2329","description":"Injection_ ublituximab-xiiy_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC40","description":"Very High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fats/lipids feces qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82705","description":"Fats/lipids feces qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv saliv glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64611","description":"Chemodenerv saliv glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKE0","description":"ICD-JGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUD1","description":"ICD-GCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPD0","description":"ICD-GAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-97007","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","description":"CPT-97007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress spine cord add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63057","description":"Decompress spine cord add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC31","description":"ICD-4CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOE1","description":"ICD-CBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSC0","description":"ICD-LFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKD1","description":"ICD-CGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise spine cord vsl thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63252","description":"Revise spine cord vsl thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFE0","description":"ICD-GHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cpm device_ other than knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0936","description":"Cpm device_ other than knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13B","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA11","description":"ICD-4HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m mebrofenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9537","description":"Tc99m mebrofenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUB0","description":"ICD-ACUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMC0","description":"ICD-IBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYE1","description":"ICD-PDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMF0","description":"ICD-NCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63266","description":"Excise intrspinl lesion thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vutrisiran_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0225","description":"Injection_ vutrisiran_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assess cyst contrast inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49424","description":"Assess cyst contrast inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE112","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAB0","description":"ICD-OJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-62331","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","description":"CPT-62331","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYE0","description":"ICD-LCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITC0","description":"ICD-CITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEE0","description":"ICD-FDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAID1","description":"ICD-JAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES144","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA111","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Splicing of ureters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50770","description":"Splicing of ureters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGC0","description":"ICD-OJGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELF0","description":"ICD-BELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENB0","description":"ICD-KENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWF1","description":"ICD-OBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLE0","description":"ICD-JCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0509U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509U","description":"CPT-0509U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTF1","description":"ICD-MLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy control bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46614","description":"Anoscopy control bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1093T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1093T","description":"CPT-1093T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX20","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKB1","description":"ICD-CAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removable prosthodontic proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5899","description":"Removable prosthodontic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXC0","description":"ICD-KHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTD1","description":"ICD-MKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQA0","description":"ICD-GAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYC1","description":"ICD-OCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMF1","description":"ICD-ECMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINA1","description":"ICD-BINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCE1","description":"ICD-MDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHE0","description":"ICD-OHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMC0","description":"ICD-NCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary pouch on barr w/flng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5073","description":"Urinary pouch on barr w/flng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11312","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ob us < 14 wks single fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76801","description":"Ob us < 14 wks single fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intrvl 3/>yr pts clnscp docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0529F","description":"Intrvl 3/>yr pts clnscp docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOA1","description":"ICD-LCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESD1","description":"ICD-GESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDE0","description":"ICD-GGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33460","description":"Revision of tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOB0","description":"ICD-DFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Crisis interven svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2011","description":"Crisis interven svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46744","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone biopsy trocar/needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20225","description":"Bone biopsy trocar/needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm splint plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4021","description":"Cast sup sht arm splint plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAA1","description":"ICD-JEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Med record copy admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9981","description":"Med record copy admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEB0","description":"ICD-IFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Long tongue stirrup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2265","description":"Long tongue stirrup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2037","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","description":"HCPCS-A2037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMA1","description":"ICD-BCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLC0","description":"ICD-NJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Standard size footplate each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0042","description":"Standard size footplate each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIC0","description":"ICD-FIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKB1","description":"ICD-FFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHB1","description":"ICD-IIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drug scrn quan mycophenolate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80180","description":"Drug scrn quan mycophenolate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27750","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44145","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEA0","description":"ICD-NLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCC1","description":"ICD-AGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25295","description":"Release wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair fibula nonunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27726","description":"Repair fibula nonunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGE0","description":"ICD-OIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOE0","description":"ICD-KGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2005","description":"HCPCS-B2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYB0","description":"ICD-LCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWC0","description":"ICD-GFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Manual pump enema_ reusable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4459","description":"Manual pump enema_ reusable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJB0","description":"ICD-FAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biodfence 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4140","description":"Biodfence 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUA1","description":"ICD-OLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELC1","description":"ICD-BELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITD1","description":"ICD-KITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEE0","description":"ICD-FCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dentistry Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0067","description":"Dentistry Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHB0","description":"ICD-MFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIE1","description":"ICD-KHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67935","description":"Repair eyelid wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesth lung chest wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54651","description":"Anesth lung chest wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLF0","description":"ICD-GDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLA0","description":"ICD-FCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No hepc rna after med no rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9211","description":"No hepc rna after med no rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGE1","description":"ICD-BBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50393","description":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAE0","description":"ICD-JBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67974","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of bronchus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31770","description":"Repair/graft of bronchus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Serv part of phase i trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9988","description":"Serv part of phase i trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Habilitation_ prevocational_ waiver; per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2047","description":"Habilitation_ prevocational_ waiver; per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom mold shoe remov prost","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3250","description":"Custom mold shoe remov prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1735","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1735","description":"HCPCS-C1735","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEC1","description":"ICD-NEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICED1","description":"ICD-ICED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAB1","description":"ICD-FHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDA1","description":"ICD-NCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9073","description":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB31","description":"ICD-1HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXC0","description":"ICD-GCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing assessment/evaluatn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1001","description":"Nursing assessment/evaluatn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Create tear duct drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68745","description":"Create tear duct drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVE1","description":"ICD-CCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelet pheres leukoreduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9035","description":"Platelet pheres leukoreduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit est age 40-64","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99396","description":"Prev visit est age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRC1","description":"ICD-DIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPD0","description":"ICD-NAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic image jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70336","description":"Magnetic image jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of patient-activated cardiac event recorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33282","description":"Implantation of patient-activated cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFA0","description":"ICD-NAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE160","description":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suspend bowel w/prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44700","description":"Suspend bowel w/prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rolapitant_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2797","description":"Injection_ rolapitant_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Iiv3 vaccine 3 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90658","description":"Iiv3 vaccine 3 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Foam propulsion tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2218","description":"Foam propulsion tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1903","description":"HCPCS-A1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cricotracheal resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31592","description":"Cricotracheal resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHE1","description":"ICD-OBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUC1","description":"ICD-EAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwr wc drivewheel motor repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2368","description":"Pwr wc drivewheel motor repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCC0","description":"ICD-JGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYC0","description":"ICD-KGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No documentation of a chlamydia screening test with proper follow-up","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9821","description":"No documentation of a chlamydia screening test with proper follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBC1","description":"ICD-GEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70010","description":"Contrast x-ray of brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54105","description":"Biopsy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of anal septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46070","description":"Incision of anal septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIB1","description":"ICD-CHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE213","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0507U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","description":"CPT-0507U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9482","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILC0","description":"ICD-EILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAB1","description":"ICD-KHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Denervation of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27035","description":"Denervation of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLA1","description":"ICD-AGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUC0","description":"ICD-NFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJC1","description":"ICD-KAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adj chem not pres rsn spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8928","description":"Adj chem not pres rsn spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOE0","description":"ICD-DGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCE0","description":"ICD-KDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXA0","description":"ICD-KCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Surgical opening esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43352","description":"Surgical opening esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEB1","description":"ICD-AAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRE0","description":"ICD-GGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRA0","description":"ICD-CCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hospice/home hlth in asst lv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5002","description":"Hospice/home hlth in asst lv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insrt/redo pn/gastr stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64590","description":"Insrt/redo pn/gastr stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELF0","description":"ICD-IELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCD1","description":"ICD-OFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair Of Fixed Retainer_ Includes Reattachment - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8702","description":"Repair Of Fixed Retainer_ Includes Reattachment - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIA1","description":"ICD-MKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear rx iv admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79101","description":"Nuclear rx iv admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXF0","description":"ICD-OGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Immntx 1 sting insect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95130","description":"Immntx 1 sting insect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1827","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","description":"HCPCS-E1827","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0462T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES117","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAC0","description":"ICD-ICAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOA1","description":"ICD-CBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC216","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEF0","description":"ICD-ABEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28D","description":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJF0","description":"ICD-KGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cephalothin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1890","description":"Cephalothin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNB0","description":"ICD-BCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIF1","description":"ICD-MLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNC0","description":"ICD-CCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIF1","description":"ICD-JHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cmv antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86644","description":"Cmv antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXF0","description":"ICD-NAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHB0","description":"ICD-JIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNA1","description":"ICD-KHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hd hosp bed_ 350-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0301","description":"Hd hosp bed_ 350-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXA1","description":"ICD-BDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMC1","description":"ICD-FDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gammagard liquid injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1569","description":"Gammagard liquid injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETA1","description":"ICD-EETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNC1","description":"ICD-GCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4047F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92511","description":"Nasopharyngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFC0","description":"ICD-OFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast tomosynthesis uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77061","description":"Breast tomosynthesis uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69100","description":"Biopsy of external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skull base/brainstem surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61576","description":"Skull base/brainstem surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKE0","description":"ICD-GBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs)_ from cultured CSCs and primary tumor cells_ categorical drug response reported based on cytotox","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0435U","description":"Oncology_ chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs)_ from cultured CSCs and primary tumor cells_ categorical drug response reported based on cytotox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHD1","description":"ICD-KCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEA1","description":"ICD-IGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEB1","description":"ICD-OIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDE0","description":"ICD-NLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLND1","description":"ICD-NLND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSF1","description":"ICD-PLSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33736","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGE0","description":"ICD-OKGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrical bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20974","description":"Electrical bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE205","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of tendons at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25301","description":"Fusion of tendons at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYA0","description":"ICD-GIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILC1","description":"ICD-GILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Addl neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22552","description":"Addl neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colorectal ca screen doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3017F","description":"Colorectal ca screen doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No electrodiag polyneuro 6mn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3752F","description":"No electrodiag polyneuro 6mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81274","description":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00916","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","description":"CPT-00916","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA60","description":"High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUB0","description":"ICD-NFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITA0","description":"ICD-IITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change of percutaneous biliary drainage catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47525","description":"Change of percutaneous biliary drainage catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIF0","description":"ICD-MAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"AMNIOREPAIR or AltiPly_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4235","description":"AMNIOREPAIR or AltiPly_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-sterile gloves","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4927","description":"Non-sterile gloves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETF1","description":"ICD-GETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Carmustine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9050","description":"Carmustine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSF0","description":"ICD-DCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVC1","description":"ICD-KHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tisotumab vedotin-tftv_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9273","description":"Injection_ tisotumab vedotin-tftv_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20A","description":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJB0","description":"ICD-FCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA12","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEA0","description":"ICD-AIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUC0","description":"ICD-MEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCF0","description":"ICD-ACCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (wg critical care)_ per 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0611","description":"Injection_ calcium gluconate (wg critical care)_ per 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUE1","description":"ICD-KGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Procuren or other growth fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9055","description":"Procuren or other growth fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3 comp foot exam completed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9226","description":"3 comp foot exam completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTC0","description":"ICD-FDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01770","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","description":"CPT-01770","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBD0","description":"ICD-BIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10C","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"D5w/0.45ns w kcl and mgs04","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5014","description":"D5w/0.45ns w kcl and mgs04","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAND1","description":"ICD-BAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIA1","description":"ICD-KGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermabind sl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4284","description":"Dermabind sl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rad exc lesion up to 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7410","description":"Rad exc lesion up to 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0548U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","description":"CPT-0548U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAD1","description":"ICD-MCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXB1","description":"ICD-OBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Face bone graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21210","description":"Face bone graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNA1","description":"ICD-KCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87662","description":"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVE1","description":"ICD-CHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX55","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ coronary venous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1900","description":"Lead_ coronary venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGB1","description":"ICD-KCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAC1","description":"ICD-CEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVB0","description":"ICD-OAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVF0","description":"ICD-KGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1360","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACA0","description":"ICD-OACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ustekinumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3357","description":"Ustekinumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9169","description":"HCPCS-C9169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1098","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","description":"HCPCS-J1098","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOE1","description":"ICD-DEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval laryngoscopy sense tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92615","description":"Eval laryngoscopy sense tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEND0","description":"ICD-KEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test nonparaspinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95870","description":"Muscle test nonparaspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVB0","description":"ICD-GFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRA1","description":"ICD-LHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ipilimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9228","description":"Ipilimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBF1","description":"ICD-OEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKC1","description":"ICD-KHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLE0","description":"ICD-IBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB141","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1075T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1075T","description":"CPT-1075T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHD1","description":"ICD-OLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g. virtual check-in_ by a qualified health care professional who cannot report evaluation and management services_ provided to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2251","description":"Brief communication technology-based service_ e.g. virtual check-in_ by a qualified health care professional who cannot report evaluation and management services_ provided to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATE0","description":"ICD-IATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBE1","description":"ICD-NEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGC0","description":"ICD-KGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCC0","description":"ICD-MGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQE0","description":"ICD-HBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXD1","description":"ICD-NAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOC0","description":"ICD-OJOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L0720","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","description":"HCPCS-L0720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1402","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1402","description":"CDT-D1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic positional obstructive sleep apnea treatment_ with sensor_ includes all components and accessories_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0530","description":"Electronic positional obstructive sleep apnea treatment_ with sensor_ includes all components and accessories_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUC0","description":"ICD-BCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATA1","description":"ICD-JATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dose optimization auc - 5fu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3722","description":"Dose optimization auc - 5fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSD0","description":"ICD-CDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXC0","description":"ICD-KBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic sgd interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2351","description":"Electronic sgd interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Musculoskeletal nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78399","description":"Musculoskeletal nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILD0","description":"ICD-JILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELD0","description":"ICD-FELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUE0","description":"ICD-MKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prep bk ptb thermopls molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5530","description":"Prep bk ptb thermopls molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTA0","description":"ICD-EHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOD0","description":"ICD-OFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDA1","description":"ICD-JCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Idarubicin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9211","description":"Idarubicin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUD0","description":"ICD-CAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKE1","description":"ICD-NBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDB0","description":"ICD-OFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Degarelix injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9155","description":"Degarelix injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRE0","description":"ICD-CHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKA1","description":"ICD-CCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJD0","description":"ICD-NFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADF1","description":"ICD-MADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKF0","description":"ICD-FBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acoustic cardiography_ including automated analysis of combined acoustic and electrical intervals; single_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0223T","description":"Acoustic cardiography_ including automated analysis of combined acoustic and electrical intervals; single_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB17","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung perfusion imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78580","description":"Lung perfusion imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWC0","description":"ICD-KDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement air bubble detec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1530","description":"Replacement air bubble detec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10A","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dmd dup/delet analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81161","description":"Dmd dup/delet analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ promoter methylation profiling by real-time PCR of 3 genes (GSTP1_ APC_ RASSF1)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81551","description":"Oncology (prostate)_ promoter methylation profiling by real-time PCR of 3 genes (GSTP1_ APC_ RASSF1)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35021","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0079","description":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGE0","description":"ICD-GAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVD0","description":"ICD-CFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD214","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGE1","description":"ICD-OCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB55","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing care in home rn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9123","description":"Nursing care in home rn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrocardiogram tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93005","description":"Electrocardiogram tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTF1","description":"ICD-OKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDF1","description":"ICD-AHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA31","description":"ICD-1FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANA1","description":"ICD-KANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/band ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45398","description":"Colonoscopy w/band ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUF0","description":"ICD-EHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRB1","description":"ICD-GCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8856","description":"Ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair bearings","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2210","description":"Wheelchair bearings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLA1","description":"ICD-FGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBF1","description":"ICD-CCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cytomeg dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87495","description":"Cytomeg dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77285","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99324","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18D","description":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPE0","description":"ICD-CEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBF0","description":"ICD-JHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHC0","description":"ICD-NKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBA1","description":"ICD-NBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (oropharyngeal)_ evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR)_ cell-free DNA_ algorithm reported as a prognostic risk score for cancer recurrence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0356U","description":"Oncology (oropharyngeal)_ evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR)_ cell-free DNA_ algorithm reported as a prognostic risk score for cancer recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92557","description":"Comprehensive hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Scan proc cranial intra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61781","description":"Scan proc cranial intra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUC1","description":"ICD-CBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCE1","description":"ICD-OFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENC1","description":"ICD-BENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Q fever antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86638","description":"Q fever antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKB1","description":"ICD-GFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27443","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"A/d tx program_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2036","description":"A/d tx program_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abduct rotation bar w/o shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3150","description":"Abduct rotation bar w/o shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45327","description":"Proctosigmoidoscopy w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheterize for urine spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9612","description":"Catheterize for urine spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMF0","description":"ICD-MIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHA1","description":"ICD-MAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSE0","description":"ICD-KHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOA1","description":"ICD-DEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug interven","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0022","description":"Alcohol and/or drug interven","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMD1","description":"ICD-KHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUB1","description":"ICD-CIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQD1","description":"ICD-HAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eeg monitoring/function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95958","description":"Eeg monitoring/function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat vaginal bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57180","description":"Treat vaginal bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Screening performed and positive and provision of recommendations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9919","description":"Screening performed and positive and provision of recommendations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcondylar approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61597","description":"Transcondylar approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQB0","description":"ICD-PFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDA1","description":"ICD-EBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWE1","description":"ICD-OGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18B","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNF0","description":"ICD-NHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJD1","description":"ICD-GDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25455","description":"Revision of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVC1","description":"ICD-NFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFA0","description":"ICD-NEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc t-pa admin considered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4077F","description":"Doc t-pa admin considered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXD0","description":"ICD-FFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant spinal canal cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62351","description":"Implant spinal canal cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inner ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69949","description":"Inner ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide ova aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76948","description":"Echo guide ova aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc t cabg s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9604","description":"Perc d-e cor revasc t cabg s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36905","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients Who Use Palliative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9995","description":"Patients Who Use Palliative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2516","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","description":"HCPCS-J2516","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQB0","description":"ICD-DEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWB0","description":"ICD-DFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLF1","description":"ICD-FDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00920","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","description":"CPT-00920","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGD0","description":"ICD-GEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath_hemodialysis_short-term","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1752","description":"Cath_hemodialysis_short-term","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB215","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSE1","description":"ICD-GDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg_ spinocerebellar ataxia)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0231U","description":"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg_ spinocerebellar ataxia)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Free omental flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49906","description":"Free omental flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAD0","description":"ICD-BDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD206","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28C","description":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCD0","description":"ICD-OLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Creatinine clearance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82575","description":"Creatinine clearance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDA0","description":"ICD-JHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nutrition class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9452","description":"Nutrition class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEA0","description":"ICD-KEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVD1","description":"ICD-JIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMD1","description":"ICD-ICMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKC1","description":"ICD-GDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL17","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITD1","description":"ICD-IITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIA0","description":"ICD-FFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA24","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7513","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1048","description":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHA0","description":"ICD-OJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYB1","description":"ICD-LBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8A","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88007","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIA0","description":"ICD-AAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUE1","description":"ICD-ICUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB216","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dexamethasone acetate_ per 1mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1095","description":"Injection_ dexamethasone acetate_ per 1mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93644","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18G","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAF0","description":"ICD-NIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASA0","description":"ICD-HASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGE0","description":"ICD-CCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTA0","description":"ICD-IBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTF1","description":"ICD-ACTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIB1","description":"ICD-GFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPA0","description":"ICD-NDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifo 7.25-12/.25-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2211","description":"Lens sphcy bifo 7.25-12/.25-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB14","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESC1","description":"ICD-OESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx mult myeloma stg2 hig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9129","description":"Onc dx mult myeloma stg2 hig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETF0","description":"ICD-CETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise ileoanal reservior","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45136","description":"Excise ileoanal reservior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEA1","description":"ICD-EIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electric wound treatment dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0769","description":"Electric wound treatment dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOC1","description":"ICD-PLOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt alive 3 mos post proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9540","description":"Pt alive 3 mos post proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIA0","description":"ICD-NKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIC1","description":"ICD-EIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology gynecologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81535","description":"Oncology gynecologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Function stat assessed rvwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1175F","description":"Function stat assessed rvwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (pemfexy)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9304","description":"Injection_ pemetrexed (pemfexy)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAD0","description":"ICD-CDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37296","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","description":"CPT-37296","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26540","description":"Repair hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of kidney/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50400","description":"Revision of kidney/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flex/ext/rotation wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6624","description":"Flex/ext/rotation wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ esmolol hydrochloride_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1805","description":"Injection_ esmolol hydrochloride_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD231","description":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNC1","description":"ICD-JBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFE0","description":"ICD-CGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTC0","description":"ICD-KHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0987T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","description":"CPT-0987T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUC1","description":"ICD-CGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient Did Not Receive Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2159","description":"Patient Did Not Receive Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61583","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQB1","description":"ICD-KFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Platelets_ hla-m_ l/r_ unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9052","description":"Platelets_ hla-m_ l/r_ unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High compres band w>=3in<5inyd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6452","description":"High compres band w>=3in<5inyd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18E","description":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBA0","description":"ICD-AEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96381","description":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTE1","description":"ICD-OCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIE1","description":"ICD-FGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWD0","description":"ICD-PJWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99236","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOD0","description":"ICD-PBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 sq cm_ or part thereof (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14302","description":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 sq cm_ or part thereof (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNE0","description":"ICD-NGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0558U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","description":"CPT-0558U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Close tear system fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68770","description":"Close tear system fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACB1","description":"ICD-MACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXE1","description":"ICD-JAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nerve repair; with nerve allograft_ each nerve_ first strand (cable)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64912","description":"Nerve repair; with nerve allograft_ each nerve_ first strand (cable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEF1","description":"ICD-AAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of reti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1220","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of reti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Safety counseling dementia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6101F","description":"Safety counseling dementia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAD0","description":"ICD-MFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01965","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","description":"CPT-01965","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise max/zygoma mal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21034","description":"Excise max/zygoma mal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Technetium tc-99m teboroxime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9501","description":"Technetium tc-99m teboroxime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull/brain biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61750","description":"Incise skull/brain biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clotting funct activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85397","description":"Clotting funct activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGA0","description":"ICD-JEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"2d tee w or w/o fol w/con_in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8925","description":"2d tee w or w/o fol w/con_in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEF0","description":"ICD-FGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0500","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEA1","description":"ICD-MHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11A","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAF1","description":"ICD-JBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occlusal guard - hard appliance_ full arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9944","description":"Occlusal guard - hard appliance_ full arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11313","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITB0","description":"ICD-JITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAB1","description":"ICD-FAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESF1","description":"ICD-LESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEB1","description":"ICD-NCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLB0","description":"ICD-IFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise foot tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28088","description":"Excise foot tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUF1","description":"ICD-MFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aneurysm pressure sens study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93982","description":"Aneurysm pressure sens study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHF1","description":"ICD-GEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFC1","description":"ICD-CAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01270","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","description":"CPT-01270","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTA0","description":"ICD-IHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flu vac pandem prsrv free im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90666","description":"Flu vac pandem prsrv free im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHA1","description":"ICD-JDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1054T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1054T","description":"CPT-1054T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip socket fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27220","description":"Treat hip socket fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSA1","description":"ICD-DCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brain biopsy w/ct/mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61751","description":"Brain biopsy w/ct/mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUF0","description":"ICD-KIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ankle/heel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28100","description":"Removal of ankle/heel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antiepileptics nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80340","description":"Antiepileptics nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0934T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","description":"CPT-0934T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fractionation ketosteroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83593","description":"Fractionation ketosteroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKA0","description":"ICD-GEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (sandoz)_ not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9297","description":"Injection_ pemetrexed (sandoz)_ not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQD0","description":"ICD-GEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIF1","description":"ICD-GFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise additional leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27692","description":"Revise additional leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD155","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec sz spec ht b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1228","description":"Wheelchair spec sz spec ht b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQC1","description":"ICD-DDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with ligation of sphenopalatine artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31241","description":"Nasal/sinus endoscopy_ surgical; with ligation of sphenopalatine artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24116","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYA0","description":"ICD-GAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILE0","description":"ICD-MILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16074","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16074","description":"CPT-16074","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating at or above the he","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93587","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating at or above the he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA52","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCA1","description":"ICD-OCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77062","description":"Breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ob us >/= 14 wks sngl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76805","description":"Ob us >/= 14 wks sngl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLA0","description":"ICD-OJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRC1","description":"ICD-OCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso sagittal rigid panel cus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0636","description":"Lso sagittal rigid panel cus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX15","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMD0","description":"ICD-ICMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUB0","description":"ICD-OJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit anti-tnf per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9359","description":"Hit anti-tnf per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECE1","description":"ICD-IECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12A","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL02","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise breast duct fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19112","description":"Excise breast duct fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSA1","description":"ICD-LBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21C","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01420","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","description":"CPT-01420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee orth pos locking joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1831","description":"Knee orth pos locking joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFE0","description":"ICD-CEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUC1","description":"ICD-OBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ep & ablate supravent arrhyt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93653","description":"Ep & ablate supravent arrhyt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDC1","description":"ICD-NDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15013","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","description":"CPT-15013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHA1","description":"ICD-CCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYD1","description":"ICD-HGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHA1","description":"ICD-AFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8F","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQA1","description":"ICD-PGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq lamot/lam lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0275T","description":"Perq lamot/lam lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQA0","description":"ICD-OIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body pos goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8982","description":"Body pos goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy shower protect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7523","description":"Tracheostomy shower protect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each multiplex probe stain procedure (List separately in addition to code for prima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0850T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each multiplex probe stain procedure (List separately in addition to code for prima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No disc tx choices","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9401","description":"No disc tx choices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAD1","description":"ICD-GHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13B","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis a antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86708","description":"Hepatitis a antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychiatry (eg_ depression_ anxiety)_ genomic sequence analysis panel_ variant analysis of 13 genes_ saliva or buccal swab_ report of each gene phenotype","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0419U","description":"Neuropsychiatry (eg_ depression_ anxiety)_ genomic sequence analysis panel_ variant analysis of 13 genes_ saliva or buccal swab_ report of each gene phenotype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLD0","description":"ICD-KGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUB0","description":"ICD-EGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection for ankle x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27648","description":"Injection for ankle x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Microbe susceptible mic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87186","description":"Microbe susceptible mic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLD1","description":"ICD-NDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8C","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD130","description":"Special Care High _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB21","description":"ICD-1BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEF0","description":"ICD-MHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOC1","description":"ICD-LAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Patient Pregnancy Anytime During The Measurement Period Prior To And Including The Current Encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9997","description":"Documentation Of Patient Pregnancy Anytime During The Measurement Period Prior To And Including The Current Encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTC1","description":"ICD-MJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKF1","description":"ICD-GIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastroplasty w/o v-band","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43843","description":"Gastroplasty w/o v-band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc back tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21932","description":"Exc back tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cont airway pressure device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0601","description":"Cont airway pressure device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQF1","description":"ICD-GCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pm device eval in person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93288","description":"Pm device eval in person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tumor cell deplete of harvst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38211","description":"Tumor cell deplete of harvst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albumin (human)_ 25%_ 20 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9046","description":"Albumin (human)_ 25%_ 20 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVE1","description":"ICD-CEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAB0","description":"ICD-GDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVD1","description":"ICD-NDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOF0","description":"ICD-CHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALD0","description":"ICD-OALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFE0","description":"ICD-GEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brief emotional/behav assmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96127","description":"Brief emotional/behav assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; bilateral placement_ including cystoscopy and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0548T","description":"Transperineal periurethral balloon continence device; bilateral placement_ including cystoscopy and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYD1","description":"ICD-CHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear diagnostic exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78999","description":"Nuclear diagnostic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fall plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0518F","description":"Fall plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVC1","description":"ICD-BHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXA0","description":"ICD-CCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0823","description":"Pwc gp 2 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Addition to lower extremity prostheses_ osseointegrated external prosthetic connector","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5991","description":"Addition to lower extremity prostheses_ osseointegrated external prosthetic connector","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trichomonas vaginalis amplif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87661","description":"Trichomonas vaginalis amplif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB234","description":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGA1","description":"ICD-CEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revis reconst shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23473","description":"Revis reconst shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRD0","description":"ICD-PIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHF0","description":"ICD-AFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone biopsy trocar/needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20220","description":"Bone biopsy trocar/needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64605","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body-worn bilat hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5100","description":"Body-worn bilat hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66920","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIE0","description":"ICD-OHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Collection of microorganisms","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0415","description":"Collection of microorganisms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDND0","description":"ICD-GDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVA0","description":"ICD-NJVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICA0","description":"ICD-KICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2253","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","description":"HCPCS-J2253","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8G","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABB0","description":"ICD-KABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELF1","description":"ICD-JELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDB0","description":"ICD-MKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWB1","description":"ICD-HDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPD0","description":"ICD-CGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (RIV4)_ derived from recombinant DNA_ hemagglutinin (HA) protein only_ preservative and antibiotic free_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90682","description":"Influenza virus vaccine_ quadrivalent (RIV4)_ derived from recombinant DNA_ hemagglutinin (HA) protein only_ preservative and antibiotic free_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSE1","description":"ICD-CDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIB1","description":"ICD-JCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTB0","description":"ICD-OLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJB1","description":"ICD-NCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Supported employment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6106","description":"Supported employment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21A","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Emergency tracheotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7990","description":"Emergency tracheotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGF0","description":"ICD-GFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incobotulinumtoxin a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0588","description":"Incobotulinumtoxin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNB0","description":"ICD-JHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analys amniotic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88269","description":"Chromosome analys amniotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQD0","description":"ICD-OEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHA0","description":"ICD-IBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB23","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture ulnar styloid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25652","description":"Treat fracture ulnar styloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBE0","description":"ICD-ACBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOE0","description":"ICD-DAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31296","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHB1","description":"ICD-IGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low rsk thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3550F","description":"Low rsk thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26130","description":"Remove wrist joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUA1","description":"ICD-IEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPF0","description":"ICD-BFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICB1","description":"ICD-BICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sys<140 and dia<90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9273","description":"Sys<140 and dia<90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67850","description":"Treat eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infant safety class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9447","description":"Infant safety class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRF1","description":"ICD-OCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5260","description":"Hearing aid_ digit_ bin_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECB0","description":"ICD-EECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1038T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1038T","description":"CPT-1038T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYD0","description":"ICD-OFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUD1","description":"ICD-EIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fibrin degrade semiquant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85378","description":"Fibrin degrade semiquant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDF1","description":"ICD-NDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAD0","description":"ICD-OCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eyeglasses delux frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2025","description":"Eyeglasses delux frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRA1","description":"ICD-LBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2123","description":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMF1","description":"ICD-NCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam ribs bil 3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71110","description":"X-ray exam ribs bil 3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teprotumumab-trbw_10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9061","description":"Injection_ teprotumumab-trbw_10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0527U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","description":"CPT-0527U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Multi-vitamin nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9153","description":"Multi-vitamin nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOE0","description":"ICD-PIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nadofaragene firadenovec-vncg_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9029","description":"Injection_ nadofaragene firadenovec-vncg_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPF0","description":"ICD-CCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXF1","description":"ICD-JAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No asp therp used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8599","description":"No asp therp used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA03","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99326","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTF0","description":"ICD-NBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood glucose test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4772","description":"Blood glucose test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUB0","description":"ICD-MCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTB1","description":"ICD-CDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cabazitaxel (Sandoz)_ not therapeutically equivalent to J9043_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9064","description":"Injection_ cabazitaxel (Sandoz)_ not therapeutically equivalent to J9043_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25D","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Arthroscopy_ shoulder_ surgi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2300","description":"Arthroscopy_ shoulder_ surgi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99306","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYA1","description":"ICD-GEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEE0","description":"ICD-IIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1703","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1703","description":"CDT-D1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of chest artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37616","description":"Ligation of chest artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSE0","description":"ICD-PLSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGC0","description":"ICD-JBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPF1","description":"ICD-KCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Family psytx w/o patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90846","description":"Family psytx w/o patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2A","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open Implantation Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64582","description":"Open Implantation Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHB1","description":"ICD-MDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAB0","description":"ICD-BGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDE1","description":"ICD-OEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICB1","description":"ICD-KICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay three catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82384","description":"Assay three catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGID1","description":"ICD-JGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66130","description":"Remove eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPC0","description":"ICD-GIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBA0","description":"ICD-ODBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oximeter device for measuring bloodk osygen levels noninvasively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0445","description":"Oximeter device for measuring bloodk osygen levels noninvasively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWE0","description":"ICD-HFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKB1","description":"ICD-OKKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGE0","description":"ICD-KFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQA1","description":"ICD-OCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCID0","description":"ICD-FCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC31","description":"ICD-2AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXF0","description":"ICD-FHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSF1","description":"ICD-OFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5154","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","description":"HCPCS-Q5154","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFA1","description":"ICD-GEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTC0","description":"ICD-FBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee control condylar pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2810","description":"Knee control condylar pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69421","description":"Incision of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCE0","description":"ICD-IFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWF1","description":"ICD-LIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Home hospice case 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0271","description":"Home hospice case 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDE0","description":"ICD-AIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB221","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBD1","description":"ICD-JDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGME0","description":"ICD-CGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trim skin lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11055","description":"Trim skin lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEB0","description":"ICD-MKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biofeedback peri/uro/rectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90911","description":"Biofeedback peri/uro/rectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA17","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oxytocin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2590","description":"Oxytocin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No doc type nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9290","description":"No doc type nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Budesonide non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7626","description":"Budesonide non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Placement bile duct support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47801","description":"Placement bile duct support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB12","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJA0","description":"ICD-ODJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24101","description":"Explore/treat elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXF1","description":"ICD-KIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB23","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLF0","description":"ICD-OGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUF0","description":"ICD-OJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNE1","description":"ICD-KGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJC1","description":"ICD-OJJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHC0","description":"ICD-KIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD145","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCF0","description":"ICD-MCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pap oral interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7044","description":"Pap oral interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATD1","description":"ICD-IATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDC0","description":"ICD-MGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Improving care for lower extremity joint repair mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0058","description":"Improving care for lower extremity joint repair mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBC0","description":"ICD-KBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31370","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lso flex w/rigid stays cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0629","description":"Lso flex w/rigid stays cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPC0","description":"ICD-JBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAB0","description":"ICD-JBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dev interrog remote 1/2/mlt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93295","description":"Dev interrog remote 1/2/mlt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ed svc ckd grp per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0421","description":"Ed svc ckd grp per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraventricular pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93612","description":"Intraventricular pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28H","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0586T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATC1","description":"ICD-MATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMC1","description":"ICD-OKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"intravenous moderate  (conscious) sedation/analgesia- first 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9239","description":"intravenous moderate  (conscious) sedation/analgesia- first 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKD1","description":"ICD-BCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJC1","description":"ICD-BEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nail plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11730","description":"Removal of nail plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSB0","description":"ICD-KBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPC1","description":"ICD-CHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJE1","description":"ICD-CEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVD1","description":"ICD-BFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; not otherwise specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0129U","description":"Anesthesia for intracranial procedures; not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBE1","description":"ICD-NIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Art byp spenorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35636","description":"Art byp spenorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBE0","description":"ICD-CEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1497","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","description":"HCPCS-M1497","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDD0","description":"ICD-MDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Respite not-in-home per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0045","description":"Respite not-in-home per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18F","description":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Peri-px device eval & prgr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93287","description":"Peri-px device eval & prgr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fungus isolation culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87102","description":"Fungus isolation culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIA0","description":"ICD-NFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEF1","description":"ICD-OGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA255","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33511","description":"Cabg vein two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBA0","description":"ICD-BFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNE1","description":"ICD-BDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKF0","description":"ICD-ODKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEB0","description":"ICD-CHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKA1","description":"ICD-FFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVD0","description":"ICD-GHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGF1","description":"ICD-OLGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGF1","description":"ICD-BAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31070","description":"Exploration of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUB1","description":"ICD-IDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHD1","description":"ICD-IEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEC1","description":"ICD-NBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLD1","description":"ICD-IGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWD0","description":"ICD-LDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIA0","description":"ICD-NAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXC1","description":"ICD-JIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSC1","description":"ICD-KBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQE1","description":"ICD-KEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGA1","description":"ICD-KIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I131 iodide sol_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9530","description":"I131 iodide sol_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBE1","description":"ICD-MJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTB1","description":"ICD-IBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBA1","description":"ICD-FCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDD0","description":"ICD-IBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXF0","description":"ICD-KEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0553","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","description":"HCPCS-G0553","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Us exam of head and neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76536","description":"Us exam of head and neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEA1","description":"ICD-KIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFC0","description":"ICD-JFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFA0","description":"ICD-BFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHF1","description":"ICD-EDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINB0","description":"ICD-GINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostoma stent/stud/bttn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7524","description":"Tracheostoma stent/stud/bttn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKF0","description":"ICD-NKKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Soft Tissue_ Other_ Harvested By Direct Excision (Eg_ Fat_ Dermis_ Fascia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15769","description":"Grafting Of Autologous Soft Tissue_ Other_ Harvested By Direct Excision (Eg_ Fat_ Dermis_ Fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGA1","description":"ICD-BBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOF1","description":"ICD-CBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0878","description":"Pwc gp4 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCE1","description":"ICD-CGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg > 48 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6256","description":"Absorpt drg > 48 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFF1","description":"ICD-KCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTE1","description":"ICD-ECTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj enoxaparin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1650","description":"Inj enoxaparin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ elotuzumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9176","description":"Injection_ elotuzumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCC0","description":"ICD-MHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Seg pneum int legs/trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0670","description":"Seg pneum int legs/trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVC0","description":"ICD-BGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"late eposode 0-13 therapies_clinical severity level 1_ functional sererity level","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKS","description":"late eposode 0-13 therapies_clinical severity level 1_ functional sererity level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPE0","description":"ICD-FGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJB1","description":"ICD-GHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"3D Echocardiographic Imaging And Postprocessing During Transesophageal Echocardiography_ Or During Transthoracic Echocardiography For Congenital Cardiac Anomalies_ For The Ass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93319","description":"3D Echocardiographic Imaging And Postprocessing During Transesophageal Echocardiography_ Or During Transthoracic Echocardiography For Congenital Cardiac Anomalies_ For The Ass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Quant her2 ihc eval brst cx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3394F","description":"Quant her2 ihc eval brst cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAB1","description":"ICD-CDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNA1","description":"ICD-OGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5878","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5878","description":"CDT-D5878","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect femur/knee tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27365","description":"Resect femur/knee tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESD1","description":"ICD-LESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNE1","description":"ICD-GHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWD1","description":"ICD-HFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHA0","description":"ICD-GFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOD1","description":"ICD-GAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAE0","description":"ICD-MFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA expression profiling of HOXC6 and DLX1_ reverse transcription polymerase chain reaction (RT-PCR)_ first-void urine following digital rectal examinati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0339U","description":"Oncology (prostate)_ mRNA expression profiling of HOXC6 and DLX1_ reverse transcription polymerase chain reaction (RT-PCR)_ first-void urine following digital rectal examinati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYE0","description":"ICD-OHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHB1","description":"ICD-AIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGD1","description":"ICD-JIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRA0","description":"ICD-PFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5A","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9164","description":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELB0","description":"ICD-NELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0503T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43832","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Circumcision w/regionl block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54150","description":"Circumcision w/regionl block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGB0","description":"ICD-ODGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0803","description":"HCPCS-B0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBF0","description":"ICD-GFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVF0","description":"ICD-OBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNB1","description":"ICD-BCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTA1","description":"ICD-MKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13A","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45346","description":"Sigmoidoscopy w/ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKB0","description":"ICD-FAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWF0","description":"ICD-CIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33025","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL20","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVC1","description":"ICD-GEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTA0","description":"ICD-GBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC07","description":"Ultra High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Uxtr/Perph Nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0440T","description":"Abltj Perc Cryoabltj Img Gdn Uxtr/Perph Nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","description":"HCPCS-E1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB31","description":"ICD-1AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWF1","description":"ICD-DHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I125 serum albumin_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9532","description":"I125 serum albumin_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cochlear implt f/up exam <7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92601","description":"Cochlear implt f/up exam <7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQD1","description":"ICD-KAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKE1","description":"ICD-OBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lipoprotein bld by nmr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83704","description":"Lipoprotein bld by nmr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUF1","description":"ICD-GHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVD1","description":"ICD-OEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTB1","description":"ICD-ICTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No beta-lactam abx ther_ rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9560","description":"No beta-lactam abx ther_ rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Breast milk proc/store/dist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2101","description":"Breast milk proc/store/dist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44156","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLC1","description":"ICD-AFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tisagenlecleucel_ up to 250 million CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2040","description":"Tisagenlecleucel_ up to 250 million CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB140","description":"Clinically Complex _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKB1","description":"ICD-CFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Coch implant microphone repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8616","description":"Coch implant microphone repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIF1","description":"ICD-ECIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCB0","description":"ICD-NGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAB0","description":"ICD-MHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA213","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPA0","description":"ICD-CFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWF0","description":"ICD-CEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBD1","description":"ICD-EGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer with compression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0570","description":"Nebulizer with compression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatric symptoms assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9742","description":"Psychiatric symptoms assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3760F","description":"Pt w/dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33015","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adj skin pro/pos wc cus>=22","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2625","description":"Adj skin pro/pos wc cus>=22","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQC0","description":"ICD-GBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAF0","description":"ICD-NBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHD0","description":"ICD-BFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMB1","description":"ICD-NFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATD1","description":"ICD-CATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJD0","description":"ICD-GBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fluorodopa f-18_ diagnostic_ per mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9602","description":"Fluorodopa f-18_ diagnostic_ per mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDC1","description":"ICD-BFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJF0","description":"ICD-JDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81213","description":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWC1","description":"ICD-GCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLC0","description":"ICD-GFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair & adjust spectacles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92371","description":"Repair & adjust spectacles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA31","description":"Medium Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2A","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLF1","description":"ICD-GHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine potassium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84133","description":"Assay of urine potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTC0","description":"ICD-IHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ther injection carp tunnel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20526","description":"Ther injection carp tunnel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Composite drsg >16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6204","description":"Composite drsg >16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJD0","description":"ICD-CBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOD0","description":"ICD-CBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBD0","description":"ICD-FBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJC0","description":"ICD-NLJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHC0","description":"ICD-MHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ coagulation Factor Xa (recombinant)_ inactivated-zhzo (Andexxa)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7169","description":"Injection_ coagulation Factor Xa (recombinant)_ inactivated-zhzo (Andexxa)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13D","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEED1","description":"ICD-KEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSF0","description":"ICD-PGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAF1","description":"ICD-GAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC45","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTA0","description":"ICD-CDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of aldosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82088","description":"Assay of aldosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gallium ga-68 psma-11_ diagnostic_ (ucsf)_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9593","description":"Gallium ga-68 psma-11_ diagnostic_ (ucsf)_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINB1","description":"ICD-NINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Asp not presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9437","description":"Asp not presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSD0","description":"ICD-GGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Colistimethate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0770","description":"Colistimethate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQA0","description":"ICD-KIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3271F","description":"Low risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4C","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTC1","description":"ICD-BBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWA0","description":"ICD-LGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYD0","description":"ICD-PCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1009","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bcg live intravesical vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9031","description":"Bcg live intravesical vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGA0","description":"ICD-FDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUC1","description":"ICD-BGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5945","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5945","description":"CDT-D5945","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXB0","description":"ICD-NLXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWB0","description":"ICD-OBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGE1","description":"ICD-FFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2251","description":"Injection_ midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGB0","description":"ICD-JEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKC1","description":"ICD-CIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Waterproof tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4452","description":"Waterproof tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIA0","description":"ICD-KAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML32","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25929","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYC0","description":"ICD-CHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB21","description":"ICD-1KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFA1","description":"ICD-BEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWF0","description":"ICD-OGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea sen ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0425T","description":"Insj/rplc nstim apnea sen ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDD0","description":"ICD-MJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2D","description":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial thyroid excision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60212","description":"Partial thyroid excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC201","description":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of liver duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47400","description":"Incision of liver duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHD1","description":"ICD-FHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATF0","description":"ICD-JATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLA0","description":"ICD-GCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Change of windpipe airway","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31502","description":"Change of windpipe airway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUA1","description":"ICD-CIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBD0","description":"ICD-CGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEE0","description":"ICD-MBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOD1","description":"ICD-DHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFE1","description":"ICD-GHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRA1","description":"ICD-LGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRB1","description":"ICD-KDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALF0","description":"ICD-MALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monitor elec or comb vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0484","description":"Monitor elec or comb vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6004","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRC1","description":"ICD-HHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43360","description":"Gastrointestinal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision of neck cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42810","description":"Excision of neck cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6537","description":"Gc stocking full lngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTA1","description":"ICD-EFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32220","description":"Release of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIF1","description":"ICD-GHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intentional replantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3470","description":"Intentional replantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUC1","description":"ICD-GHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKE1","description":"ICD-KFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAD0","description":"ICD-GAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rilonacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2793","description":"Rilonacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIE1","description":"ICD-IIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genital surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58999","description":"Genital surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45112","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0602","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0602","description":"CDT-D0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTC1","description":"ICD-ODTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hpv high-risk types","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87624","description":"Hpv high-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aflibercept hd_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0177","description":"Injection_ aflibercept hd_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAB1","description":"ICD-MBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove torus mandibularis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7473","description":"Remove torus mandibularis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neostim membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4266","description":"Neostim membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIA0","description":"ICD-KDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIF1","description":"ICD-MDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVF0","description":"ICD-OEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18A","description":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWC1","description":"ICD-OEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUE1","description":"ICD-GIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDF1","description":"ICD-BCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25275","description":"Repair forearm tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYF0","description":"ICD-OKYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENC0","description":"ICD-KENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUE0","description":"ICD-GIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYD0","description":"ICD-CCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQC0","description":"ICD-KHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHE0","description":"ICD-JFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXC0","description":"ICD-FAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAD1","description":"ICD-FCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQE0","description":"ICD-DIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ vaginal pathogen panel_ identification of 27 organisms_ amplified probe technique_ vaginal swab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0330U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ vaginal pathogen panel_ identification of 27 organisms_ amplified probe technique_ vaginal swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exploration carotid artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35701","description":"Exploration carotid artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJA1","description":"ICD-FBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay myeloperoxidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83876","description":"Assay myeloperoxidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDA1","description":"ICD-MIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFB0","description":"ICD-GDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDB1","description":"ICD-NIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISA0","description":"ICD-LISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHE0","description":"ICD-MEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC21","description":"ICD-4LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPA1","description":"ICD-BHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDE0","description":"ICD-EIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33250","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAA0","description":"ICD-KGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00842","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","description":"CPT-00842","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD240","description":"Clinically Complex _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap revise gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43771","description":"Lap revise gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Health Safety)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7336","description":"Community Transition Svcs (Health Safety)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCB0","description":"ICD-MGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLE0","description":"ICD-FGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXF1","description":"ICD-BBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATA1","description":"ICD-AATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEB0","description":"ICD-JFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27158","description":"Revision of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKF0","description":"ICD-GBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt tlk psych & rx opd addic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4306F","description":"Pt tlk psych & rx opd addic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPF1","description":"ICD-NDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1705","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1705","description":"CDT-D1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLE0","description":"ICD-BBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCC1","description":"ICD-MHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKC0","description":"ICD-KIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chore services per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5120","description":"Chore services per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52283","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBB0","description":"ICD-KDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat scor nek/ts not don","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8674","description":"Fun stat scor nek/ts not don","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8H","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAF1","description":"ICD-KFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGD0","description":"ICD-OKGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"I131 serum albumin_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9524","description":"I131 serum albumin_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAD0","description":"ICD-JFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSF0","description":"ICD-DGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extraction coronal remnants","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7111","description":"Extraction coronal remnants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTE0","description":"ICD-BCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLD0","description":"ICD-NFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect neck tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21558","description":"Resect neck tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Above knee leather socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5642","description":"Above knee leather socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGC0","description":"ICD-NKGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXC1","description":"ICD-FCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rubella virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90706","description":"Rubella virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARE0","description":"ICD-OARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1370","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","description":"HCPCS-J1370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0506","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES210","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRE0","description":"ICD-DBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Attempted vbac delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59618","description":"Attempted vbac delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ corticotropin (Acthar Gel)_ up to 40 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0801","description":"Injection_ corticotropin (Acthar Gel)_ up to 40 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBD1","description":"ICD-OFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC01","description":"Very High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSA0","description":"ICD-DHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0671U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671U","description":"CPT-0671U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUD0","description":"ICD-OCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28X","description":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLF1","description":"ICD-CGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6526","description":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sutimlimab-jome_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9094","description":"Injection_ sutimlimab-jome_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Methadone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2067","description":"Medication Assisted Treatment_ Methadone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99235","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUF0","description":"ICD-FDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMF1","description":"ICD-JHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Syst corticosteroids not rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4136F","description":"Syst corticosteroids not rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCF0","description":"ICD-EGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Intraop cyto path consult 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88333","description":"Intraop cyto path consult 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE105","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8A","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMA1","description":"ICD-AEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D7-2D6 hybrid gene) (List separately in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0073U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D7-2D6 hybrid gene) (List separately in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAC1","description":"ICD-JGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEB0","description":"ICD-KHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVF0","description":"ICD-JDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1020T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","description":"CPT-1020T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc perm/cont/parox atr fib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1060F","description":"Doc perm/cont/parox atr fib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0572U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","description":"CPT-0572U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDE0","description":"ICD-IGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLC1","description":"ICD-ACLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANA0","description":"ICD-JANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Relocation Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To Existing Dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0681T","description":"Relocation Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To Existing Dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLE1","description":"ICD-OHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELE1","description":"ICD-AELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3B","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBE1","description":"ICD-JFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUE0","description":"ICD-FIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYF1","description":"ICD-HGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSD1","description":"ICD-DFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRF1","description":"ICD-GDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0B","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDF1","description":"ICD-ACDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trastuzumab administered within 12 months of diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9835","description":"Trastuzumab administered within 12 months of diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAF1","description":"ICD-IAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCF1","description":"ICD-FFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ob us < 14 wks addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76802","description":"Ob us < 14 wks addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo examination procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76999","description":"Echo examination procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc advncd dis comfort 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1152F","description":"Doc advncd dis comfort 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chemo iv infusion 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96413","description":"Chemo iv infusion 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL01","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMD0","description":"ICD-IFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylindr 4.00d/2.12-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2104","description":"Spherocylindr 4.00d/2.12-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTE1","description":"ICD-AFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1496","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","description":"HCPCS-M1496","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDB0","description":"ICD-AGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; up to 7 vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22836","description":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; up to 7 vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37298","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","description":"CPT-37298","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIB0","description":"ICD-MCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA244","description":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion radioulnar jnt/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25830","description":"Fusion radioulnar jnt/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Custom gradient sleev/glov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8420","description":"Custom gradient sleev/glov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cath w/o bag 2-way silicone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4312","description":"Cath w/o bag 2-way silicone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBF1","description":"ICD-NIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"NUDT15 (nudix hydrolase 15) (eg_ drug metabolism) gene analysis_ common variant(s) (eg_ *2_ *3_ *4_ *5_ *6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81306","description":"NUDT15 (nudix hydrolase 15) (eg_ drug metabolism) gene analysis_ common variant(s) (eg_ *2_ *3_ *4_ *5_ *6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92636","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","description":"CPT-92636","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMF1","description":"ICD-MEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKD1","description":"ICD-NAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMD1","description":"ICD-OKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage lymph node lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38305","description":"Drainage lymph node lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reopen fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58350","description":"Reopen fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOD1","description":"ICD-LGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99157","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an RHC or FQHC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0071","description":"Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an RHC or FQHC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAD1","description":"ICD-JHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWE0","description":"ICD-DIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXF0","description":"ICD-GFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEE1","description":"ICD-GEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD251","description":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPA1","description":"ICD-FBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7519","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAB0","description":"ICD-OKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84144","description":"Assay of progesterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orthoptic/pleoptic training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92065","description":"Orthoptic/pleoptic training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ugt1a1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81350","description":"Ugt1a1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEB0","description":"ICD-CFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin/1000u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0725","description":"Chorionic gonadotropin/1000u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDA1","description":"ICD-KBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCA0","description":"ICD-KGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRE0","description":"ICD-PDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC121","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tafasitamab-cxix_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9349","description":"Injection_ tafasitamab-cxix_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dna analysis deafness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3844","description":"Dna analysis deafness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBID0","description":"ICD-EBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33864","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Refill/maint pump/resvr syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96522","description":"Refill/maint pump/resvr syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC46","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCF0","description":"ICD-CHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ delandistrogene moxeparvovec-rokl_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1413","description":"Injection_ delandistrogene moxeparvovec-rokl_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90833","description":"Psytx pt&/fam w/e&m 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFA1","description":"ICD-ODFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINF1","description":"ICD-KINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"O shoe add standard toe tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3550","description":"O shoe add standard toe tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDED0","description":"ICD-NDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","description":"HCPCS-E1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18D","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of donor heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33940","description":"Removal of donor heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTC0","description":"ICD-NFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transab esoph hiat hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43332","description":"Transab esoph hiat hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJE1","description":"ICD-CDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXC0","description":"ICD-CBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEA1","description":"ICD-FAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Team conf w/o pat by phys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99367","description":"Team conf w/o pat by phys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip clevis/thrust bearing fr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2600","description":"Hip clevis/thrust bearing fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Brachytherapy needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1715","description":"Brachytherapy needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHED0","description":"ICD-GHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRD0","description":"ICD-DDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66020","description":"Injection treatment of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL31","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL40","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cyto/molecular report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88291","description":"Cyto/molecular report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc no events on discharg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8907","description":"Pt doc no events on discharg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J8541","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","description":"HCPCS-J8541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD215","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYC0","description":"ICD-GFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOC0","description":"ICD-CAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hpv types 16 & 18 only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87625","description":"Hpv types 16 & 18 only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy_ single or multiple_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7542","description":"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy_ single or multiple_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Frenulectomy/frenulotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7960","description":"Frenulectomy/frenulotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLD0","description":"ICD-EHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tracheal suction tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4624","description":"Tracheal suction tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ins tun ip cath for dial opn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49421","description":"Ins tun ip cath for dial opn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rbc_ frz/deg/wsh_ l/r_ irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9057","description":"Rbc_ frz/deg/wsh_ l/r_ irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ efgartigimod alfa_ 2 mg and hyaluronidase-qvfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9334","description":"Injection_ efgartigimod alfa_ 2 mg and hyaluronidase-qvfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Kanamycin sulfate 500 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1840","description":"Kanamycin sulfate 500 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNA1","description":"ICD-CGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gardner vag dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87512","description":"Gardner vag dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nvr cndj tst 1-2 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95907","description":"Nvr cndj tst 1-2 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINC0","description":"ICD-KINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrics (expanded carrier screening)_ 145 genes by nextgeneration sequencing_ fragment analysis and multiplex ligationdependent probe amplification_ DNA_ reported as carrie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0400U","description":"Obstetrics (expanded carrier screening)_ 145 genes by nextgeneration sequencing_ fragment analysis and multiplex ligationdependent probe amplification_ DNA_ reported as carrie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove coronoid process","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21070","description":"Remove coronoid process","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmi documented outside normal parameters_ no follow-up plan documented_ no reason given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1276","description":"Bmi documented outside normal parameters_ no follow-up plan documented_ no reason given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lang express d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9164","description":"Lang express d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXF0","description":"ICD-FBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKE0","description":"ICD-KAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBE0","description":"ICD-GIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEB0","description":"ICD-OLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_phys coor-care ovrsght","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9008","description":"Mccd_phys coor-care ovrsght","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQC1","description":"ICD-OIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE236","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flortaucipir F 18 injection_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9601","description":"Flortaucipir F 18 injection_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1105","description":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54200","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEE0","description":"ICD-NLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28A","description":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIF0","description":"ICD-EDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBF0","description":"ICD-KCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDF0","description":"ICD-CBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ace/arb thxpy for mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4210F","description":"Ace/arb thxpy for mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUF1","description":"ICD-AIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal fat absorpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3708","description":"Gastrointestinal fat absorpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGB0","description":"ICD-NCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHA1","description":"ICD-NBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Install spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63740","description":"Install spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA15","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFA1","description":"ICD-GGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33750","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; each additional electr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64597","description":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; each additional electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBC1","description":"ICD-FGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar artif diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22857","description":"Lumbar artif diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATF1","description":"ICD-NATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVC0","description":"ICD-OFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Near ifr spectrsc of wounds","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0286T","description":"Near ifr spectrsc of wounds","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Macroscopic exam arthropod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87168","description":"Macroscopic exam arthropod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOA1","description":"ICD-KIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Red cell sequestration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78140","description":"Red cell sequestration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC30","description":"Very High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRF0","description":"ICD-LGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Group audiometric testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92559","description":"Group audiometric testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWE1","description":"ICD-PIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Capecitabine_ oral_ 150 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8520","description":"Capecitabine_ oral_ 150 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUE0","description":"ICD-CHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient received combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9956","description":"Patient received combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD205","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Botulism ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90288","description":"Botulism ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand propeptide_ enzyme-linked immunosorbent assays (ELISA)_ plasma_ diagnostic report of von Willebrand factor (VWF) prop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0281U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand propeptide_ enzyme-linked immunosorbent assays (ELISA)_ plasma_ diagnostic report of von Willebrand factor (VWF) prop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTB0","description":"ICD-FFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMF1","description":"ICD-AFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55000","description":"Drainage of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOC0","description":"ICD-GGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHE1","description":"ICD-GHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCC0","description":"ICD-IFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALD1","description":"ICD-KALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHC1","description":"ICD-CBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30462","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlh uterus 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58570","description":"Tlh uterus 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCB1","description":"ICD-OCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt no tx sys bio rx 6 mths","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9653","description":"Pt no tx sys bio rx 6 mths","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tte w/doppler complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93306","description":"Tte w/doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx duod intub w/asp specs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43757","description":"Dx duod intub w/asp specs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTD0","description":"ICD-ICTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of mesentery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44850","description":"Repair of mesentery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHB1","description":"ICD-MFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lung volume reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32491","description":"Lung volume reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCC1","description":"ICD-BHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCA1","description":"ICD-BFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61313","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Procure donor sperm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4026","description":"Procure donor sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDF1","description":"ICD-EBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVB1","description":"ICD-JHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METC0","description":"ICD-METC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUC1","description":"ICD-EGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRB1","description":"ICD-DCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc fcn/care plan w/30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8942","description":"Doc fcn/care plan w/30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJB1","description":"ICD-CHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIE0","description":"ICD-NGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKD1","description":"ICD-GDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTA0","description":"ICD-KCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLC1","description":"ICD-OCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIE1","description":"ICD-MLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skilled Nursing Facility Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4033","description":"Skilled Nursing Facility Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUC0","description":"ICD-OGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQA0","description":"ICD-HIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE224","description":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAE1","description":"ICD-JBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLE0","description":"ICD-JGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0124A","description":"IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incision of spinal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64772","description":"Incision of spinal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL32","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELD0","description":"ICD-BELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ eteplirsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1428","description":"Injection_ eteplirsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHB1","description":"ICD-BEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXE1","description":"ICD-FFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAC1","description":"ICD-CCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of finger lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26210","description":"Removal of finger lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQC1","description":"ICD-HEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIME1","description":"ICD-EIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj olanzapine 2.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0166","description":"Inj olanzapine 2.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDB1","description":"ICD-KDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOC0","description":"ICD-GAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88377","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCF1","description":"ICD-NFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPD1","description":"ICD-NAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDF1","description":"ICD-GHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dyspnea scrnd no-mild dysp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3450F","description":"Dyspnea scrnd no-mild dysp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBD0","description":"ICD-MJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAC0","description":"ICD-JBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFA0","description":"ICD-GGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22D","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETC0","description":"ICD-GETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNB1","description":"ICD-GFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYC1","description":"ICD-DFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Trabeculostomy Ab Interno By Laser;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0621T","description":"Trabeculostomy Ab Interno By Laser;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1082","description":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exam synovial fluid crystals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89060","description":"Exam synovial fluid crystals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGA1","description":"ICD-JIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB114","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBE1","description":"ICD-IDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML55","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-63032","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","description":"CPT-63032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sebelipase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2840","description":"Injection_ sebelipase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bone/skin graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20969","description":"Bone/skin graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISF0","description":"ICD-PISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech Language Pathology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4034","description":"Speech Language Pathology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAC0","description":"ICD-GDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20C","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73630","description":"X-ray exam of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUA1","description":"ICD-EIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNC0","description":"ICD-BDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTA0","description":"ICD-ODTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEE1","description":"ICD-IIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ho abduction hip adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1650","description":"Ho abduction hip adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVF0","description":"ICD-GBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55815","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip joint adjustable flexion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2622","description":"Hip joint adjustable flexion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay porc 3/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2630","description":"Dental onlay porc 3/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pontic-indirect resin based","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6205","description":"Pontic-indirect resin based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAE1","description":"ICD-KIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAE1","description":"ICD-NCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTF0","description":"ICD-ADTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSF1","description":"ICD-GHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHD1","description":"ICD-MCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKF1","description":"ICD-NDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRF1","description":"ICD-PIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUE0","description":"ICD-BCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIF0","description":"ICD-ODIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27087","description":"Remove hip foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin hydral swg ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5814","description":"Endo knee-shin hydral swg ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIID0","description":"ICD-CIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIF1","description":"ICD-EAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGF0","description":"ICD-KCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXA0","description":"ICD-OBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEF0","description":"ICD-NIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: occipital headache in children","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2195","description":"Patients with clinical indications for imaging of the head: occipital headache in children","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-surg tx root canal obs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3331","description":"Non-surg tx root canal obs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ht muscle image spect mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78452","description":"Ht muscle image spect mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQB1","description":"ICD-DFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFD0","description":"ICD-BBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUC0","description":"ICD-MHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28540","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99214","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKF1","description":"ICD-KDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUB0","description":"ICD-FGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILA1","description":"ICD-GILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reptilase test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85635","description":"Reptilase test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hf assessment tool completed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3117F","description":"Hf assessment tool completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIC1","description":"ICD-KIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBC1","description":"ICD-NIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYE1","description":"ICD-HAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUD1","description":"ICD-FDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVF1","description":"ICD-NIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJC1","description":"ICD-CCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFA0","description":"ICD-JDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELA0","description":"ICD-OELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUA1","description":"ICD-OEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENF0","description":"ICD-CENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHA0","description":"ICD-EAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0861","description":"Pwc gp3 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46735","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","description":"HCPCS-M1379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB11","description":"ICD-4DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61641","description":"Dilate ic vasospasm add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29875","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sinusitis comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9464","description":"Sinusitis comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-rays bone length studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77073","description":"X-rays bone length studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dorsi & plantar flex ass/res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2220","description":"Dorsi & plantar flex ass/res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIC1","description":"ICD-IFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive jaw surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21045","description":"Extensive jaw surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj ivig privigen 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1459","description":"Inj ivig privigen 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYD1","description":"ICD-KIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Open_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33267","description":"Exclusion Of Left Atrial Appendage_ Open_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUC0","description":"ICD-AIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients receiving rrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1199","description":"Patients receiving rrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Memory d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9170","description":"Memory d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCB1","description":"ICD-CBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHE1","description":"ICD-EFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCE1","description":"ICD-EFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISE0","description":"ICD-DISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14C","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair double ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33611","description":"Repair double ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVD0","description":"ICD-BBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINB0","description":"ICD-CINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIC1","description":"ICD-KCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOD0","description":"ICD-LGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDF1","description":"ICD-ABDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVB1","description":"ICD-FIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNF1","description":"ICD-KFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQD1","description":"ICD-HCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8E","description":"Low Rehab_ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHF0","description":"ICD-BFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRF0","description":"ICD-PGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test cran nerve bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95868","description":"Muscle test cran nerve bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPB1","description":"ICD-OJPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5159","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","description":"HCPCS-Q5159","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug screenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0003","description":"Alcohol and/or drug screenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSF0","description":"ICD-KHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCE0","description":"ICD-OCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDE0","description":"ICD-FDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documentation that the patient declined therapy change or alternative therapies were unavailable_ has documented contraindications_ or has not been treated with an oral system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9765","description":"Documentation that the patient declined therapy change or alternative therapies were unavailable_ has documented contraindications_ or has not been treated with an oral system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRE1","description":"ICD-PIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1301","description":"HCPCS-B1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERC1","description":"ICD-KERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICC0","description":"ICD-EICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of femur epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27185","description":"Revision of femur epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHB0","description":"ICD-OKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion And Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual An","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2072","description":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion And Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIE1","description":"ICD-NIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWF0","description":"ICD-CFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXB0","description":"ICD-JBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1743","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1743","description":"HCPCS-C1743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTD1","description":"ICD-FGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84580","description":"Assay of urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFE1","description":"ICD-BGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGF0","description":"ICD-GCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUC0","description":"ICD-IIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLE1","description":"ICD-GFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace socket above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5701","description":"Replace socket above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incise spin&cord 2 stgs crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63198","description":"Incise spin&cord 2 stgs crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1045T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1045T","description":"CPT-1045T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQE0","description":"ICD-CBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmi calc_ pt no f/u plan elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8938","description":"Bmi calc_ pt no f/u plan elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6519","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","description":"HCPCS-A6519","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt has symp&signs neuropathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3753F","description":"Pt has symp&signs neuropathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Muscle-skin graft head/neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15732","description":"Muscle-skin graft head/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTD0","description":"ICD-KFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHA0","description":"ICD-EDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Body fluid cell count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89050","description":"Body fluid cell count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUE0","description":"ICD-BDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD136","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUA1","description":"ICD-CHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJE0","description":"ICD-JCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge porcelain high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6240","description":"Bridge porcelain high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRD0","description":"ICD-OLRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXF0","description":"ICD-BIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPC1","description":"ICD-JBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0303","description":"HCPCS-B0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFC1","description":"ICD-GEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce radius and ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25492","description":"Reinforce radius and ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phys blood bank serv reactj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86078","description":"Phys blood bank serv reactj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26410","description":"Repair hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTC1","description":"ICD-IGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUA1","description":"ICD-BIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFA0","description":"ICD-ODFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMD1","description":"ICD-GEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"BCG live intravesical instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9030","description":"BCG live intravesical instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIF0","description":"ICD-KFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Xcell amnio matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4280","description":"Xcell amnio matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alerting device_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5269","description":"Alerting device_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cranial electrotherapy stimulation (ces) system_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0732","description":"Cranial electrotherapy stimulation (ces) system_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Janssen Covid-19 Vaccine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91303","description":"Janssen Covid-19 Vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Human epididymis protein 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86305","description":"Human epididymis protein 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBC1","description":"ICD-ICBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digital sub 2 or more images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0394","description":"Digital sub 2 or more images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGD0","description":"ICD-GIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQC0","description":"ICD-DHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Belt/vest elec/combo vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0499","description":"Belt/vest elec/combo vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Corneal topography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92025","description":"Corneal topography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBD1","description":"ICD-CHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANA1","description":"ICD-FANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech lang current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9174","description":"Speech lang current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cygnus dual_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4282","description":"Cygnus dual_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQB1","description":"ICD-KGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52234","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCA1","description":"ICD-KHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBD1","description":"ICD-KBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADC0","description":"ICD-IADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC11","description":"ICD-3HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMF1","description":"ICD-MBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLC0","description":"ICD-JDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Report_ diabetes measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8485","description":"Report_ diabetes measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAF0","description":"ICD-BEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl/rplc nstim apnea pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0431T","description":"Rmvl/rplc nstim apnea pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAF1","description":"ICD-GBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dihydromorphinone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6046","description":"Dihydromorphinone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCD0","description":"ICD-CHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWC0","description":"ICD-PKWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYE1","description":"ICD-HIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAB1","description":"ICD-EDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9894","description":"Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVC1","description":"ICD-BGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAC1","description":"ICD-NAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21B","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive Care Management Services For A Single High-Risk Disease_ E.G._ Principal Care Management_ At Least 30 Minutes Of Physician  Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2064","description":"Comprehensive Care Management Services For A Single High-Risk Disease_ E.G._ Principal Care Management_ At Least 30 Minutes Of Physician  Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for blood smear_ peripheral_ interpretation by physician with written report (List separately in addition to code for primary procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0854T","description":"Digitization of glass microscope slides for blood smear_ peripheral_ interpretation by physician with written report (List separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB115","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOD1","description":"ICD-HBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22847","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIB0","description":"ICD-OFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy revise stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31638","description":"Bronchoscopy revise stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTE1","description":"ICD-FBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) Class II_ III_ IVA heart failure; transcatheter implantation of left atrial to coronary sinus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9792","description":"Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) Class II_ III_ IVA heart failure; transcatheter implantation of left atrial to coronary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replace chest compress vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7025","description":"Replace chest compress vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90616","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90616","description":"CPT-90616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amputee adapter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0959","description":"Amputee adapter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQD1","description":"ICD-DCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHE1","description":"ICD-OLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mepolizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2182","description":"Injection_ mepolizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Copd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8757","description":"Copd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23A","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (cerebral folate deficiency)_ serum_ detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA)_ q","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0399U","description":"Neurology (cerebral folate deficiency)_ serum_ detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA)_ q","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADB0","description":"ICD-IADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9192","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9192","description":"HCPCS-J9192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD231","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13B","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUC0","description":"ICD-CFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATD1","description":"ICD-BATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ olaratumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9285","description":"Injection_ olaratumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMD1","description":"ICD-MFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHC0","description":"ICD-BDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01180","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01180","description":"CPT-01180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47141","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Replacement pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33475","description":"Replacement pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEC1","description":"ICD-MDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFA1","description":"ICD-KAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36815","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIB1","description":"ICD-CAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD101","description":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Create tear duct drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68750","description":"Create tear duct drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lap vent/abd hern proc comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49653","description":"Lap vent/abd hern proc comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRE0","description":"ICD-CFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJA1","description":"ICD-BDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99243","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9629","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behind ear hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5060","description":"Behind ear hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPA0","description":"ICD-OLPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal duct glbldr calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47544","description":"Removal duct glbldr calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70330","description":"X-ray exam of jaw joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUD1","description":"ICD-MJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIA0","description":"ICD-JBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6087","description":"Implant Supported Crown - Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transesoph doppl cardiac mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9157","description":"Transesoph doppl cardiac mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12D","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33777","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILD0","description":"ICD-EILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant spike protein nanoparticle_ saponin-based adjuvant_5mcg/0.5m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91304","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant spike protein nanoparticle_ saponin-based adjuvant_5mcg/0.5m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cryoablate renal mass open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50250","description":"Cryoablate renal mass open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10C","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNA0","description":"ICD-FDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVC0","description":"ICD-FAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEC1","description":"ICD-FHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLE0","description":"ICD-MHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBF0","description":"ICD-NJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation of speech fluency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92521","description":"Evaluation of speech fluency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTD0","description":"ICD-MCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHA1","description":"ICD-GHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34706","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDA0","description":"ICD-JIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUA1","description":"ICD-KGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQD0","description":"ICD-CEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy lymph node biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38570","description":"Laparoscopy lymph node biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXE1","description":"ICD-KHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27557","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHE1","description":"ICD-AIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAC1","description":"ICD-FBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEA0","description":"ICD-FEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETA1","description":"ICD-JETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABD0","description":"ICD-JABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOC1","description":"ICD-PIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0801","description":"HCPCS-A0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSB1","description":"ICD-PFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone_ lacrimal ophthalmic insert_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1096","description":"Dexamethasone_ lacrimal ophthalmic insert_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fixation of tongue_ mechanical_ other than suture (eg_ K-wire)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41500","description":"Fixation of tongue_ mechanical_ other than suture (eg_ K-wire)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ankle ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27698","description":"Repair of ankle ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDD1","description":"ICD-EFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAE0","description":"ICD-JEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Battery pneum vad replacemnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0503","description":"Battery pneum vad replacemnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14D","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hallux implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8642","description":"Hallux implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWC1","description":"ICD-LHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4384","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","description":"HCPCS-Q4384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"guided tissue regeneration_ edentulous area - non-resorbable barrier_ per site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7957","description":"guided tissue regeneration_ edentulous area - non-resorbable barrier_ per site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC156","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Removal Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0679T","description":"Laparoscopic Removal Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21490","description":"Repair dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXA1","description":"ICD-FDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQD0","description":"ICD-KEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45349","description":"Sigmoidoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Legg perthes patten bottom t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1755","description":"Legg perthes patten bottom t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCB0","description":"ICD-GBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE211","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ CROS_ in the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5170","description":"Hearing aid_ CROS_ in the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTC0","description":"ICD-AGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBED0","description":"ICD-NBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76705","description":"Echo exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTB1","description":"ICD-NFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01400","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","description":"CPT-01400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIB0","description":"ICD-CFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Sequencing And Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Tissue_ Blood_ Or Bone Marrow_ Comparative Sequenc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0300U","description":"Oncology (Pan Tumor)_ Whole Genome Sequencing And Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Tissue_ Blood_ Or Bone Marrow_ Comparative Sequenc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCD0","description":"ICD-JGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVA0","description":"ICD-CDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Orchiopexy (fowler-stephens)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54650","description":"Orchiopexy (fowler-stephens)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOE1","description":"ICD-DHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of tendons at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25300","description":"Fusion of tendons at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCE0","description":"ICD-KFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE234","description":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNF0","description":"ICD-GGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOD1","description":"ICD-PGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLE0","description":"ICD-BGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert xdrl body thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63301","description":"Remove vert xdrl body thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4337","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","description":"HCPCS-Q4337","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXF0","description":"ICD-NHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim 6mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2505","description":"Injection_ pegfilgrastim 6mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEE1","description":"ICD-OHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59121","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg myelomeningo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2404","description":"Fetal surg myelomeningo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHE1","description":"ICD-GFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCA1","description":"ICD-JFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2A","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11600","description":"Exc tr-ext mal+marg 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dx gastr intub w/asp specs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43755","description":"Dx gastr intub w/asp specs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (bluepoint) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9322","description":"Injection_ pemetrexed (bluepoint) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIC0","description":"ICD-BCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLC0","description":"ICD-GDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"IDH1 (isocitrate dehydrogenase 1 [NADP+]_ soluble) (eg_ glioma)_ common variants (eg_ R132H_ R132C)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81120","description":"IDH1 (isocitrate dehydrogenase 1 [NADP+]_ soluble) (eg_ glioma)_ common variants (eg_ R132H_ R132C)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Soft interface material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1820","description":"Soft interface material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEA1","description":"ICD-MJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFC0","description":"ICD-BAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADB1","description":"ICD-MADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENA0","description":"ICD-FENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMC1","description":"ICD-FCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1805","description":"HCPCS-A1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLE0","description":"ICD-JHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0014","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0014","description":"HCPCS-J0014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect tibia tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27645","description":"Resect tibia tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Abciximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0130","description":"Abciximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFA0","description":"ICD-OBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lacer molded to patient mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2330","description":"Lacer molded to patient mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPB1","description":"ICD-FFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGA1","description":"ICD-BAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic injection/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51715","description":"Endoscopic injection/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUB1","description":"ICD-BCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism ehealthline clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1021","description":"Clinical decision support mechanism ehealthline clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAD1","description":"ICD-JAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2003","description":"HCPCS-B2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES314","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18D","description":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 2mod symphis-xipho pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0458","description":"Tlso 2mod symphis-xipho pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUF1","description":"ICD-MKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIA1","description":"ICD-CHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental tmj arthrogram incl i","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0320","description":"Dental tmj arthrogram incl i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Laps impltj nstim vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0312T","description":"Laps impltj nstim vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27235","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reusable enema bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4458","description":"Reusable enema bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKD0","description":"ICD-OLKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC155","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0085","description":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHF0","description":"ICD-IEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cholera vaccine live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90625","description":"Cholera vaccine live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB22","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXE1","description":"ICD-OLXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98013","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","description":"CPT-98013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDF0","description":"ICD-MIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENA1","description":"ICD-JENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99177","description":"Ocular instrumnt screen bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMC0","description":"ICD-MBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9066","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9066","description":"HCPCS-J9066","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYF1","description":"ICD-HAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eia hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0432","description":"Eia hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-S4024","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","description":"HCPCS-S4024","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIE0","description":"ICD-IBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7638","description":"Dexamethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISA1","description":"ICD-GISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQA1","description":"ICD-GGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFC1","description":"ICD-GGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTB1","description":"ICD-FHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Inj ferric pyrophosphate cit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1443","description":"Inj ferric pyrophosphate cit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pin hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26676","description":"Pin hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOE1","description":"ICD-DBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWA1","description":"ICD-OCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABF0","description":"ICD-AABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBA1","description":"ICD-FIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0543","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","description":"HCPCS-G0543","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUC0","description":"ICD-BHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIA0","description":"ICD-FEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOC1","description":"ICD-GIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE125","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit hydra total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9373","description":"Hit hydra total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKD1","description":"ICD-CBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTC0","description":"ICD-MBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Specimen not intraop image","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8873","description":"Specimen not intraop image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis g dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87526","description":"Hepatitis g dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUE0","description":"ICD-MIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60220","description":"Partial removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lipase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83690","description":"Assay of lipase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXA1","description":"ICD-BFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVB0","description":"ICD-KCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGB0","description":"ICD-KFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adult size brief/diaper sm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4521","description":"Adult size brief/diaper sm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFA0","description":"ICD-KAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPA0","description":"ICD-KIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXE0","description":"ICD-FDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADF0","description":"ICD-AADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bile duct endoscopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47550","description":"Bile duct endoscopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASA1","description":"ICD-GASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dental case management - patient education to improve oral health literacy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9994","description":"Dental case management - patient education to improve oral health literacy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMC0","description":"ICD-CFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUD0","description":"ICD-JEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"D/c hemo or perit dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9523","description":"D/c hemo or perit dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFB1","description":"ICD-FHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Geriatrics Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4008","description":"Geriatrics Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWD0","description":"ICD-ODWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg cast chg wrst/elb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6380","description":"Postop dsg cast chg wrst/elb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTD0","description":"ICD-OKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthro w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29861","description":"Hip arthro w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Explore/biopsy eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67450","description":"Explore/biopsy eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"W/c dpth 22-25 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2343","description":"W/c dpth 22-25 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26235","description":"Partial removal finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJA0","description":"ICD-OJJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63081","description":"Remove vert body dcmprn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA11","description":"ICD-3CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92314","description":"Prescription of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caries preventive medicament application - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1355","description":"Caries preventive medicament application - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUE1","description":"ICD-GDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTD0","description":"ICD-OJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRC0","description":"ICD-PLRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELD0","description":"ICD-GELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBB1","description":"ICD-BDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cannabinoids synthetic 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80351","description":"Cannabinoids synthetic 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove mesh from abd wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11008","description":"Remove mesh from abd wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBC1","description":"ICD-CIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWE1","description":"ICD-DIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYA1","description":"ICD-LHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA141","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic pneumothorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32960","description":"Therapeutic pneumothorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADE0","description":"ICD-FADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Structured Day Habilitation Group 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0105","description":"Structured Day Habilitation Group 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD150","description":"Special Care High _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antinuclear antibodies (ana)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86039","description":"Antinuclear antibodies (ana)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX35","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65101","description":"Removal of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr trunk 10.1-30sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14001","description":"Tis trnfr trunk 10.1-30sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAA0","description":"ICD-BAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rabies vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90675","description":"Rabies vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSD0","description":"ICD-KBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGD0","description":"ICD-KAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRC1","description":"ICD-PDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCB0","description":"ICD-IBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB235","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRE1","description":"ICD-KGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQB0","description":"ICD-OGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit pain imp pump diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9328","description":"Hit pain imp pump diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27284","description":"Fusion of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB236","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1415","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","description":"HCPCS-M1415","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-1 piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21141","description":"Lefort i-1 piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Not all data norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9324","description":"Not all data norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBA0","description":"ICD-MCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61512","description":"Remove brain lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOB0","description":"ICD-PGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hla class ii high defin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86833","description":"Hla class ii high defin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAF0","description":"ICD-CIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Non-Invasive Calculation And Analysis Of Central Arterial Pressure Waveforms With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0311T","description":"Non-Invasive Calculation And Analysis Of Central Arterial Pressure Waveforms With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC11","description":"ICD-2BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXB0","description":"ICD-CDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLC1","description":"ICD-NDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sgd prerec msg>20min <=40min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2504","description":"Sgd prerec msg>20min <=40min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBC0","description":"ICD-KGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUC1","description":"ICD-KAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1023","description":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc medrsn no histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9282","description":"Doc medrsn no histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7514","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0517T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMA1","description":"ICD-FFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acylcarnitines quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82017","description":"Acylcarnitines quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLA0","description":"ICD-MBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUC1","description":"ICD-OCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No unheal etoh user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9622","description":"No unheal etoh user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Self care d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8989","description":"Self care d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUA1","description":"ICD-FIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neutron beam tx simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77422","description":"Neutron beam tx simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMC1","description":"ICD-JCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBD0","description":"ICD-JEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMD1","description":"ICD-AEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPC0","description":"ICD-GHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQD0","description":"ICD-DBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC06","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOA1","description":"ICD-KFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Implant mid ear hearing pros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5095","description":"Implant mid ear hearing pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITF0","description":"ICD-AITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXE0","description":"ICD-GGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC31","description":"ICD-4FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDD0","description":"ICD-MEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIA0","description":"ICD-IBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLE1","description":"ICD-ACLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWE0","description":"ICD-KCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJF0","description":"ICD-OCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Paranasal sinus ultrasound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9024","description":"Paranasal sinus ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITE0","description":"ICD-NITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQE1","description":"ICD-DHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mohs 1 stage t/a/l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17313","description":"Mohs 1 stage t/a/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m labeled rbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9560","description":"Tc99m labeled rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34451","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKB1","description":"ICD-BFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8H","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDE0","description":"ICD-GCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAD0","description":"ICD-OIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUE1","description":"ICD-FCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTB0","description":"ICD-BDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMA1","description":"ICD-JEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAD0","description":"ICD-IFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQD0","description":"ICD-GIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWE1","description":"ICD-KHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of pylorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43800","description":"Reconstruction of pylorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8G","description":"Medium Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teprotumumab-trbw_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3241","description":"Injection_ teprotumumab-trbw_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYD0","description":"ICD-PGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transection or ligation_ carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61612","description":"Transection or ligation_ carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYE0","description":"ICD-HEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVE1","description":"ICD-FIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDA1","description":"ICD-NJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25B","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC155","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRF1","description":"ICD-DHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5C","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL52","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQF1","description":"ICD-GBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Full mouth debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4355","description":"Full mouth debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray 1 view frontal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71010","description":"Chest x-ray 1 view frontal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0915T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","description":"CPT-0915T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMD0","description":"ICD-CHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFB1","description":"ICD-JDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA116","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEF0","description":"ICD-JBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLA1","description":"ICD-KBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLD1","description":"ICD-GDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Telehealth consultation_ critical care_ initial_ physicians typically spend 60 minutes communicating with the patient and providers via telehealth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0508","description":"Telehealth consultation_ critical care_ initial_ physicians typically spend 60 minutes communicating with the patient and providers via telehealth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWB0","description":"ICD-CBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Apply surf ldr radionuclide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77789","description":"Apply surf ldr radionuclide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOF1","description":"ICD-PKOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ceftizoxime sodium / 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0715","description":"Ceftizoxime sodium / 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect tarsal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28171","description":"Resect tarsal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPB1","description":"ICD-GIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRA1","description":"ICD-PBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILC1","description":"ICD-IILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88364","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMB0","description":"ICD-JIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSD0","description":"ICD-LDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDD1","description":"ICD-ADDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEA1","description":"ICD-JDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRE1","description":"ICD-OKRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54312","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61530","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0B","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMF1","description":"ICD-JCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXD1","description":"ICD-JEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90482","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","description":"CPT-90482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treated water per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4714","description":"Treated water per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1061T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1061T","description":"CPT-1061T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNF1","description":"ICD-JHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTC1","description":"ICD-GBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGB1","description":"ICD-OCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Infect agent det by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0003","description":"Infect agent det by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent leadless pacemaker_ ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0388T","description":"Transcatheter removal of permanent leadless pacemaker_ ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Performance Not Met: Multimodal Pain Management Was Not Used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2150","description":"Performance Not Met: Multimodal Pain Management Was Not Used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFE0","description":"ICD-CFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBF0","description":"ICD-BGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Blood clot lysis time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85175","description":"Blood clot lysis time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISA0","description":"ICD-KISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pw actuator replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2378","description":"Pw actuator replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24500","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elevated or hypertensive blood pressure reading documented_ and the indicated follow-up is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1278","description":"Elevated or hypertensive blood pressure reading documented_ and the indicated follow-up is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUF0","description":"ICD-JFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTC1","description":"ICD-EHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFF1","description":"ICD-OCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine fuse&remov bel c2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22551","description":"Neck spine fuse&remov bel c2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIA0","description":"ICD-EIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNA0","description":"ICD-JHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMF0","description":"ICD-BAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Onc (colorectal)_ quant assess of three urine metabolites  by liq chromatography w tandem mass spectro (LC-MS/MS) using multireaction monitoring acquisition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002U","description":"Onc (colorectal)_ quant assess of three urine metabolites  by liq chromatography w tandem mass spectro (LC-MS/MS) using multireaction monitoring acquisition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWE1","description":"ICD-DHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Eval aud rehab status","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92626","description":"Eval aud rehab status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTF1","description":"ICD-NDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOD0","description":"ICD-PJOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUB0","description":"ICD-IDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mannitol for inhaler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7665","description":"Mannitol for inhaler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBA0","description":"ICD-NBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIC1","description":"ICD-AHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Adenovirus ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87260","description":"Adenovirus ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lactoferrin fecal (qual)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83630","description":"Lactoferrin fecal (qual)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin barrier with flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4373","description":"Skin barrier with flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test rbc protoporphyrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84203","description":"Test rbc protoporphyrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCE1","description":"ICD-IGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA01","description":"Medium Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPF1","description":"ICD-GIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHA1","description":"ICD-AEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA31","description":"ICD-3KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alkalin batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4233","description":"Alkalin batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0D","description":"High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITF1","description":"ICD-JITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSF0","description":"ICD-CGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABB0","description":"ICD-BABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit cont antiemetic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9351","description":"Hit cont antiemetic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBE0","description":"ICD-MIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTB0","description":"ICD-FDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXF0","description":"ICD-OCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAB1","description":"ICD-AHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0D","description":"Very High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOF0","description":"ICD-HHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDC0","description":"ICD-JIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFC1","description":"ICD-KEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1017T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","description":"CPT-1017T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Documented reason for not screening or recommending a follow-up for high blood pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1288","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove carotid body lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60605","description":"Remove carotid body lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDF0","description":"ICD-IBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"General Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4007","description":"General Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLF0","description":"ICD-OKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sphincteroplasty_ anal_ for incontinence_ adult; implantation artificial sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46762","description":"Sphincteroplasty_ anal_ for incontinence_ adult; implantation artificial sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score knee < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8648","description":"Fun stat score knee < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ext amb insulin delivery sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9274","description":"Ext amb insulin delivery sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEB0","description":"ICD-KDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMC1","description":"ICD-MIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRB0","description":"ICD-PLRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); common variant(s) (eg_ HbS_ HbC_ HbE)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81361","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); common variant(s) (eg_ HbS_ HbC_ HbE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUE0","description":"ICD-CIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERB0","description":"ICD-LERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMF0","description":"ICD-BHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAD0","description":"ICD-MIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAA1","description":"ICD-IAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRF1","description":"ICD-LCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUE0","description":"ICD-FFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Occlusive eye patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6412","description":"Occlusive eye patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93315","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast_ Followed By Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0635T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast_ Followed By Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTB1","description":"ICD-GFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJF1","description":"ICD-OHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Enterovirus antibody dfa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87267","description":"Enterovirus antibody dfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVB1","description":"ICD-BCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dermabrasion segmental face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15781","description":"Dermabrasion segmental face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHD0","description":"ICD-KAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLD0","description":"ICD-JCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75580","description":"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQF1","description":"ICD-OJQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARD1","description":"ICD-GARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASC0","description":"ICD-KASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast 1st us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19285","description":"Perq dev breast 1st us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC31","description":"ICD-3HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67800","description":"Remove eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Glasses cros hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5190","description":"Glasses cros hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"H pylori drug admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83014","description":"H pylori drug admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ptnot rcvng anti-rhm thxpyra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4196F","description":"Ptnot rcvng anti-rhm thxpyra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bridge porcelain nobel metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6242","description":"Bridge porcelain nobel metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Phakic iol refractive error","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0596","description":"Phakic iol refractive error","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMA1","description":"ICD-OIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1106T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1106T","description":"CPT-1106T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDE0","description":"ICD-MHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Touch quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0106T","description":"Touch quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA15","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIB0","description":"ICD-ABIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNB0","description":"ICD-NCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLE1","description":"ICD-EHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAME0","description":"ICD-FAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8G","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTC1","description":"ICD-AHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14B","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWD0","description":"ICD-PBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARF0","description":"ICD-CARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Placental alpha-micro globulin-1 (PAMG-1)_ immunoassay with direct optical observation_ cervico-vaginal fluid_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0066U","description":"Placental alpha-micro globulin-1 (PAMG-1)_ immunoassay with direct optical observation_ cervico-vaginal fluid_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ bra_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6528","description":"Gradient compression garment_ bra_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Genotype dna/rna hiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87906","description":"Genotype dna/rna hiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIA0","description":"ICD-GEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEB1","description":"ICD-JAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35303","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amniocentesis therapeutic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59001","description":"Amniocentesis therapeutic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXB0","description":"ICD-JAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOB0","description":"ICD-OCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27040","description":"Biopsy of soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"MRI abdomen w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74182","description":"MRI abdomen w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec stim other than wound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0283","description":"Elec stim other than wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBF0","description":"ICD-JBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noc retail items andsupplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1999","description":"Noc retail items andsupplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINE1","description":"ICD-NINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14A","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/3-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34803","description":"Endovas aaa repr w/3-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee heavy dut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1195","description":"Wheelchair amputee heavy dut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICA1","description":"ICD-BICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amoxicillin_ with or without clavulanate_ not prescribed as first line antibiotic at the time of diagnosis for documented reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9313","description":"Amoxicillin_ with or without clavulanate_ not prescribed as first line antibiotic at the time of diagnosis for documented reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9225","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9225","description":"CDT-D9225","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0735T","description":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBA1","description":"ICD-NEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLD0","description":"ICD-GGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITF1","description":"ICD-IITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAE0","description":"ICD-OGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompress spine cord add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63066","description":"Decompress spine cord add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of circumcision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54163","description":"Repair of circumcision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tamoxifen/ai prescribed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4179F","description":"Tamoxifen/ai prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMB0","description":"ICD-CHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plastic surgery neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15819","description":"Plastic surgery neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYA0","description":"ICD-DCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 5.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4172","description":"Parenteral sol amino acid 5.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0685","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0685","description":"HCPCS-G0685","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNE1","description":"ICD-CFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","description":"CPT-15014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPF1","description":"ICD-FDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antithrombin iii antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85301","description":"Antithrombin iii antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1139","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLF1","description":"ICD-IGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDE0","description":"ICD-CEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOA1","description":"ICD-PLOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTC0","description":"ICD-EBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of protein urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84156","description":"Assay of protein urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1332","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYD0","description":"ICD-GFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFF0","description":"ICD-JAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal kidney open radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50230","description":"Removal kidney open radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB31","description":"ICD-1EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXB1","description":"ICD-OFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release of foot contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28270","description":"Release of foot contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFID1","description":"ICD-EFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-ss pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0457","description":"Tlso flex trnk sj-ss pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC104","description":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt prgrm for implt neurostim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8681","description":"Pt prgrm for implt neurostim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJE0","description":"ICD-JIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAD1","description":"ICD-CEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLF0","description":"ICD-FBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEF1","description":"ICD-JEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deoxyribonuclease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86215","description":"Deoxyribonuclease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of idh enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83570","description":"Assay of idh enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Staph a dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87640","description":"Staph a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKC1","description":"ICD-GBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary venous angiography of each distinct pulmo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93574","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary venous angiography of each distinct pulmo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB105","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTB0","description":"ICD-AHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIB0","description":"ICD-GIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDB1","description":"ICD-KBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRB0","description":"ICD-LIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCC0","description":"ICD-EBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pres/absn urine incon assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1090F","description":"Pres/absn urine incon assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUA1","description":"ICD-MBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHC0","description":"ICD-EDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNF1","description":"ICD-BFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGA0","description":"ICD-OAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYE1","description":"ICD-OIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAB0","description":"ICD-IHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0788T","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA11","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Test socket symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5618","description":"Test socket symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPE0","description":"ICD-FIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4593","description":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJE0","description":"ICD-FDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHF1","description":"ICD-MAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPB0","description":"ICD-KBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLF0","description":"ICD-NBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYB0","description":"ICD-OCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"External beam to prost only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4200F","description":"External beam to prost only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAA0","description":"ICD-NHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10A","description":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFD1","description":"ICD-BFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX51","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ovulation tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84830","description":"Ovulation tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure for chemonucleolysis_ including discography_ intervertebral disc_ single or multiple levels_ lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62292","description":"Injection procedure for chemonucleolysis_ including discography_ intervertebral disc_ single or multiple levels_ lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXE1","description":"ICD-CHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20C","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Spinal Puncture_ Lumbar_ Diagnostic; With Fluoroscopic Or Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62328","description":"Spinal Puncture_ Lumbar_ Diagnostic; With Fluoroscopic Or Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise intestine lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44110","description":"Excise intestine lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUF1","description":"ICD-BDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Wrst mold sock w/exp interfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6055","description":"Wrst mold sock w/exp interfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVB1","description":"ICD-OFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCC0","description":"ICD-ADCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51550","description":"Partial removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pros_ urinary sph_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1815","description":"Pros_ urinary sph_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Next Generation ACO model_ 10-20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9869","description":"Next Generation ACO model_ 10-20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOA0","description":"ICD-OEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEC0","description":"ICD-AIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE106","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove neuroreceiver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63688","description":"Revise/remove neuroreceiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHA0","description":"ICD-EGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01232","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","description":"CPT-01232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9244","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9244","description":"CDT-D9244","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33776","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPC1","description":"ICD-KIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBB1","description":"ICD-NIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNF1","description":"ICD-NBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJB0","description":"ICD-NKJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; ta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81176","description":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; ta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLA0","description":"ICD-NCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25660","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXC0","description":"ICD-CHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduct compnd facial bone fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7780","description":"Reduct compnd facial bone fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect back tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21935","description":"Resect back tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Hit enteral bolus nurs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9343","description":"Hit enteral bolus nurs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGF1","description":"ICD-OCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29240","description":"Strapping of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0539","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","description":"HCPCS-G0539","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKB0","description":"ICD-CHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24A","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57260","description":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic device repair rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7510","description":"Prosthetic device repair rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53520","description":"Repair of urethra defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Urinary cath anchor device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4333","description":"Urinary cath anchor device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEA0","description":"ICD-KFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Deb bone 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11044","description":"Deb bone 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Acute gi blood loss imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78278","description":"Acute gi blood loss imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASA0","description":"ICD-GASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOB1","description":"ICD-HBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPE1","description":"ICD-CFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXE1","description":"ICD-BFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBE1","description":"ICD-FFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1326","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","description":"HCPCS-J1326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHC1","description":"ICD-NKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBME1","description":"ICD-CBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLE1","description":"ICD-NHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTB1","description":"ICD-OBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPB1","description":"ICD-GHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAED0","description":"ICD-BAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13C","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1163","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Plasma fresh frozen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86927","description":"Plasma fresh frozen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIE1","description":"ICD-GIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD111","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVA1","description":"ICD-GBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCF0","description":"ICD-JFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Assay of chromium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82495","description":"Assay of chromium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDB1","description":"ICD-FGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Benesch boot pair infant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3212","description":"Benesch boot pair infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX24","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23552","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEC0","description":"ICD-IBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRA0","description":"ICD-PBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATF1","description":"ICD-OATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXF0","description":"ICD-KBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; first physician or other qualified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0820T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; first physician or other qualified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBC0","description":"ICD-NKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ selective-cellular enhancement technique with interpretation (eg_ liquid-based slide preparation method)_ except cer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0830T","description":"Digitization of glass microscope slides for cytopathology_ selective-cellular enhancement technique with interpretation (eg_ liquid-based slide preparation method)_ except cer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78264","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0220","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC11","description":"ICD-2HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAB0","description":"ICD-NIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA45","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDE0","description":"ICD-MKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJF0","description":"ICD-KDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Albumin (human)_5%_ 50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9041","description":"Albumin (human)_5%_ 50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDB1","description":"ICD-KCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bmi not documented and no reason is given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1314","description":"Bmi not documented and no reason is given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGD0","description":"ICD-NHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11107","description":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWC0","description":"ICD-HHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIB0","description":"ICD-MKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIID0","description":"ICD-BIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHB0","description":"ICD-NAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15951","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQE1","description":"ICD-CHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50728","description":"Revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLC0","description":"ICD-NDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQE0","description":"ICD-OHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXF0","description":"ICD-GHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lumasiran_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9074","description":"Injection_ lumasiran_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2312","description":"Lens sphc trifo 7.25-12/2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJB1","description":"ICD-BDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect radius/ulnar tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25170","description":"Resect radius/ulnar tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Sbrt management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77435","description":"Sbrt management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC11","description":"ICD-3IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUB0","description":"ICD-IHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert pacing lead & connect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33224","description":"Insert pacing lead & connect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 3_ gene duplication/multiplication) (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0076U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 3_ gene duplication/multiplication) (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC31","description":"ICD-2LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Extensive thyroid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60254","description":"Extensive thyroid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLB1","description":"ICD-FDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Bordetella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86615","description":"Bordetella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO hip intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9729","description":"Patient unable to complete the FOTO hip intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt no doc hear loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8567","description":"Pt no doc hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ human fibrinogen concentrate (Fibryga)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7177","description":"Injection_ human fibrinogen concentrate (Fibryga)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density_ tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0508T","description":"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density_ tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42104","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHB0","description":"ICD-EEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Statin not presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9443","description":"Statin not presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"reline custom sleep apnea appliance (indirect)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9953","description":"reline custom sleep apnea appliance (indirect)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB145","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFC1","description":"ICD-FGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWD1","description":"ICD-KAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair anomaly w/conduit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33608","description":"Repair anomaly w/conduit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a baseline pam score and/or a second score within 6 to 12 month of baseline pam score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1344","description":"Patients who did not have a baseline pam score and/or a second score within 6 to 12 month of baseline pam score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Excise excess skin arm/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15837","description":"Excise excess skin arm/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Child sitting services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1009","description":"Child sitting services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1457","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","description":"HCPCS-M1457","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2208","description":"Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Semen analysis w/count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89310","description":"Semen analysis w/count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Biliary duct stone extraction_ percutaneous via t-tube tract_ basket_ o snare (eg_ burhenne technique)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47630","description":"Biliary duct stone extraction_ percutaneous via t-tube tract_ basket_ o snare (eg_ burhenne technique)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Lifestyle mod 2 or 3 stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0341","description":"Lifestyle mod 2 or 3 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWC0","description":"ICD-OAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove pelvis lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38770","description":"Remove pelvis lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDA0","description":"ICD-KFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBB1","description":"ICD-JBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6559","description":"Gradient compression stocking_ full length/chap style_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1604","description":"HCPCS-C1604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00142","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","description":"CPT-00142","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Flotufolastat F-18_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9156","description":"Flotufolastat F-18_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJF1","description":"ICD-NAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14A","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFC1","description":"ICD-OHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Continent stoma catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5082","description":"Continent stoma catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL35","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQB1","description":"ICD-LCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Edetate calcium disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0600","description":"Edetate calcium disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Aqueous shunt eye w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66179","description":"Aqueous shunt eye w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIE1","description":"ICD-AGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel pad removable for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3485","description":"Shoe heel pad removable for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44160","description":"Removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWA0","description":"ICD-OJWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ biochemical assays of 7 proteins (follicle stimulating hormone_ human epididymis protein 4_ apolipoprotein A-1_ transferrin_ beta-2 macroglobulin_ prealbum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0375U","description":"Oncology (ovarian)_ biochemical assays of 7 proteins (follicle stimulating hormone_ human epididymis protein 4_ apolipoprotein A-1_ transferrin_ beta-2 macroglobulin_ prealbum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUF0","description":"ICD-NFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSB1","description":"ICD-KBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Head control proximity switc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2330","description":"Head control proximity switc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB21","description":"ICD-4DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0939T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","description":"CPT-0939T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Amphotericin b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0285","description":"Amphotericin b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Debride nail 1-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11720","description":"Debride nail 1-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21080","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWE0","description":"ICD-LGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEA1","description":"ICD-OJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Resect radius tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24152","description":"Resect radius tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLE0","description":"ICD-EDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAA1","description":"ICD-NLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-maly_ biosimilar_ (alymsys)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5126","description":"Injection_ bevacizumab-maly_ biosimilar_ (alymsys)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUC0","description":"ICD-OAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14A","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31238","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0522T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDC0","description":"ICD-CEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Antidepres rxthxpy not rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4063F","description":"Antidepres rxthxpy not rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC31","description":"ICD-2CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Speech volume modulation system_ any type_ including all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E3000","description":"Speech volume modulation system_ any type_ including all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport lodgng escrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0200","description":"Noner transport lodgng escrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACF1","description":"ICD-EACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Igh vari regional mutation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81263","description":"Igh vari regional mutation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABD1","description":"ICD-BABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDE0","description":"ICD-IHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOE1","description":"ICD-PIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMF0","description":"ICD-AAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUB1","description":"ICD-NCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAF1","description":"ICD-IHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPF0","description":"ICD-KBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXD1","description":"ICD-JDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ home monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9006","description":"Mccd_ home monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Insert mesh/pelvic flr addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57267","description":"Insert mesh/pelvic flr addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMA0","description":"ICD-MLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of midface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21188","description":"Reconstruction of midface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKA0","description":"ICD-NKKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Interim crown-further treatment or completion of diagnosis necessary prior to final impression","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2799","description":"Interim crown-further treatment or completion of diagnosis necessary prior to final impression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISB0","description":"ICD-OISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA204","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBA1","description":"ICD-GIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15241","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE113","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIA1","description":"ICD-BFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCID1","description":"ICD-MCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remote assessment of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including interpretation with follow-up with the patient withi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2250","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including interpretation with follow-up with the patient withi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVB0","description":"ICD-GBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKD0","description":"ICD-KFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKE0","description":"ICD-OHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97550","description":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJB1","description":"ICD-KGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3A","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Release palm/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26440","description":"Release palm/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTF1","description":"ICD-NFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder ASD) RNA next-generation sequencing saliva algorithmic analysis and results reported as predictive probability of ASD diagnosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0170U","description":"Neurology (autism spectrum disorder ASD) RNA next-generation sequencing saliva algorithmic analysis and results reported as predictive probability of ASD diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMC0","description":"ICD-EBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8F","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAD0","description":"ICD-IEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATD1","description":"ICD-OATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPB1","description":"ICD-NLPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00534","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","description":"CPT-00534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0614U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","description":"CPT-0614U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Dyspnea scrnd mod-high dysp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3451F","description":"Dyspnea scrnd mod-high dysp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPD1","description":"ICD-BAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1201","description":"HCPCS-A1201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNC0","description":"ICD-BHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CAD])_ 9 genes (12 variants)_ targeted variant genotyping_ blood_ saliva_ or buccal swab_ algorithm reported as a genetic risk score for a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0401U","description":"Cardiology (coronary heart disease [CAD])_ 9 genes (12 variants)_ targeted variant genotyping_ blood_ saliva_ or buccal swab_ algorithm reported as a genetic risk score for a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53515","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLC0","description":"ICD-IGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKD1","description":"ICD-BBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0407","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0407","description":"CDT-D0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Cyclosporin parenteral 250mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7516","description":"Cyclosporin parenteral 250mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 2 piece rigid shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0491","description":"Tlso 2 piece rigid shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUB0","description":"ICD-AIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPD0","description":"ICD-JGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Solid skin barrier 6x6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5121","description":"Solid skin barrier 6x6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of tibia nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28035","description":"Decompression of tibia nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEB0","description":"ICD-FHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Drain shoulder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23030","description":"Drain shoulder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBD0","description":"ICD-IFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"2019-nCoV Coronavirus_ SARS-CoV-2/2019-nCoV (COVID-19)_ any technique_ multiple types or subtypes (includes all targets)_ non-CDC_ making use of high throughput technologies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0004","description":"2019-nCoV Coronavirus_ SARS-CoV-2/2019-nCoV (COVID-19)_ any technique_ multiple types or subtypes (includes all targets)_ non-CDC_ making use of high throughput technologies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPC0","description":"ICD-NIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUE1","description":"ICD-FBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pne scrn done doc vac done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9279","description":"Pne scrn done doc vac done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAE1","description":"ICD-OBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPB1","description":"ICD-GBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHD1","description":"ICD-JIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKB0","description":"ICD-KFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ non-lypohilized (e.g. liquid)_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9065","description":"Injection_ romidepsin_ non-lypohilized (e.g. liquid)_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLC0","description":"ICD-BBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDF1","description":"ICD-FEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBD1","description":"ICD-GCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMC0","description":"ICD-CAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB34","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQF0","description":"ICD-PDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJD1","description":"ICD-FAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIC0","description":"ICD-EHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Monitor cable elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0485","description":"Monitor cable elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTB1","description":"ICD-IHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADB1","description":"ICD-AADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEE1","description":"ICD-FFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTC1","description":"ICD-FBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1088","description":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGE1","description":"ICD-FBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0028","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUA0","description":"ICD-KDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHD1","description":"ICD-NEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAE1","description":"ICD-JCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHE0","description":"ICD-BGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc md rsn no antipla/p2y12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9610","description":"Doc md rsn no antipla/p2y12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18F","description":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHC1","description":"ICD-KFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo mech stance ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5716","description":"Knee-shin exo mech stance ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJC1","description":"ICD-BGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Diphtheria antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90296","description":"Diphtheria antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMB1","description":"ICD-ECMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA220","description":"Clinically Complex _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIA1","description":"ICD-CAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMB1","description":"ICD-CDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0914T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","description":"CPT-0914T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Automated diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85004","description":"Automated diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gadobutrol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9585","description":"Gadobutrol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0884","description":"Pwc gp4 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE251","description":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGED0","description":"ICD-KGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIF1","description":"ICD-JCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92972","description":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Elec med comp dev_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1505","description":"Elec med comp dev_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7531","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7531","description":"HCPCS-J7531","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUC1","description":"ICD-OLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ urine_ 31 drug panel_ reported as quantitative results_ detected or not detected_ per date of service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ urine_ 31 drug panel_ reported as quantitative results_ detected or not detected_ per date of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCB1","description":"ICD-BGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Electroretinography (ERG) with interpretation and report_ pattern (PERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0509T","description":"Electroretinography (ERG) with interpretation and report_ pattern (PERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTE1","description":"ICD-FFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHF0","description":"ICD-ABHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJD1","description":"ICD-CFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB45","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL22","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWE1","description":"ICD-PAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTE1","description":"ICD-KHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; each additional target lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76983","description":"Ultrasound_ elastography; each additional target lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLE0","description":"ICD-GBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBC0","description":"ICD-EGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAA0","description":"ICD-OJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Removal of elbow bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24105","description":"Removal of elbow bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4D","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNC0","description":"ICD-CBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHC0","description":"ICD-KHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFD0","description":"ICD-KCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRE1","description":"ICD-LDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX06","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKB0","description":"ICD-NKKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9773","description":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Gamma globulin > 10 cc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1560","description":"Gamma globulin > 10 cc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB11","description":"ICD-2BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"No start/rec antvir tx hep c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9499","description":"No start/rec antvir tx hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFE1","description":"ICD-BEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDC0","description":"ICD-NFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVA0","description":"ICD-OAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSB1","description":"ICD-KCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCF0","description":"ICD-GGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Esophagus surgery for veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43401","description":"Esophagus surgery for veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Balance lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2700","description":"Balance lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOD1","description":"ICD-GDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGD1","description":"ICD-OBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54640","description":"Suspension of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATA0","description":"ICD-CATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 45","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88263","description":"Chromosome analysis 45","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVB0","description":"ICD-NLVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKF0","description":"ICD-JEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMB0","description":"ICD-MLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Pt cat/pn cat/hist grd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3260F","description":"Pt cat/pn cat/hist grd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXC1","description":"ICD-GFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pertuzumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9306","description":"Injection_ pertuzumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWC0","description":"ICD-PGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Air injection into abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49400","description":"Air injection into abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Remove tissue expander(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11971","description":"Remove tissue expander(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEE1","description":"ICD-KIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESF0","description":"ICD-KESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGF1","description":"ICD-FDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUA1","description":"ICD-EAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFA1","description":"ICD-NBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Levonorgestrel-releasing intrauterine contraceptive system_ (Kyleena)_ 19.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7296","description":"Levonorgestrel-releasing intrauterine contraceptive system_ (Kyleena)_ 19.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUA0","description":"ICD-EGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4429","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","description":"HCPCS-Q4429","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXC0","description":"ICD-OEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC21","description":"ICD-4DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYA0","description":"ICD-HEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPA0","description":"ICD-NJPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Legion pneumophilia ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87278","description":"Legion pneumophilia ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXD0","description":"ICD-GBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Doc opioid tx 1x during ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9578","description":"Doc opioid tx 1x during ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMA1","description":"ICD-GAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21720","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","description":"HCPCS-M1414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Nonemergency transport taxi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0100","description":"Nonemergency transport taxi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNE1","description":"ICD-BHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTD1","description":"ICD-IDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIA1","description":"ICD-IGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Influenza immunization was not administered_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1308","description":"Influenza immunization was not administered_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0651U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0651U","description":"CPT-0651U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQA0","description":"ICD-OCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEC0","description":"ICD-OAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDC0","description":"ICD-CHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHC0","description":"ICD-GHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKD0","description":"ICD-NDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAA1","description":"ICD-BIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCA0","description":"ICD-BFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHD1","description":"ICD-GHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYE1","description":"ICD-PIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTB1","description":"ICD-FCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCA0","description":"ICD-IGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDA1","description":"ICD-AGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"Docrsn for catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9239","description":"Docrsn for catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam si joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72200","description":"X-ray exam si joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[833863123]}]}]}